Sinusitis.pptx

Sinusitis

1. SINUSITIS Acsah s philip 4th sem Bsc Nursing Student KIMS College of Nursing

2. INTRODUCTION Sinusitis is a condition consisting of inflammation of the pasanasal sinuses, which may or may not be as a result of Infection, bacterial, fungal, viral, allergic or autoimmune diseases. Newer classifications of sinusitis refer to it as rhinosinusitis, asking into account the thought that inflammation of sinuses cannot occur without some inflammation of nose.

3. NOSE ANATOMY EXTERNAL NOSE Extemal nose has a bony cartilagenous structure .The bony Framework is formed by a pair of nasal bones, the frontal process of maxilla and the nasal spine of the frontal bone.

4. Cartilages of the Nose 1. Paired upper lateral nasal cartilages 2. Paired lower nasal cartilages 3. Accessory cartilages 4. Seped collage

5. NASAL CAVITIES • The interior of the nasal cavities is divided into two halves by Central setum. • The anterior and posteror apertures of the nose are called the anterior and posterior chroanae respectively. • It has a root, floor and medial and lateral walls. . The roof is made by nasal bones , floor by palatine process of maxillae . .Medial wall is formed by nasal septum . .The lateral wall of the nose has ridges and depressions.

6. NASAL SEPTUM The nasal septum has cartilagenous and bony parts.

7. PARANASAL SINUSES MAXILLARY SINUS This is a Pyramidal cavily in the maxilla. The roof of the sinus is formed by the floor of the orbit. The anterolateral wall is formed by theanterior part of the body of maxilla. The medial wall is formed by the nasal surface of the maxilla.

8. FRONTAL SINUS Frontal sinus are two in number and develop in the frontal bone. The two sinuses are usually unequal in size. The anterior wall and floor of the sinus have marrow containing bone hence osteomyelitis can develop in this region at any age.

9. ETHMOID SINUS These are multiple air contaming cells SPENOID SINUS Sphenoid sinus develop in the body of the sphenoid bone. The two sinuses are unequally divided by a septum.

10. PHYSIOLOGY The nose forms the gateway of the respiratory system and serves be following important functions. 1.Respiratory passage. 2. Filtration 3.Air conditioning and humidification 4. Vocal resonance 5. Nasal reflex functions 6. Olfaction

11. Definition Sinusitis is a condition consisting of inflammation of paranasal sinuses,which may or may not be as a result of infection ,from bacterial,fungal,viral , allergic or auto immune issues.

12. Etiology Bacterial agents like streptococcus pneumoniae,Haemophillus influenza Viral agents like Rhinovirus Fungal sinusitis is uncommon , usually occuring at immunocompromised patients

13. Risk factors Swimming or diving Smoking Structural problems such as a deviated nasal septum,adenoids,infected tonsils Dental infections

14. Pathophysiology Due to viral & bacterial infection of upper respiratory tract Microorganisms will spread &affect the paranasal air sinuses

15. Inflammation ,edema&exudate Leads to obstruction of sinus cavity

16. Classification Acute sinusitis- lasts for 4 weeks or less Subacute sinusitis -lasts for 4 to 12 weeks Chronic sinusitis - lasts for more than 12 weeks Recurrent sinusitis - severe acute attack within a year

17. ACUTE SINUSITIS Last for 4 weeks or less Result from an upper respiratory infection Swimming Dental manipulation Sometimes Lead to brain infection and serious complications

18. Clinical Manifestations Pain Tenderness Purulent nasal drainage Nasal obstruction Congestion Fever Malaise Edema of eyelids Sore throat Bad breath Tiredness

19. Diagnostic Evaluation History collection Physical examination Translumination Test Sinus X-ray CT Scan

20. CHRONIC SINUSITIS Last for more than 12 weeks Membranes become thicker Result of incompletely resolved acute sinusitis

21. Clinical Manifestations Facial pain Dental pain Nasal congestion Increased drainage Severe pain Night time coughing General Malaise Green or yellow discharge Epistaxis Feeling facial fullness

22. Diagnostic Evaluation History collection Physical examination Translumination Test Nasal endoscopy Sinus X-ray CT scan MRI Scan

23. Medical Management

24. Antibiotics - Amoxicillin It is the first drug of choice continued for 10 to 14 days If symptoms do not resolve , antibiotics should be changed to broad spectrum agents such as trimethoprim, erythromycin.

25. Nasal decongestant eg psuedoephedrine-Helps to relieve nasal obstruction and mucosal swelling thereby improving drainage of sinuses

26. Antihistamine Drug If allergy is suspected antihistamine drugs are provided

27. Analgesics Paracetamol and ibuprofen can relieve some of symptoms ,such as headache ,pressure and pain

28. Surgical Management

29. When medicine fails,surgery may be the only alternative for treating chronic sinusitis. The goal of surgery Improve drainage Reduce blockage of nasal passages

30. Antrum Puncture A cannula inserted into maxillary sinus via inferial meatus to irrigate sinus cavity by normal saline . Discharge comes through natural ostium . After procedure local medication instilled . Cannula withdrawn and nose is cleaned .

31. Intranasal Antrostomy In this procedure a permanent window is created near floor of antrum . To facilitate drainage of discharge .

32. Caldwell -Luc Radial Antrostomy An operation to remove irreversibly damaged mucosa of the maxillary sinus. It is done when maxillary sinusitis is not cured by medication or other non-invasive technique. Introduced by George Caldwall and Henry Luc.

33. Balloon Sinuplasty Balloon catheter inserted and inflates. It expands the openings of sinuses in a less invasive manner .

34. Functional Endoscopic Sinus Surgery Recent advance in treatment of chronic sinusitis Removing pathological and anatomical obstruction that causes sinusitis. It allows a targeted approach to affected sinuses

35. Nursing Management Advice the client to use steam inhalation to promote drainage Increase fluid intake Apply moist heat by warm, wet towel against face .this will relieve sinus pressure and help open sinus passages.

36. Prevention Keep the nose as moist as possible with frequent use of saline sprays. Avoid upper respiratory tract infections Minimize contact with people who have colds Avoid exposure to irritants such as cigarette smoke

37. Thank you