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Rhinosinusitis Primary Care: Clinics in Office Practice

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Presentation on theme: "Rhinosinusitis Primary Care: Clinics in Office Practice"— Presentation transcript:

1 Rhinosinusitis Primary Care: Clinics in Office Practice
Welby Winstead, MD, FACS  Primary Care: Clinics in Office Practice  Volume 30, Issue 1, Pages (March 2003) DOI: /S (02)

2 Fig. 1 Schematic diagram of the anterior ethmoid sinus–middle meatus region in a coronal projection. The shaded area is the OMC, which includes the middle turbinate (MT), middle meatus, maxillary ostium (O), and anterior ethmoid (B). Blockage in this critical area can cause secondary obstruction in the frontal (F) and maxillary (M) sinuses. Also shown are the inferior turbinate (IT) and septum (S). Primary Care: Clinics in Office Practice  , DOI: ( /S (02) )

3 Fig. 2 Classification of rhinosinusitis.
Primary Care: Clinics in Office Practice  , DOI: ( /S (02) )

4 Fig. 3 Nasal endoscopic views of the OMC region demonstrating anatomic variations that may predispose to chronic rhinosinusitis. (A) The right middle turbinate (MT) is enlarged by pneumatization (concha bullosa). (B) This view shows the left middle turbinate (∗) and deviation of the septum (S) with a spur (double arrows) impacted into the inferior turbinate (IT). (C) This view shows a deformity of the uncinate process (U). Primary Care: Clinics in Office Practice  , DOI: ( /S (02) )

5 Fig. 4 Coronal CT scan through the anterior ethmoid region demonstrating concha bullosa of the middle turbinate (white arrow). Also note the septal deviation and mucosal disease in both maxillary sinuses. Primary Care: Clinics in Office Practice  , DOI: ( /S (02) )

6 Fig. 5 Schematic diagram of the OMC region demonstrating the situation after functional endoscopic sinus surgery on the right side. The uncinate process (U) has been removed, and the natural ostium (O) of the maxillary sinus (M) has been widened. The anterior ethmoid cells (B) are opened, and the frontal sinus (F) drainage pathway is enlarged. The middle turbinate (MT) is preserved intact. Also shown are the inferior turbinate (IT) and septum (S). Primary Care: Clinics in Office Practice  , DOI: ( /S (02) )

7 Fig. 6 Coronal CT scan in a patient with allergic fungal rhinosinusitis. Flocculent calcifications (black arrows) within the opacified sinus are typical of fungal disease. Primary Care: Clinics in Office Practice  , DOI: ( /S (02) )


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