* Sinusitis. * - Single, multi,or pansinusitis. - Acute or chronic. - Closed or opened.

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Presentation transcript:

* Sinusitis

* - Single, multi,or pansinusitis. - Acute or chronic. - Closed or opened.

* Acute sinusitis Causes: 1.Acute infective rhinitis. 2.Swimming & diving. 3.Dental extraction & infection. 4.Fractures involving sinus. 5.Barotrauma.

* Predisposing factors: a.Local: Nasal obstruction. Sinus meatus obstruction. Neighbouring infection. Previous infection. b.General: Debilitation & immune diffic. Mucociliary disorders. Irritating atmospheric conditions.

* Bacteriology: Usually mixed &proceeded by viral *Pneumococcus,Strep.,Staph., Kleb. pneum. *E.coli + Anaerobic strep. in dental origin.

* Clinical Features: 1.Preceding URTI. 2.Constitutional symptoms(s.t.sever) 3.Nasal obstruction. 4.Nasal discharge &postnasal drip 5.Sever facial pain over sinus, icreases by bending or coughing. 6.Swelling & tenderness over affected sinus.

* Investigations: 1.Endoscopical examinations. 2.Radiological examinations.

* Differential diagnosis: 1.Dental pain. 2.Migraine. 3.Trigeminal neuralgia. 4.Neoplasms of sinuses. 5.Infections eg.erysipelas&H.zoster. 6.Temporal arteritis,Angioneurotic oedema & Insect bite.

* Principles of Tt.: 1.Tt. of infections. 2.Tt. of pain. 3.Drainage; a.Decongestant. B.Irrigation.

* Bacteriology: Usually mixed *Strep. Including some anaerobic. *Pneumococci. *Proteus,Pseudomonus &E.colli Fungal infestion???

* Clinical features: Same as acute but lesser degree *Nasal &post nasal discharge of mucoid or purulent. *Headache; heavy or dull ache. *Anosmia or cachosmia. *Less sever constitutional symptoms.

* c.Others: 1.Infection of nasopharynx. 2.Lateral pharyngitis & Tonsillitis. 3.Otitis media ;acute or ch. 4.Laryngotracheitis. 5.Bronchitis. 6.Association with broncheictasis. 7.Association with asthma. 8.Polyarteritis,Tenosynovitis, fobrositis …