sinusitis - definition - classification - symptomatology-pathology-management

1. SINUSITIS
Dr.SHIVAPRASAD SHARMA THANUGULA (MD)

2. Inflammation of the mucosal lining of the Para-nasal sinus
always accompanied with rhinitis
CLASSIFICATION
Acute
Chronic
Infective
Allergic
Fungal
Atrophic
Hypertrophic
Secondary to other disease – Young syndrome / kartegener/ samtars
triod

3. PATHOGENESIS
1. Excessive mucus secretion
2. Improper drainage
3. Ostia blockage
Symptoms
Feverin acute stage
Nasal discharge
Obstruction
Post nasal drip
Headache
Heaviness
Frontal sinusitis–
office headache
Maxillary- unilateral/
bilateral
Signs
Tenderness
Frontal recess
Maxillary canine
fossa

4. INVESTIGATIONS
• X-ray PNS
• CT PNS – sensitive
• CBC – in acute leukocytosis, with neutropenia
• Allergic- eosinophilia / AEC
• Chronic – ESR rises
Impression : thickeningof mucosa
Collections- radio opaque areas

5. TREATMENT
• STEAM INHALATION – provides humidity /
relieves mucosal congestion / ostial edema
• Nasal decongestants –
• Oral decongestants
• Anti histamines
• Antibiotics
• Anti fungal
Surgical - FESS

6. COMPLICATIONS
• ACUTE TO CHRONIC
CHRONIC
• Osteomyelitis
• Mucocele
• Orbital cellulitis etc…………………….