Sinusitis

Question 1

Structure of sinuses

Answer 1

Air-filled out-pouching of nasal cavity that invaginate the bones of skull

Question 2

4 pairs of sinuses

Answer 2

1. Frontal
2. Ethmoid
3. Maxillary
4. Sphenoid

Question 3

Anterior group of sinuses and where does it drain?

Answer 3

• Frontal
• Maxillary
• Anterior ethmoidal

Drains into infundibulum of ostiomeatal complex and into middle meatus
*obstruction leads to sinusitis in the anterior group of sinuses

Question 4

Posterior group of sinuses and where does it drain?

Answer 4

• Posterior ethmoidal
• Spenoid

Drains into nasal cavity in the superior meatus/ sphenoethmoidal recess

Question 5

Where drains into inferior meatus?

Answer 5

Nasolacrimal duct

Question 6

Mucosa epithelium of sinuses

Answer 6

Pseudostratified columnar epithelium with goblet cells

Question 7

Definition of acute rhinosinusitis

Answer 7

Increase in symptoms after 5 days or persistent symptoms after 10 days and less than 3 months

Question 8

Pathophysiology of acute rhinosinusitis

Answer 8

Initiating event is viral infection/ severe allergic reaction, causing:
- obstruction of the ostiomeatal complex results in mucus retention in sinus
–> Increased acidity, decreased oxygen tension and decreased mucociliary clearance
–> Good medium for bacterial infection

Question 9

Risk factors of acute rhinosinusitis

Answer 9

1. Any condition that blocks sinus ostia
   - URTI
   - AR
   - Nasal polyps
2. Any condition that interferes with airflow through the nose
   - Deviated septum
   - Fractures
3. Upper jaw infection -> maxillary sinusitis
4. Barotrauma
   - Swimming and diving