Disorders of the Nose and Sinuses Flashcards
(11 cards)
Anosmia
absent smell function Congenital Midline facial abnormalities Cleft palate Neurosensory hearing loss
DYSOSMIA
distortion of smell function Nasal and paranasal sinus disease Head Trauma Upper respiratory infection Medications Exposure to toxins
PAROSMIA & HYPOSMIA
Aging and neurodegenerative processes Sense of smell decreases with normal aging Number of sensory cells in the olfactory bulb decrease with age Nasal obstruction Upper respiratory infections Head trauma Facial trauma Central olfactory damage
Acute sinusitis is associated with the same bacteria as otitis media
Streptococcus pneumoniae
Hemophilus influenzae
Moraxella catarrhalis
Thirty five percent of H.influenzae and 75% of M.catarrhalis strains produce beta-lactamase, making them resistant to penicillin antibiotics
Chronic sinusitis is associated with
Staphylococcus aureus and anaerobes
Frontal sinusitis
Pain when the forehead over the frontal sinuses is touched
Pain exacerbated by leaning forward
Ethmoid Sinusitis:
Pain behind eyes, between eyes
Sphenoid Sinusitis:
Pain behind the eyes
Maxillary sinuses
Upper jaw and teeth to ache
Cheeks become tender to the touch
Purulent drainage in the patient’s nose or throat may sometimes be apparent
Nasal mucosa is often erythematous and swollen
Presence of mucoid pus in the external nares or posterior pharynx is highly suggestive of sinusitis
Bacterial Sinusitis Tx
Amoxicillin is first-line therapy in patients who are not allergic to penicillin. (ten day course)
Amoxicillin/clavulanate (Augmentin) if B lactam resistant
Doxycycline (no kids)
Zithromax (Z-pak )
Nasal Polyps Tx.
Topical steroids (first line) Antihistamines Oral steroids Leukotriene inhibitors Intrapolyp steroid injections
Surgery involves:
Removal of polyp
