Diseases of the paranasal sinuses.

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Diseases of the paranasal sinuses.

  1. 1. DISEASES OF THE PARANASAL SINUSES
  2. 2. Anatomy of the SINUSES
  3. 3. Sinusitis
  4. 4. SINUSITIS <ul><li>Sinusitis is the inflammatory condition of the mucous membrane lining of the sinuses. It may progress to pus formation. </li></ul><ul><li>Sinusitis may be acute and chronic. </li></ul><ul><li>inflammation of the maxillary sinus is called maxillitis; </li></ul><ul><li>inflammation of the ethmoidal sinus is called ethmoiditis; </li></ul>
  5. 5. SINUSITIS <ul><li>inflammation of the frontal sinus is called frontal sinusitis ; </li></ul><ul><li>inflammation of the sphenoid sinus is called sphenoiditis; </li></ul>
  6. 6. SINUSITIS <ul><li>hemisinusitis – the involvement all sinuses on one side into inflammation process; </li></ul><ul><li>pansinusitis – all sinuses are involved; </li></ul><ul><li>polisinusitis – several sinuses, but not all, are involved </li></ul>
  7. 7. SINUSITIS <ul><li>For their origination sinusitis </li></ul><ul><li>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 . </li></ul>
  8. 8. SINUSITIS <ul><li>Sinusitis may divided into: </li></ul><ul><li>R hinogenous – infection spreads from the nasal cavity. It is the most common way for infection and such sinusitis is the complication of the flu. </li></ul><ul><li>O dontogenic – 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 </li></ul><ul><li>Traumatic </li></ul><ul><li>H ematogenic </li></ul><ul><li>Allergic . </li></ul>
  9. 9. PATHOGENESIS OF SINUSITIS <ul><li>There are three main factors lead to the sinusitis development: </li></ul><ul><li>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. </li></ul>
  10. 10. PATHOGENESIS OF SINUSITIS <ul><li>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. </li></ul>
  11. 11. 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 .
  12. 12. PATHOGENESIS OF SINUSITIS <ul><li>There are two additional factors : </li></ul><ul><li>I mmunodeficiency . </li></ul><ul><li>Pathological changes of nose and nasopharynx that make difficulties for normal outflow from the sinuses (septum deviation, hypertrophic rhinitis, adenoids) . </li></ul>
  13. 13. SINUSITIS <ul><li>ACUTE sinusitis are divided into: </li></ul><ul><li>Catarrhal. </li></ul><ul><li>Purulent. </li></ul><ul><li>Necrotic. </li></ul><ul><li>CHRONIC: </li></ul><ul><li>Purulent </li></ul><ul><li>Polyps of sinuses </li></ul><ul><li>mixed </li></ul>
  14. 14. Diagnosis of Acute Rhinosinusitis, Major and Minor Factors   Fever Ear pain/ pressure/ fullness Purulence in nasal cavity on examination Cough Hyposmia/anosmia Dental pain Nasal discharge/ purulence/ discolored postnasal drainage Halitosis Nasal obstruction/blockage Fatigue Facial congestion/fullness Headache Facial pain/pressure Minor Factors Major Factors
  15. 15. SINUSITIS SYMPTOMS <ul><li>Common symptoms: </li></ul><ul><li>rise in temperature </li></ul><ul><li>bad appetite </li></ul><ul><li>sleep disturbances </li></ul><ul><li>changes of the blood (leukocytosis) </li></ul><ul><li>Local symptoms: </li></ul><ul><li>Pain located in the affected sinus . </li></ul><ul><li>Nasal obstruction . </li></ul><ul><li>Purulent discharge from the nose . </li></ul><ul><li>Oedema of facial tissues . </li></ul><ul><li>Watering . </li></ul><ul><li>Smell disturbances (hyposmia) . </li></ul>
  16. 16. DIAGNOSTICS
  17. 17. ONE-SIDED MAXILLARY SINUSITIS
  18. 18. ONE-SIDED ETHMOIDITIS
  19. 19. ONE-SIDED SPHENOIDITIS
  20. 22. CONSERVATIVE TREATMENT <ul><li>Antibiotics </li></ul><ul><li>Nasal decongestant </li></ul><ul><li>Mucoactive drugs </li></ul><ul><li>Symptomatic treatment </li></ul><ul><li>Puncture of the affected sinuses </li></ul><ul><li>Physiotherapy </li></ul><ul><li>Treatment of the affected tooth </li></ul>
  21. 23. PUNCTURE OF MAXILLARY SINUS
  22. 25. NASAL IRRIGATION
  23. 26. SURGICAL TREATMENT <ul><li>Necrotic sinusitis </li></ul><ul><li>Orbital complications ( abscess and phlegmon of orbit ) </li></ul><ul><li>Intracranial complications ( meningitis, brain abscess) </li></ul><ul><li>Rhinogenic sepsis </li></ul><ul><li>Odontogenic sinusitis combined with maxillary osteomielitis </li></ul>
  24. 27. SURGERY

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