Podcast
Questions and Answers
What is the primary cause of chronic sinusitis?
What is the primary cause of chronic sinusitis?
What is the radiographic picture of chronic sinusitis?
What is the radiographic picture of chronic sinusitis?
What is the primary treatment for chronic sinusitis?
What is the primary treatment for chronic sinusitis?
What is the usual treatment duration for antibiotics in acute sinusitis?
What is the usual treatment duration for antibiotics in acute sinusitis?
Signup and view all the answers
What is the complication of chronic sinusitis that can lead to formation of multiple or single mucosal polyps?
What is the complication of chronic sinusitis that can lead to formation of multiple or single mucosal polyps?
Signup and view all the answers
What is the common symptom of chronic sinusitis?
What is the common symptom of chronic sinusitis?
Signup and view all the answers
What is the local treatment for chronic sinusitis?
What is the local treatment for chronic sinusitis?
Signup and view all the answers
What is the difference between chronic and acute sinusitis?
What is the difference between chronic and acute sinusitis?
Signup and view all the answers
What is the result of loss of permanent teeth and alveolar bone on the sinus?
What is the result of loss of permanent teeth and alveolar bone on the sinus?
Signup and view all the answers
What is the primary function of the maxillary sinus?
What is the primary function of the maxillary sinus?
Signup and view all the answers
What is the best view for sinus examination in radiographic examination?
What is the best view for sinus examination in radiographic examination?
Signup and view all the answers
What is the duration of disease classified as acute sinusitis?
What is the duration of disease classified as acute sinusitis?
Signup and view all the answers
What is the cause of sinusitis in a patient with an oro-antral fistula?
What is the cause of sinusitis in a patient with an oro-antral fistula?
Signup and view all the answers
What is the term used to describe sinusitis lasting 1 to 3 months?
What is the term used to describe sinusitis lasting 1 to 3 months?
Signup and view all the answers
What is the purpose of transillumination in clinical examination of sinusitis?
What is the purpose of transillumination in clinical examination of sinusitis?
Signup and view all the answers
What is the term used to describe inflammation of the mucosal lining of the sinus?
What is the term used to describe inflammation of the mucosal lining of the sinus?
Signup and view all the answers
What is a potential complication of maxillary sinusitis?
What is a potential complication of maxillary sinusitis?
Signup and view all the answers
What is the primary goal of decongestants in treating sinusitis?
What is the primary goal of decongestants in treating sinusitis?
Signup and view all the answers
What is the name of the surgical procedure mentioned in the text for treating sinusitis?
What is the name of the surgical procedure mentioned in the text for treating sinusitis?
Signup and view all the answers
What is the consequence of an Oroantral Communication (OAC)?
What is the consequence of an Oroantral Communication (OAC)?
Signup and view all the answers
What is the difference between a fistula and a communication?
What is the difference between a fistula and a communication?
Signup and view all the answers
What is a possible cause of an Oroantral Communication (OAC)?
What is a possible cause of an Oroantral Communication (OAC)?
Signup and view all the answers
What is a sign of a recent Oroantral Communication (OAC)?
What is a sign of a recent Oroantral Communication (OAC)?
Signup and view all the answers
What is the primary goal of antibiotics in treating sinusitis?
What is the primary goal of antibiotics in treating sinusitis?
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.
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.
