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Sinusitis Acute nonspecific infective Chronic simple infective.

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Presentation on theme: "Sinusitis Acute nonspecific infective Chronic simple infective."— Presentation transcript:

1 Sinusitis Acute nonspecific infective Chronic simple infective

2 Acute non-specific infective sinusitis

3 Etiology Acute infective rhinitis Swimming and diving Dental extraction or infection Fracture involving the sinuse Barotrauma

4 Local predisposing factors Nasal obstruction Obstruction of the sinus ostium Neighboring infection Previous infection in the same sinus

5 General predisposing factors Chilling Fatigue Poor diet Irritating atmospheric conditions

6 Bacteriology Pneumococcus Streptococcus Staphyalococcus Hemophilus inluenzae K.pneumonii E.coli and anaerobic streptococci in sinusitis of dental origin

7 The inflammatory changes in the mucosa of infected sinus include Hypermia Oedema Cellular infiltration Glandular hyperactivity Exudation. Serous at first,then comes purulent so an empyema results.

8 Clinical features Vary with intensity of inflammation and efficiency of drainage Pain Discharge Nasal obstruction Tenderness Oedema of the overlying soft tissues Constitutional symptoms

9 Diagnosis Pain of dental origin Migraine Trigeminal neuralgia Neoplasms of sinuses Temporal arteritis Angioedema Insect bite

10 Treatment Analgesics Local heat Antibiotics Nasal decongestants Drainage

11 Simple chronic infective sinusitis Follows repeated attacks of acute sinusitis

12 Pathalogy Oedema,polyps Chronic inflammatory cellular infiltration Fibrosis,venous and lymphatic compression Multiple small abscesses in thickened mucosa Epithelial metaplasia and glandular hypertrophy True cyst formation Ulceration of epithelium leading to production of grannulations

13 Bacteriology Usually mixed

14 Clinical features Post-nasal discharge Nasal obstruction Headache Anosmia Mild constitutional disturbances

15 Maxillary sinusitis Commonest of all sinus infections Nasal origin (90 %) Dental origin (10%)

16 Pain in the cheek Tenderness over the cheek Oedema of the cheek, rare except in children Discharge Dullness on transillumination Radiographs

17 Differential diagnosis Dental abscess Neoplasm of the upper jaw Facial neuralgia

18 Maxillary sinusitis of dental origin Following dental extraction Following apical abscess Acute dental sac infection in infancy

19 Frontal sinusitis Frontal headache Tenderness over orbital roof Oedema of upper eyelid Discharge in middle meatus

20 Differential diagnosis Herpes zoster Insect bite Erysipelas

21 Ethmoiditis Pain between the eyes Discharge

22 Acute sphenoiditis Rare Headache discharge

23 Treatment Antibiotics Pain killers Drainage

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