Chronic Sinusitis
24 Questions
0 Views

Chronic Sinusitis

Created by
@SpectacularDjinn

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary cause of chronic sinusitis?

  • Low-grade inflammation in the antral mucosa
  • Polypoidal type of inflammation
  • Inadequately treated acute or subacute disease (correct)
  • Prolonged use of nasal drops

    • What is the radiographic picture of chronic sinusitis?

  • Sinus lining thickening only
  • Sinus opacity with a horizontal fluid level and sinus polyps (correct)
  • No radiographic signs
  • Sinus opacity without a horizontal fluid level

    • What is the primary treatment for chronic sinusitis?

  • Oxygenation of the sinuses through opening of the ostia (correct)
  • Rest and fluid only
  • Decongestants and nasal drops
  • Antibiotics and analgesics

    • What is the usual treatment duration for antibiotics in acute sinusitis?

    <p>5-7 days</p> Signup and view all the answers

    What is the complication of chronic sinusitis that can lead to formation of multiple or single mucosal polyps?

    <p>Polypoidal type of inflammation</p> Signup and view all the answers

    What is the common symptom of chronic sinusitis?

    <p>Dull pain and intermittent headache</p> Signup and view all the answers

    What is the local treatment for chronic sinusitis?

    <p>Daily irrigation of the sinus with warm saline or steam inhalation</p> Signup and view all the answers

    What is the difference between chronic and acute sinusitis?

    <p>Duration of the disease</p> Signup and view all the answers

    What is the result of loss of permanent teeth and alveolar bone on the sinus?

    <p>Pneumatization of the sinus</p> Signup and view all the answers

    What is the primary function of the maxillary sinus?

    <p>Lightening the weight of the skull</p> Signup and view all the answers

    What is the best view for sinus examination in radiographic examination?

    <p>Waters view</p> Signup and view all the answers

    What is the duration of disease classified as acute sinusitis?

    <p>Less than 1 month</p> Signup and view all the answers

    What is the cause of sinusitis in a patient with an oro-antral fistula?

    <p>Oro-antral fistula</p> Signup and view all the answers

    What is the term used to describe sinusitis lasting 1 to 3 months?

    <p>Subacute sinusitis</p> Signup and view all the answers

    What is the purpose of transillumination in clinical examination of sinusitis?

    <p>To diagnose sinusitis</p> Signup and view all the answers

    What is the term used to describe inflammation of the mucosal lining of the sinus?

    <p>Acute sinusitis</p> Signup and view all the answers

    What is a potential complication of maxillary sinusitis?

    <p>Osteomyelitis</p> Signup and view all the answers

    What is the primary goal of decongestants in treating sinusitis?

    <p>To decrease congestion of the nasal mucosa and relief nasal obstruction</p> Signup and view all the answers

    What is the name of the surgical procedure mentioned in the text for treating sinusitis?

    <p>Functional Endoscope Assisted Sinus Surgery (FEASS)</p> Signup and view all the answers

    What is the consequence of an Oroantral Communication (OAC)?

    <p>Invasion of bacteria into the sinus, causing sinusitis</p> Signup and view all the answers

    What is the difference between a fistula and a communication?

    <p>The type of lining differs between a fistula and a communication</p> Signup and view all the answers

    What is a possible cause of an Oroantral Communication (OAC)?

    <p>Extraction of maxillary teeth</p> Signup and view all the answers

    What is a sign of a recent Oroantral Communication (OAC)?

    <p>Unilateral epistaxis</p> Signup and view all the answers

    What is the primary goal of antibiotics in treating sinusitis?

    <p>To control and overcome infection</p> Signup and view all the answers

    Study Notes

    Sinusitis

    • Defined as disease lasting more than three months
    • Usually due to inadequately treated acute or subacute disease
    • Considered irreversible by medical therapy alone
    • Oxygenation of the sinuses through opening of the ostia is the primary treatment

    Signs and Symptoms of Sinusitis

    • Headache
    • Pain and tenderness
    • Nasal obstruction
    • Nasal discharge
    • Heavy feeling when bending
    • Nasal congestion
    • Fever and malaise

    Radiographic Picture of Sinusitis

    • Sinus opacity
    • Horizontal fluid level (usually unilateral sinus opacity if of dental cause)

    Treatment of Sinusitis

    • Rest and fluid intake
    • Antibiotics for 5-7 days
    • Analgesics and antihistamines
    • Decongestant and nasal drops to shrink mucosa lining and drainage
    • Local treatment: daily irrigation of sinus with warm saline or steam inhalation (especially if oro-antral fistula present)

    Chronic Sinusitis

    • Result of prolonged low-grade inflammation in antral mucosa following acute phase or recurrence of acute sinusitis
    • Antral mucosa is thickened with edema and sometimes accompanied by creation of polyp
    • Signs and symptoms:
      • Dull pain and intermittent headache
      • Posterior nasal discharge
      • Nasal congestion
      • Repeated attacks of acute mucopurulent rhinitis
      • Toothache during chewing
    • Radiographic picture:
      • Sinus opacity with horizontal fluid level
      • Sinus lining thickening
      • Sinus polyps are also present

    Function of Sinuses

    • Lighten the weight of the skull
    • Warm the air
    • Resonance of voice
    • Act as a shock absorber
    • Regulation of intranasal pressure

    Clinical Examination of Sinusitis

    • Tapping on the lateral wall of the sinus extraorally and palpation intraorally
    • Transillumination (old method)
    • Sinoscope (recent method)

    Radiographic Examination of Sinusitis

    • Waters view: best view for sinus examination
    • Panoramic view: provides a good overview of both maxillary sinuses
    • Intraoral views (Occlusal & Periapical views): demonstrates the relation of root apices to the floor of the sinus
    • Submento-vertex view: demonstrates the posterior wall of the maxillary sinus
    • Occipito-frontal view: shows all the paranasal sinuses, useful to exclude pansinusitis
    • Lateral sinus projection: confirms the presence of fluid or cyst or foreign body in the sinus
    • Computerized tomography (CT): detection of neoplasms and bony wall erosions within the sinus

    Maxillary Sinusitis

    • Acute sinusitis: suppurative or non-suppurative inflammation of the mucosal lining of the sinus
    • Causes:
      • Infection from dental abscess
      • Infection from cystic lesion of related teeth
      • Dental material pushed into sinus
      • Tooth pushed into sinus
      • Oro-antral fistula
      • Facial fracture involving sinus

    Pathophysiology of Sinusitis

    • Acute sinusitis: disease lasting less than one month
    • Subacute sinusitis: disease lasting 1 to 3 months

    Treatment of Acute Sinusitis

    • Analgesics: to relieve pain
    • Antibiotics: to control and overcome infection
    • Decongestants: to decrease congestion of the nasal mucosa and relieve nasal obstruction
    • Surgery: surgical removal of polyps and thickened lining if present, through Functional Endoscope Assisted Sinus Surgery (FEASS)

    Complications of Maxillary Sinusitis

    • Orbital abscess and orbital cellulitis
    • Intracranial abscesses
    • Meningitis
    • Cavernous sinus thrombosis
    • Spread of infection to neighboring sinuses, structures, and organs
    • Osteomyelitis
    • Gastrointestinal disturbances

    Oroantral Communication (OAC)

    • Abnormal connection between the oral cavity and the maxillary sinus
    • Etiology:
      • Extraction or instrumentation around maxillary teeth
      • Facial trauma
      • Surgical procedure
      • Malignant neoplasms
      • Other causes (osteomyelitis and syphilitic gamma of the palate)

    Why OAC is a Problem

    • Allows the flow of food and fluids from the mouth into the nose, leading to invasion of bacteria into the sinus and causing sinusitis

    Signs and Symptoms of OAC

    • Recent OAC:
      • Escape of fluids from the mouth into the nose
      • Unilateral epistaxis
      • Inability to blow out the cheeks due to escape of air from the mouth to the nose
      • Bubbles of blood from the socket

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers the definition, symptoms, and treatment of chronic sinusitis, a disease that lasts more than three months and is often caused by inadequately treated acute or subacute disease.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser