diseases of the paranasal sinuses
DESCRIPTION
TRANSCRIPT
DISEASES OF THE PARANASAL SINUSES
Anatomy of the SINUSES
Sinusitis
SINUSITIS
Sinusitis is the inflammatory condition of the mucous membrane lining of the sinuses. It may progress to pus formation.
Sinusitis may be acute and chronic.
• inflammation of the maxillary sinus is called maxillitis;
• inflammation of the ethmoidal sinus is called ethmoiditis;
SINUSITIS
• inflammation of the frontal sinus is called frontal sinusitis;
• inflammation of the sphenoid sinus is called sphenoiditis;
SINUSITIS
• hemisinusitis – the involvement all sinuses on one side into inflammation process;
• pansinusitis – all sinuses are involved;
• polisinusitis – several sinuses, but not all, are involved
SINUSITIS
For their origination sinusitis may be primary and
secondary. Primary sinusitis are rare diseases, they appear as result of trauma or allergy. But usually infection spreads to sinuses from other focuses.
SINUSITIS
Sinusitis may divided into:• Rhinogenous – infection spreads from the nasal
cavity. It is the most common way for infection and such sinusitis is the complication of the flu.
• Odontogenic – infection spreads from upper teeth. This way is typical only for maxillary sinus. The pathologic process may spreads from 4,5,6 cheek-teeth apex to the inferior wall of the maxillary sinus
• Traumatic• Hematogenic• Allergic.
PATHOGENESIS OF SINUSITIS
There are three main factors lead to the sinusitis development:
• The most important factor is the opening of sinus hole. It may be blocked due to different reasons. As a rule, the hole may be blocked by the swollen mucous membrane. The other reason may be an anomaly of anatomical structures. The retain of secret, decrease the pressure of oxygen contribute the bacteria multiplication.
PATHOGENESIS OF SINUSITIS
• The other important factor is the defect of self-cleaning mechanism of the mucous membrane of sinus. Bacteria, viruses damage the respiratory epithelium and cause the immobility of the cilia.
PATHOGENESIS OF SINUSITIS
Changes of secret quality are taken place in the development of sinusitis. Secret becomes more concentrated and stick and therefore it can not be eliminated from the sinus.
PATHOGENESIS OF SINUSITIS
There are two additional factors:
• Immunodeficiency.• Pathological changes
of nose and nasopharynx that make difficulties for normal outflow from the sinuses (septum deviation, hypertrophic rhinitis, adenoids).
SINUSITIS
ACUTE sinusitis are divided into:
• Catarrhal.• Purulent.• Necrotic.CHRONIC:• Purulent• Polyps of sinuses• mixed
Diagnosis of Acute Rhinosinusitis, Major and
Minor Factors Major Factors Minor Factors
Facial pain/pressure Headache
Facial congestion/fullness Fatigue
Nasal obstruction/blockage
Halitosis
Nasal discharge/ purulence/ discolored postnasal drainage
Dental pain
Hyposmia/anosmia Cough
Purulence in nasal cavity on examination
Ear pain/ pressure/ fullness
Fever
SINUSITIS SYMPTOMSCommon symptoms:• rise in temperature• bad appetite• sleep disturbances• changes of the blood
(leukocytosis)Local symptoms:• Pain located in the affected
sinus.• Nasal obstruction.• Purulent discharge from the
nose.• Oedema of facial tissues.• Watering.• Smell disturbances (hyposmia).
DIAGNOSTICS
ONE-SIDED MAXILLARY SINUSITIS
ONE-SIDED ETHMOIDITIS
ONE-SIDED SPHENOIDITIS
CONSERVATIVE TREATMENT
• Antibiotics• Nasal decongestant• Mucoactive drugs• Symptomatic treatment• Puncture of the
affected sinuses• Physiotherapy• Treatment of the
affected tooth
PUNCTURE OF MAXILLARY SINUS
NASAL IRRIGATION
SURGICAL TREATMENT
1. Necrotic sinusitis2. Orbital complications
(abscess and phlegmon of orbit)
3. Intracranial complications (meningitis, brain abscess)
4. Rhinogenic sepsis5. Odontogenic sinusitis
combined with maxillary osteomielitis
SURGERY