SINUSITIS Flashcards
Sinusitis
inflammation of the mucous membrane of the paranasal sinus.
Location of the Paranasal sinuses
within the cranio-maxillo-facial bones.
Paranasal sinuses
Maxillary
Frontal
Ethmoid
Sphenoid
Why are they called paranasal sinuses
Mucous membrane of the paranasal sinuses are in direct continuity with the nasal cavity
The paranasal sinuses drain into the nasal cavity
Function of the paranasal sinuses
Humidifying and warming inspired air
Regulation of intranasal pressure
Lightening the skull
Resonance
Absorbing shock
Contribute to facial growth
Stages of sinusitis
Acute stage
Subacute stage
Chronic stage
Recurrent episode
Acute stage
lasts for (1-3) weeks
Subacute stage
3weeks to 3 months
Chronic stage
longer than 3 months
Recurrent episdoe
Repetitive acute bouts of more than 4 bouts in a year
Viral causes of sinusistis
Rhinovirus
Reovirus
Myxovirus
Paramyxovirus
Coxsachivirus
ECHOvirus
Gram positive Bacterial causes of sinusitis
Stept. pneumonia
Strept. haemolyticus
Staph. aureus
Neiserria (Moraxella now) catarrhalis
Gram negative bacterial causes of sinusitis
P. aeruginosa
H. influenzae
E. coli
Proteus vulgaris
Mode of sinusitis infection
Rhinogenic
Dentogenic (Odontogenic)
Haematogenic
Traumatic
Predisposing factors of sinusitis
Cold weather
Smoking and Fumes
Allergies
Nasal deformities
Nasal polyps
Cystic fibrosis
HIV infection
Symptoms of sinusitis
Headache
Fever
Malaise
Hallitosis
Nasal irritation
Nasal obstruction
Heaviness in the head
Rhinorrhoea
Facial pains and tenderness
Forms of rhinorrhoea
Mucoid
Mucopurulent
Haemorrhagic mucopurulent
Pain in maxillary sinusitis
Frontal headache
Infra orbital pain.
Presentations of frontal sinusitis
Frontal headache
Supra orbital pain.
Presentation of ethmoid sinusitis
Intra-canthal pain on the bridge of the nose.
Canthus
Inner or outer corner of the eye
Presentations of sphenoid sinusitis
Occipital headache
Retro-ocular pain.
Investigations in sinusitis
Radiological
Haematological
Microbiology
Radiological investigations in sinusitis
X ray of paranasal sinuses
Computerized Tomography (CT Scan)
Benefits of physiotherapy in sinusitis
Reducing the inflammation in the linings
Reducing the viscosity of secretions
Aids in clearing the passages by increasing the rate of drainage from thesinuscavities.
Most common inciting event of chronic sinusitis
Viral upper respiratory tract infection
Symptoms of chronic sinusitis
Offensive yellowish or greenish mucopurulent discharge
Nasal obstruction and Irritation
Discomfort (Heaviness) in the area of the involved sinus
Halitosis
Surgical treatment of sinusitis
Antral washout
Antral washout and Antrostomy
Radical antrostomy
Caldwell Luc Operation
Also known as antral antrostomy involves removal of irreversible damaged mucosa of the maxillary sinus
Antrostomy
clear the sinus opening
Antral washout
Irrigation of the maxillary sinus
Management of sinusitis
Broad spectrum antibiotics
Analgesic/Antipyretics Nasal decongestants
Steam inhalation
Physiotherapy
Steam inhalation is done with…..
Menthol
Tincture of Benzoin Compound (TBC)
Causes of chronic sinusitis
Proteus vulgaris
E. coli
P. aeruginosa
Strep. spp.
Staph. aureus
M. catarrhalis
Allergy vs Infective sinusitis
Nostril: Allergy is usually bilateral while infective sinusitis is usually unilateral
Rhinorrhoea: Allergy is mucoid ( watery ) while infective sinusitis is mucopurulent
Halitosis: infective sinusitis
Local complications of chronic sinusitis
Fronto- ethmoidal mucocoele Nasal and Antrochoanal polyps Hypertrophic nasal turbinates Epistaxis
Distant complications of chronic sinusitis
Pharyngitis
Tonsillitis
Laryngitis
Orbital cellulitis
Otitis media.
Intra-cranial complications of chronic sinusitis
Meningitis
Cerebral abscess Cavernous sinus thrombosis
Nasal polyp
Straw coloured, mobile soft mass, insensitive and painless in the nostril
Antrochoanal polyp
benign polypoid lesions arising from the maxillary antrum and they extend into the choana
Polypectomy
Removal of polyps
