CRS 1 ppt, Dr Javed Shah FRCS Bannu Medical College

RHINOSINUSITIS: 

RHINOSINUSITIS DefiNITION Inflammation of nose and sinuses symptoms nasal blockage/congestion/nasal discharge Plus 1/facial pain/pressure 2/reduction/loss of smell. symptoms last for more than 12 weeks.

PowerPoint Presentation: 

Symptoms of sinusitis lasting for more than 12 weeks with irreversible damage to sinuses mucosa.

Chronic Rhinosinusitis Definition (clinical): : 

Chronic Rhinosinusitis Definition (clinical): Inflammatory response involving the following: mucous membranes, nasal cavity and paranasal sinuses. Fluid within the cavities and/or underlying bones. Symptomatic: nasal obstruction, congestion, discharge, purulent, postnasal drip, facial pressure and pain. Duration: 12 weeks Positive physical signs of nose and face. Ancillary studies: radiology.

Rhinosinusitis Classification: 

Rhinosinusitis Classification .1/Acute RS:Viral,Bacterial 2/ CRS ,polypoid ,glandular 3/ Fungal

PowerPoint Presentation: 

CRS with polyps. Definition; some patients with crs develop polyps with tendency to recur. symptoms and signs: Treatment, conservative ,steroids. surgery, FESS, Microdebrider.

PowerPoint Presentation: 

Sinus health depends on 1/ Mucous secretion of Normal viscosity,volume and composition, 2/Normal mucocilliary flow to prevent stasis, 3/ open sinus ostia to allow adequate drainage.

Pathology: 

Pathology 1/ edema/inflammation/allergy. 2/epithelial hyperplasia 3/squamous metaplasia 4/increases goblet cells 5/cellular damage 6/subepithelial fibrosis 7/polyposis.

PowerPoint Presentation: 

What is your diagnosis. Discuss Management.

Management: 

Management History: Examination Investigation: skin prick test. RAST.Blood Radiology, Plain Xray PNS, CT Scan.

PowerPoint Presentation: 

Contd) Treatment: Conservative Normal saline douches Steroids : Nasal spray locally , oral steroids. Antibiotics: Amoxacilline+clavulonate 500/125 mg,Ciprofloxacin, Clayrithromycin. Local decongestants.

PowerPoint Presentation: 

Surgery: Maxillary sinus: Antral washout; Caldwell luc operation.

PowerPoint Presentation: 

Ethmoids 1/ Intra nasal ethmoidectomy. 2/External ethmoidectomy FESS

PowerPoint Presentation: 

Frontal : i/ intranasal ethmoidectomy 2/ External Fronto ethmoidectomy Trephination Frontal sinus Osteoplastic flap Baloon Sinuplasty.

Case Study:: 

Case Study: Your patient is a 45 y.o. female with 3 episodes of acute sinusitis since last winter. Each time you treated with antibiotics with resolution of acute sx. However, she continues to c/o pressure “sinus” headache, nasal congestion, poor smell, and intermittent rhinorrhea.

PowerPoint Presentation: 

What is diagnosis Investigations Treatment options.