Session 7 - Oh Noes (when things go wrong)

Question 1

What are four places infections of the nasal cavity can spread and via what routes?

Answer 1

o The Anterior Cranial Fossa
 Via the cribriform plate of the ethmoid bone
o The Paranasal Sinuses
 Via their openings into the nasal cavity
o The Lacrimal Apparatus and Conjuctiva
 Via the opening of the Nasolacrimal duct
o The Middle Ear
 Via the Pharyngotympanic (Eustachian) tube

Question 2

What is rhinitis?

Answer 2

Inflammation of the nasal mucosa, leading to swelling and increased volume of secretion.

Question 3

Give three viral causes of rhinitis

Answer 3

 Adenovirus
 Rhinovirus
 Respiratory Syncytial Virus (RSV)

Question 4

Give three causes of rhinitis

Answer 4

o Allergic
o Nasal Polyps
o Infective (Viral)

Question 5

Where do nasal polyps usually grow?

Answer 5

Close to the ostiomeatal complex of the nasopharynx

Question 6

What condition are nasal polyps linked to?

Answer 6

Chronic rhinosinusitis

Question 7

What is a major annoying symptom of nasal polyps?

Answer 7

Snoring

Question 8

What is sinusitis?

Answer 8

o Inflammation of the mucosal lining of the sinuses

Question 9

What is acute sinusitis defined as?

Answer 9

7-30 days

Question 10

What is subacute sinusitis defined as?

Answer 10

4-12 weeks

Question 11

What is chronic sinusitis?

Answer 11

> 90 days

Question 12

What is the main cause of sinusitis?

Answer 12

Viral with secondary bacterial infeciton

• Strep pneumoniae
• Haemophilus influenza

Question 13

What is the danger with ethmoidal sinus air cell infection?

Answer 13

May break through the medial wall of the orbit, which is dangerous due to proximity to optic nerve, opthalmic artery and visual disorders

Question 14

What is the most commonly infected sinus? Why?

Answer 14

Maxillary

Ostia are small and located high on the supero-medial walls

Question 15

How can dental procedures cause sinusitis?

Answer 15

o The three maxillary molar teeth are close to the floor of the maxillary sinus
o During removal a fracture of the root may occur
 Piece of root may be driven superiorly into the maxillary sinus
o Communication made between oral cavity and maxillary sinus
o Infection may occur

Question 16

Why is referred molar pain a common clinical sequale of maxillary sinusitis?

Answer 16

Because the superior alveolar nerves (Branches of the Maxillary Nerve (CN V2)) supply both the maxillary teeth and the mucous membrane of the maxillary sinuses, inflammation of the mucosa of the sinus is frequently accompanied by a sensation of toothache in the molar teeth.

Question 17

How can a broken nose cause chronic breathing difficulty?

Answer 17

Sometimes the deviation of nasal septum is so severe that it is in contact with the lateral wall of the nasal cavity and often obstructs breathing or exacerbates snoring.