sinusitis Dr. Mona Ahmed A/Raheem ENT Surgeon Khartoum National Center for Ear, Nose and Throat Diseases and Head and Neck Surgery Assistant Professor Faculty of Medicine & Health Sciences Alneelain University

Sinusitis refers to inflammation of the paranasal sinusis with bacterial,viral or fungal infection. When the sinus opening become blocked or too much mucus builds up bacteria and other germs can grow more easily.

Paranasal Sinusis

-Sinusitis can be: a.acute – symptoms lasts up to 4 weeks. b.subacute – symptoms lasts 4-12 weeks. c.chronic – symptoms lasts 3months or longer.

-Causative organisms: 1- streptococcus pneumonae. 2- haemophilus influenzae. 3- morexella catarralis. Acute episodes can also results from viral or fungal infections

-Symptoms: 1. bad breath. 2.cough worse at night. 3.fatigue. 4.fever. 5.headache especialy in the morning– pressure like pain, pain behind the eyes,toothache or facial tenderness. Occipital headache indicate pansinusitis

-Causes: Some factors may predispose to sinusitis: 1.allergies. 2.deviated nasal septum 3.small sinus ostium 4.nasal polyps 5.smoking 6.dental problems

-Treatment: (A) Conservative: - nasal irrigation - decongestant nasal drops (B) Antibiotics

Vast majority of sinusitis caused by viruses and thus resolute without medications, but if symptoms do not resolutes within 10 days give amoxicillin or amoxicillin/clavulinat(Augmentin).If patient allergic to penicillin give macrolide antibiotics(Clarythromycin or Tetracyclin

-Complications: 1.orbital abscess. 2.orbital cellulitis 3.meningitis 4.brain abscess 5.visual problems

Suveral sinusis conditions requires surgery including : Recurrent chronic sinusitis Large nasal polyps Significant septal deviations Concha bullosa Noninfected cysts that fill the sinuses (mucoceles) Infected cysts (mucopyoceles) Allergic fungal sinusitis Suspected tumors Serious eye or brain complications

Frontal Mucocele

Orbital Cellulitis

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