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Flashcards in FN: Sinusitis Deck (7)
1

Pathophysiology

Viruses: mucosal oedema and reduced mucosal ciliary actions - mucus retention ± secondary bacterial infection

Acute: Pneumococus, Haemophilus, Morazella
CHronic: S. aureus, anaerobes

2

Causes

- Majority are bacterial infection secondary to viral
-5% secondary to dental root infections
3. Diving/swimming in infected water
4. Anatomical susceptibility: deviated septum, polyps
5. systemic Disease
- PCD/Kartageners
- Immunodeficiency

3

Symptoms

Pain:
-Maxillary (cheek/teeth)
- Ethmoidal (between eyes)
- worse in bending or straining

Discharge: from nose - post-nasal drip with foul taste
Nasal obstruction/congestion
Anosmia or cacosmia (bad smell w/o external source)
Systemic symptoms e.g. fever

4

Imaging

Nasendoscopy ± CT

5

Mx acute/single episode

Bed-rest decongestants, analgesia
Nasal douching and topical steroids
Abx (e.g. clartithromycin) of uncertain benefit

6

Mx chronic/recurrent

Usually a structural or drainage problem
Stop smoking _ fluticasone nasal spray
Functional endoscopic sinus surgery - if failed medical therapy

7

Complications

Mucoceles - pyoceles
Orbital cellultis/abcess
Osteomyeltitis e.g. staph in frontal bone
Intracranial infection
- meningitis, encephalitits
- Abscess
- Cavernous sinus thrombosis

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