Diseases of the paranasal sinuses.

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  • 1. DISEASES OF THE PARANASAL SINUSES
  • 2. Anatomy of the SINUSES
  • 3. Sinusitis
  • 4. 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;
  • 5. SINUSITIS
    • inflammation of the frontal sinus is called frontal sinusitis ;
    • inflammation of the sphenoid sinus is called sphenoiditis;
  • 6. 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
  • 7. 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 .
  • 8. SINUSITIS
    • Sinusitis may divided into:
    • 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.
    • 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
    • Traumatic
    • H ematogenic
    • Allergic .
  • 9. 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.
  • 10. 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.
  • 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. PATHOGENESIS OF SINUSITIS
    • There are two additional factors :
    • I mmunodeficiency .
    • Pathological changes of nose and nasopharynx that make difficulties for normal outflow from the sinuses (septum deviation, hypertrophic rhinitis, adenoids) .
  • 13. SINUSITIS
    • ACUTE sinusitis are divided into:
    • Catarrhal.
    • Purulent.
    • Necrotic.
    • CHRONIC:
    • Purulent
    • Polyps of sinuses
    • mixed
  • 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. SINUSITIS SYMPTOMS
    • Common 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) .
  • 16. DIAGNOSTICS
  • 17. ONE-SIDED MAXILLARY SINUSITIS
  • 18. ONE-SIDED ETHMOIDITIS
  • 19. ONE-SIDED SPHENOIDITIS
  • 20.  
  • 21.  
  • 22. CONSERVATIVE TREATMENT
    • Antibiotics
    • Nasal decongestant
    • Mucoactive drugs
    • Symptomatic treatment
    • Puncture of the affected sinuses
    • Physiotherapy
    • Treatment of the affected tooth
  • 23. PUNCTURE OF MAXILLARY SINUS
  • 24.  
  • 25. NASAL IRRIGATION
  • 26. SURGICAL TREATMENT
    • Necrotic sinusitis
    • Orbital complications ( abscess and phlegmon of orbit )
    • Intracranial complications ( meningitis, brain abscess)
    • Rhinogenic sepsis
    • Odontogenic sinusitis combined with maxillary osteomielitis
  • 27. SURGERY