Sinusitis Acute nonspecific infective Chronic simple infective

Acute non-specific infective sinusitis

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

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

General predisposing factors Chilling Fatigue Poor diet Irritating atmospheric conditions

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

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.

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

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

Treatment Analgesics Local heat Antibiotics Nasal decongestants Drainage

Simple chronic infective sinusitis Follows repeated attacks of acute sinusitis

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

Bacteriology Usually mixed

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

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

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

Differential diagnosis Dental abscess Neoplasm of the upper jaw Facial neuralgia

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

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

Differential diagnosis Herpes zoster Insect bite Erysipelas

Ethmoiditis Pain between the eyes Discharge

Acute sphenoiditis Rare Headache discharge

Treatment Antibiotics Pain killers Drainage