Hollow spaces in the bone of our face and skull Connect with nose through small opening Like the nose, they are lined with membrane that make mucus frontal sinuses ~ over eyes in brow area maxillary sinuses ~ inside each cheekbone ethmoid sinuses ~ just behind the bridge of the nose & between the eyes sphenoid sinuses ~ behind the ethmoids in the upper region of the nose and behind the eyes
Infection or inflammation of one or more of the paranasal sinuses Sinusitis is usually preceded by a cold, allergy attack or irritation from environmental pollutants
You can have sinusitis that lasts a long time called chronic sinusitis. Short attacks that last for four weeks or less are called acute sinusitis. Bacterial and viral acute sinusitis are difficult to distinguish. However, if symptoms last less than 10 days, it is generally considered viral sinusitis. When symptoms last more than 10 days, it is considered bacterial sinusitis (usually 30% to 50% are bacterial sinusitis)
Fungi Bacteria Allergens
Viruses Immune system problems Structural problems in the nasal cavities
Colds and Flu An irritation in the sinuses :-result of extreme weather changes and poor air quality (smoke, dust and other air pollutants). Asthma sufferers:-more prone to this condition
“Many people enjoy the fall season, whenthe leaves start to change colors, butothers suffer from cold and flu-likesymptoms that they cant get rid of. Whenyour face still hurts, your nose is stillstuffy and you still have a cough weekslater, you could have sinusitis”
Sinuses are normally lined by ciliated, pseudostratified columnar epithelium, interspread with mucus-secreating cells.
Blockage of OMC Mucusal congestion or anatomic obstruction blocks airflow and drainage. The secreations become stagnant and thicken within the sinuse cavities. Bacterial colonization and initiation of mucusal gas metabolism exchange pH and lowered oxygen tension Normally cilia Cilia damaged clean mucus and air toward the OMC ostia Inflammation and bacterial infection develop in the sinus cavity
Sinusitis occurs because of a vicious cycle that lead to further mucosal thickening and edema, creating further blockage.
Failure of normal mucus transport Mucosal edema Bacterial or viral infections Allergic rhinitis Dental infections Immunodeficiency states Nasal dryness Anatomic variations – deviated septum and turbinate hypertrophy
Nasal obstruction (most common symptom) Pain, tenderness, swelling and pressure over sinus areas (near the nose, above the teeth, the forehead) Purulent or non-purulent nasal drainage Either rhinorrhea or post-nasal drip Hyposmia/anosmia Facial congestion/fullness Fever
Halitosis Cough, especially at night Sore throat (nasal drainage irritate the throat) Fatigue Malaise - feeling generally unwell Painful headache when wake up in the morning and when bend the head down or forward Aching in the upper jaw and teeth
Also known as rhinosinusitis Lasting >12 weeks Includes two or more major symptoms Or at least one major and two minor symptoms With or without findings on physical examination
X-ray : show fluid in the sinuses CT scan : the extent & severity of sinusitis Endoscopic rhinoscopy : evaluate the upper nasal airway down to the level of vocal chords
Abscess OsteoBlood Clot myelitis General complicatio n Skin infection meningiti around s the eye
Asthma flare-ups. Acute sinusitis can trigger an asthma attack Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis is sinusitis that lasts longer than eight weeks. Meningitis. This occurs when infection spreads to the lining of the brain. Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness. This is a medical emergency that requires immediate treatment to prevent potentially permanent damage. Aneurysms or blood clots. Infection can cause problems in the veins surrounding the sinuses, interfering with blood supply to your brain and putting you at risk of a stroke. Ear infection. Acute sinusitis may occur along with an ear infection. http://melayuboleh.8forum.net/t350-acute-sinusitis
Erosion of the thinning of the bone between the brain and the sinuses or the eye and the sinuses can occur if the infection is prolonged. Blocked sinuses form mucus and enlarged become mucocoele (mucus filled cyst) -headaches, double vision Sinus infection may spread bacteria into blood stream and cause sepsis (systemic blood borne infection)- make high fever and renal failure
Keep your nose as moist as possible with frequent use of saline sprays or washes. Avoid very dry indoor environments and use a humidifier, if necessary. Be aware, however, that a humid environment also may increase the amount of dust mite, or allergens in your home. this is important only if you are allergic to any of those organisms. Avoid exposure to irritants such as cigarette and cigar smoke or strong odors from chemicals. Avoid exposure to substances to which you are allergic. If you haven’t been tested for allergies and you are getting frequent sinus infections, ask your healthcare professional to give you an allergy evaluation or refer you to an allergy specialist. Avoid long periods of swimming in pools treated with chlorine, which can irritate the lining of the nose and sinuses. Avoid water diving, which forces water into the sinuses from the nasal passages.
TRANSILLUMINATION NASAL ENDOSCOPY FINE NEEDLE (CAT SCAN) This is a narrow, flexible ASPIRATION BIOPSY It is a diagnostic technique fiber-optic scope that is The sinus is aspirated, the in which the combined use placed into the nasal cavity contents sent for culture of a computer and x-rays through the nostrils. It and staining, and the sinus are passed through the allows the doctor to view may be flushed with a body at different where the sinuses and saline solution. This is angles, producing middle ear drain into the technically the mostclear, cross-sectional images nose. accurate way to diagnose of the nasal cavities. infectious sinusitis.
RHINOSCOPY CT OR MRI SCANS CHEST X-RAYIt is a procedure where They both are helpful in If nasal cavity or the nostril is spread looking at cancers of the paranasal sinus canceropen with a small bunt nasal cavities and has beenspeculum and the nasal paranasal sinuses. MRI diagnosed, one of thesepassages can be directly is better than CT in tests may be done to examined with a distinguishing fluid find out whether the headlight. This from tumor, and cancer has spread to the examination gives sometimes they can lungs, which is the limited view of the help the doctor tell the most common site of interior of the nasal difference between a spread other than cavity. benign tumor and a lymph nodes. cancerous one.
CORTICOSTEROIDS DECONGESTANTS ReduceANTIBIOTICS Reduce the swelling ANALGESICS inflammation in the MUCOLYTICSKill bacteria. of the mucous Relieve pain. nasal passages. Thin mucus. membranes in the nose. Examples: Examples: Examples: Example: amoxicillin , acetaminophen beclomethasone guaifenesin Examples: (Tylenol), (Beconase), (Robitussin) cefdinir Oxymetazoline (Omnicef). Ibuprofen (Advil). mometasone (Afrin), (Nasonex). Phenylephrine (Neo- Synephrine).
ENDOSCOPIC SINUS SURGERY This surgery removes anatomical and pathological obstructions associated with sinusitis in order to restore normal clearance of the sinuses. BALLOON SINUPLASTY This method, similar to balloon angioplasty used to unclog arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner. CALDWELL-LUC RADICAL ANTROSTOMY This surgery involves an incision in the upper gum, opening in the anterior wall of theantrum, removal of the entire diseased maxillary sinus mucosa and drainage is allowed into inferior or middle meatus by creating a large window in the lateral nasal wall.
Tichenor, W. S. (2007). Sinusitis for Physicians. Sinusitis: A Treatment Plan That Works. Retrieved from http://www.sinuses.com/md.html Jacewicz, M. (2008). Sinusitis. The Merck Maual Home Healthn Handbook. Retrieved from http://www.merckmanuals.com/home/ear_nose _and_throat_disorders/nose_sinus_and_taste_diso rders/sinusitis.html Torpy, J. M. (2009). Acute Sinusitis. The Journal of the American Medical Association, (301)17. Retrieved from http://jama.ama-assn.org/