3. INTRODUCTION
Sinusitis is a condition consisting of
inflammation of the pasanasal sinuses, which
may or may not be as a result of Infection,
bacterial, fungal, viral, allergic or autoimmune
diseases. Newer classifications of sinusitis
refer to it as rhinosinusitis, asking into account
the thought that inflammation of sinuses cannot
occur without some inflammation of nose.
4. NOSE
ANATOMY
EXTERNAL NOSE
Extemal nose has a bony cartilagenous
structure .The bony Framework is formed by a
pair of nasal bones, the frontal process of
maxilla and the nasal spine of the frontal bone.
5. Cartilages of the Nose
1. Paired upper lateral nasal cartilages
2. Paired lower nasal cartilages
3. Accessory cartilages
4. Seped collage
6. NASAL CAVITIES
•The interior of the nasal cavities is divided into two halves by
Central setum.
•The anterior and posteror apertures of the nose are called the
anterior and posterior chroanae respectively.
•It has a root, floor and medial and lateral walls.
.The roof is made by nasal bones , floor by palatine process of
maxillae .
.Medial wall is formed by nasal septum .
8. PARANASAL SINUSES
MAXILLARY SINUS
This is a Pyramidal cavily in the maxilla.
The roof of the sinus is formed by the floor of the orbit.
The anterolateral wall is formed by theanterior part of the
body of maxilla.
The medial wall is formed by the nasal surface of the
9. FRONTAL SINUS
Frontal sinus are two in number and develop in
the frontal bone.
The two sinuses are usually unequal in size. The
anterior wall and floor of the sinus have marrow
containing bone hence osteomyelitis can develop
in this region at any age.
10. ETHMOID SINUS
These are multiple air contaming cells
SPENOID SINUS
Sphenoid sinus develop in the body of the sphenoid
bone. The two sinuses are unequally divided by a
septum.
11. PHYSIOLOGY
The nose forms the gateway of the respiratory system and serves be
following important functions.
1.Respiratory passage.
2. Filtration
3.Air conditioning and humidification
4. Vocal resonance
5. Nasal reflex functions
12. Definition
Sinusitis is a condition consisting of
inflammation of paranasal sinuses,which may
or may not be as a result of infection ,from
bacterial,fungal,viral , allergic or auto immune
issues.
13. Etiology
Bacterial agents like streptococcus
pneumoniae,Haemophillus influenza
Viral agents like Rhinovirus
Fungal sinusitis is uncommon , usually occuring
at immunocompromised patients
14. Risk factors
Swimming or diving
Smoking
Structural problems such as a deviated nasal
septum,adenoids,infected tonsils
Dental infections
15. Pathophysiology
Due to viral & bacterial infection of upper
respiratory tract
Microorganisms will spread &affect the
paranasal air sinuses
17. Classification
Acute sinusitis- lasts for 4 weeks or less
Subacute sinusitis -lasts for 4 to 12 weeks
Chronic sinusitis - lasts for more than 12 weeks
Recurrent sinusitis - severe acute attack within a year
18. ACUTE SINUSITIS
● Last for 4 weeks or less
● Result from an upper respiratory infection
● Swimming
● Dental manipulation
○ Sometimes Lead to brain infection and serious
complications
25. ● Antibiotics - Amoxicillin
It is the first drug of choice continued for 10 to
14 days
If symptoms do not resolve , antibiotics should
be changed to broad spectrum agents such as
trimethoprim, erythromycin.
26. ● Nasal decongestant
eg psuedoephedrine-Helps to relieve nasal
obstruction and mucosal swelling thereby
improving drainage of sinuses
30. ● When medicine fails,surgery may be the only alternative
for treating chronic sinusitis.
● The goal of surgery
○ Improve drainage
○ Reduce blockage of nasal passages
31. Antrum Puncture
● A cannula inserted into maxillary sinus via inferial meatus
to irrigate sinus cavity by normal saline .
● Discharge comes through natural ostium .
● After procedure local medication instilled .
● Cannula withdrawn and nose is cleaned .
32.
33. Intranasal Antrostomy
● In this procedure a permanent window is created near floor
of antrum .
● To facilitate drainage of discharge.
34.
35. Caldwell -Luc Radial Antrostomy
● An operation to remove irreversibly damaged mucosa of
the maxillary sinus.
● It is done when maxillary sinusitis is not cured by
medication or other non-invasive technique.
● Introduced by George Caldwall and Henry Luc.
36.
37. Balloon Sinuplasty
● Balloon catheter inserted and inflates.
● It expands the openings of sinuses in a less invasive
manner.
38.
39. Functional Endoscopic
Sinus Surgery
● Recent advance in treatment of chronic sinusitis
● Removing pathological and anatomical obstruction that
causes sinusitis.
● It allows a targeted approach to affected sinuses
40.
41. Nursing Management
● Advice the client to use steam inhalation
to promote drainage
● Increase fluid intake
● Apply moist heat by warm, wet towel
against face .this will relieve sinus
pressure and help open sinus passages.
42. Prevention
● Keep the nose as moist as possible with
frequent use of saline sprays.
● Avoid upper respiratory tract infections
● Minimize contact with people who have
colds
● Avoid exposure to irritants such as
cigarette smoke
