4 inflammatory diseases of paranasal sinuses

Upload: thiago-carvalho

Post on 03-Apr-2018

220 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    1/16

    Inflammatory diseases ofparanasal sinuses

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    2/16

    Acute and Chronic Inflammations ofthe Paranasal Sinuses

    Inflammatory process of the mucous tunic,

    the submucous layer and sometimes of the periosteumand the bone walls of the paranasal sinuses that lasts

    more than 2 months or recurs 4 and more times a year

    is classified as chronic sinusitis.As a rule, it is a continuation of an acute process.

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    3/16

    A. Exudative forms: catarral; serous; purulent.

    B. Productive forms: parietal- hyperplastic; polypous cystic;

    C. Alternative forms: cholesteatomic; caseous; necrotic;

    atrophic

    The

    classification of sinusitis byB.S.Preobrazhenskiy

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    4/16

    D. Mixed forms: Purulent-polypous; serous - catarral; serous - polypous; parietal- hyperplastic - polypous, etc.

    E. Vasomotor and allergic forms

    The classification of sinusitisby B.S.Preobrazhenskiy

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    5/16

    The Most Common Forms of

    Sinusitis

    purulent purulent polypoid catarral parietal hyperplastic allergic

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    6/16

    What sinuses are affectedmostly?

    1. the maxillary sinus (maxillary sinusitis)2. the ethmoidal sinus (ethmoiditis)3. the frontal sinus (frontal sinusitis)

    4. the basilar sinus (sphenoiditis)

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    7/16

    Etiology

    1)the decrease of the reactivity of the organism;2)the drainage disfunction of the anastomosis (arcuation of the

    nasal septum, hypertrophic rhinitis, adenoids);3)disfunction of the mucous tunic of the nose and the paranasalsinuses.4)nflammation of the tooth-maxillary system

    The microorganisms that vegetate on the mucous tunic of theupper airways: staphylococcus, streptococcus, blue pus bacillus,Proteus bacillus, colon bacillus, anaerobes, viruses, fungi.

    Causally relevant factors of sinusitis

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    8/16

    Pathogenesisthe inflammation of the mucous tunic of the nasal cavity

    and the paranasal sinuses

    the edema of the mucous tunic

    the closing of the natural anastomosisof the sinuses (the drainage disfunction)

    the change of the pressure in the sinus (decreasing)

    the vasodilatation and the transudation of the fluid

    the migration of the neutrophils with the pus formation (incase of the infection)

    the development of the sensitizing as a result of theabsorption of the toxins

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    9/16

    Clinical pictureThe clinical picture depends on:

    the stage of the disease (remission,exacerbation);sinusitis form; localisation of the process; extent of the affection (one or several sinuses); kind and virulence of the microorganisms; permeability of the natural anastomosis.

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    10/16

    Clinical pictureRise in temperature, headache,

    deterioration of the state of health, pain inthe area of the projection of the sinuses,edema of the eyelids, inflammatory shift inblood.

    The painful points in theinflammatory diseases of theparanasal sinuses.

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    11/16

    Rhinoscopic picture

    polypous purulentsinusitis

    purulent sinusitis

    polypous sinusitis

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    12/16

    Diagnostics of Sinusitis Anamnesis Diagnostic puncturing of the maxillar sinus X-ray (CT)

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    13/16

    1. Antibacterial therapy2. anti-inflammatory drugs

    3. dehydrating therapy4. desensitizing therapy5. symptomatic treatment

    6. vasoconstrictors endonasal7. punctures and drainage of the paranasalsinuses

    The conservative treatment

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    14/16

    Surgical Treatment

    Operations on the the maxillary sinus: Kaldvell - Lukes operation, Rudakovsoperation. Videoendoscopic maxillary sinusotomy

    Operations on the ethmoidal sinus:

    Endonasal polypusethmoidotomy

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    15/16

    Kaldvell- Lukes operation

    1. incision of the

    mucous tunic in thearea of thevestibule of the

    mouth

    2. opening of the

    maxillary sinusthrough itsanterior wall

    3. application of

    the anastomosisbetween the

    maxillary sinus andthe inferior nasal

    meatus

  • 7/28/2019 4 Inflammatory Diseases of Paranasal Sinuses

    16/16

    Operations on the ethmoidallabyrinth

    Polypotomy of the nose