sinusitis (1)
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SINUSITIS
NORAFIDATUL ASNI BT ZAMANI (2010663124)NOORASHIKIN BT HAMIZAN (2010272762)NUR IZZATI BT MD SUBI (2010294592)NOOR SYAKILA BT NOORUL DIN (2010833522)HANISAH BT NASOHA (2010610654)FARHANA AQILAH BT AB AZIZ (2010423804)
What is sinuses??? Hollow spaces in the bone of our face and skull Connect with nose through small opening Like the nose, they are lined with membrane
that make mucus frontal sinuses ~ over eyes in brow area maxillary sinuses ~ inside each cheekbone ethmoid sinuses ~ just behind the bridge of the nose & between the eyes sphenoid sinuses ~ behind the ethmoids in the upper region of the nose
and behind the eyes
Definition Infection or inflammation of one or more
of the paranasal sinuses Sinusitis is usually preceded by a cold,
allergy attack or irritation from environmental pollutants
Classification of sinusitis
You can have sinusitis that lasts a long time called chronic sinusitis.
Short attacks that last for four weeks or less are called acute sinusitis.
Bacterial and viral acute sinusitis are difficult to distinguish.
However, if symptoms last less than 10 days, it is generally considered viral sinusitis.
When symptoms last more than 10 days, it is considered bacterial sinusitis (usually 30% to 50% are bacterial sinusitis)
CAUSES OF SINUSITIS????
Fungi Bacteria Allergens
Viruses Immune system problems Structural problems in the
nasal cavities
Colds and Flu An irritation in the sinuses :-
result of extreme weather changes and poor air quality (smoke, dust and other air pollutants).
Asthma sufferers:-more prone to this condition
“Many people enjoy the fall season, when the leaves start to change colors, but others suffer from cold and flu-like symptoms that they can't get rid of. When your face still hurts, your nose is still stuffy and you still have a cough weeks later, you could have sinusitis”
PATHOPHYSIOLOGY OF SINUSITIS
Sinuses are normally lined by ciliated, pseudostratified columnar epithelium, interspread with mucus-secreating cells.
Blockage of OMC
Bacterial colonization and initiation of mucusal gas metabolism exchange
Cilia damaged
Inflammation and bacterial infection develop in the sinus cavity
pH and lowered oxygen tension
Normally cilia clean mucus and air toward the
OMC ostia
Sinusitis occurs because of a vicious cycle that lead to further mucosal thickening and edema, creating further blockage.
Factors contribute to obstruction
Failure of normal mucus transport Mucosal edema Bacterial or viral infections Allergic rhinitis Dental infections Immunodeficiency states Nasal dryness Anatomic variations – deviated septum and turbinate
hypertrophy
SIGN & SYMPTOMS OF SINUSITIS
Major Symptoms Nasal obstruction (most common
symptom) Pain, tenderness, swelling and pressure
over sinus areas (near the nose, above the teeth, the
forehead) Purulent or non-purulent nasal drainage
Either rhinorrhea or post-nasal drip Hyposmia/anosmia Facial congestion/fullness Fever
Minor Symptoms
Halitosis Cough, especially at night Sore throat (nasal drainage irritate the
throat) Fatigue Malaise - feeling generally unwell Painful headache when wake up in the
morning and when bend the head down or forward
Aching in the upper jaw and teeth
Chronis Sinusitis
Also known as rhinosinusitis Lasting >12 weeks Includes two or more major symptoms
Or at least one major and two minor symptoms
With or without findings on physical examination
Diagnosis
X-ray : show fluid in the sinuses CT scan : the extent & severity of
sinusitis Endoscopic rhinoscopy : evaluate the
upper nasal airway down to the level of vocal chords
Complication of sinusitis
General complica
tion
Abscess
Osteomyeliti
s
meningitis
Skin infectio
n around the eye
Blood Clot
Complication of Acute sinusitis
Asthma flare-ups. Acute sinusitis can trigger an asthma attack
Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis is sinusitis that lasts longer than eight weeks.
Meningitis. This occurs when infection spreads to the lining of the brain.
Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness. This is a medical emergency that requires immediate treatment to prevent potentially permanent damage.
Aneurysms or blood clots. Infection can cause problems in the veins surrounding the sinuses, interfering with blood supply to your brain and putting you at risk of a stroke.
Ear infection. Acute sinusitis may occur along with an ear infection.
http://melayuboleh.8forum.net/t350-acute-sinusitis
Complication for Chronic Sinusitis
Erosion of the thinning of the bone between the brain and the sinuses or the eye and the sinuses can occur if the infection is prolonged.
Blocked sinuses form mucus and enlarged become mucocoele (mucus filled cyst)
-headaches, double vision Sinus infection may spread bacteria into
blood stream and cause sepsis (systemic blood borne infection)- make high fever and renal failure
Can Sinusitis Be Prevented?
Keep your nose as moist as possible with frequent use of saline sprays or washes.
Avoid very dry indoor environments and use a humidifier, if necessary. Be aware, however, that a humid environment also may increase the amount of dust mite, or allergens in your home. this is important only if you are allergic to any of those organisms.
Avoid exposure to irritants such as cigarette and cigar smoke or strong odors from chemicals.
Avoid exposure to substances to which you are allergic. If you haven’t been tested for allergies and you are getting
frequent sinus infections, ask your healthcare professional to give you an allergy evaluation or refer you to an allergy specialist.
Avoid long periods of swimming in pools treated with chlorine, which can irritate the lining of the nose and sinuses.
Avoid water diving, which forces water into the sinuses from the nasal passages.
investigation and treatment for
SINUSITIS
INVESTIGATION OF SINUSITIS
TRANSILLUMINATION (CAT SCAN)It is a diagnostic
technique in which the combined use of a computer and x-
rays are passed through the body at
different angles, producing clear, cross-sectional
images of the nasal cavities.
NASAL ENDOSCOPY
This is a narrow, flexible fiber-optic
scope that is placed into the nasal cavity through the nostrils. It allows the doctor to view where the
sinuses and middle ear drain into the
nose.
FINE NEEDLE ASPIRATION
BIOPSYThe sinus is
aspirated, the contents sent for
culture and staining, and the sinus may be flushed with a saline
solution. This is technically the most
accurate way to diagnose infectious
sinusitis.
RHINOSCOPYIt is a procedure
where the nostril is spread open with a
small bunt speculum and the
nasal passages can be directly
examined with a headlight. This
examination gives limited view of the interior of the nasal
cavity.
CT OR MRI SCANSThey both are helpful in looking at cancers of the nasal cavities
and paranasal sinuses. MRI is better
than CT in distinguishing fluid
from tumor, and sometimes they can help the doctor tell
the difference between a benign
tumor and a cancerous one.
CHEST X-RAYIf nasal cavity or paranasal sinus cancer has been
diagnosed, one of these tests may be
done to find out whether the cancer has spread to the lungs, which is the most common site
of spread other than lymph nodes.
TREATMENTS
CORTICOSTEROIDS
Reduce inflammation in
the nasal passages.
Examples:beclomethasone
(Beconase),mometasone (Nasonex).
MUCOLYTICSThin mucus.
Example: guaifenesin (Robitussin)
SURGERY
ENDOSCOPIC SINUS SURGERY This surgery removes anatomical and
pathological obstructions associated with sinusitis in order to restore normal clearance
of the sinuses.
BALLOON SINUPLASTYThis method, similar to balloon
angioplasty used to unclog arteries of the heart, utilizes balloons in an attempt to
expand the openings of the sinuses in a less invasive manner.
CALDWELL-LUC RADICAL ANTROSTOMYThis surgery involves an incision in the upper gum,
opening in the anterior wall of the antrum, removal of the entire diseased maxillary sinus mucosa and drainage is allowed into inferior
or middle meatus by creating a large window in the lateral nasal wall.
PHYSIOTHERAPY MANAGEMENT
NEBULISATION
LASER THERAPY
THERAPEUTIC
ULTRASOUND
RHINOFLOW
THERAPY
SHORTWAVE
DIATHEMY
MASSAGE
THANK YOU….for being so
attentive.
References Tichenor, W. S. (2007). Sinusitis for Physicians.
Sinusitis: A Treatment Plan That Works. Retrieved from http://www.sinuses.com/md.html
Jacewicz, M. (2008). Sinusitis. The Merck Maual Home Healthn Handbook. Retrieved from http://www.merckmanuals.com/home/ear_nose_and_throat_disorders/nose_sinus_and_taste_disorders/sinusitis.html
Torpy, J. M. (2009). Acute Sinusitis. The Journal of the American Medical Association, (301)17. Retrieved from http://jama.ama-assn.org/
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