FESSDRRAJINI

RHINOSINISITIS
THE TERM RHINOSINUSITIS MEANS INFLAMATION OF CONTIGUOS TISSUES OF UPPER RESPIRATORY TRACT ,WHERE THE EFFECT OF NASAL MUCOSA ALSO AFFECTS THE ADJACENT SINUS TISSUES.
THE MUCOUS MEMBRANE OF NOSE AND SINUS CAVITIES CONTIGUOS AND SUBJECT TO THE SAME DISEASE PROCESS,THEREFORE RHINOSINUSITIS IS A MORE ACCURATE TERM FOR WHAT IS TERMED AS SINUSITIS SINUSITIS WITHOUT RHINITIS IS RARE.

RHINOSINUSITIS IS DIVIDED IN IN TO 4 SUB TYPES
1 ACUTE
2 RECURRENT ACUTE
3 SUB ACUTE
4 CHRONIC

ACUTE RHINOSINUSITIS

INFLAMATION OR INFECTION OF MUCOSA OF NASAL PASSAGES ATLEAST ONE OF THE PARANASAL SINUS.IT IS CAUSED BY VIRUS WITH OR WITHOUT BACTERIAL CO INFECTION.THE ONSET IS RAPID OCCURS WITH IN 5 TO 7 DAYS AND PATIENT RECOVERY WITH OR WITHOUT MEDICATION.
RECURRENT ACUTE RHINOSINUSITIS IS DEFINED AS 4 OR MORE EPISODES OF ACUTE DISEASE WITH IN 12 MONTHS PERIOD

SUB ACUTE RHINOSINUSITIS
IT IS BASICALLY A LOW GRADE CONTINUOUS INFECTION OF MORE THAN 4 WEEKS BUT LESS THAN 12 WEEKS DURATION.

CHRONIC RHINOSINUSITIS
IT IS SUB ACUTE INFECTION SPREAD OUT SIDE THE SINUSES TO ORBITAL AREA OR TO MENINGES THE SYMPTOMS PERSISTS FOR 12 WEEKS OR MORE
CAUSES OF RHINOSINUSITIS
AIR POLLUTION,ESPECIALLY TOBACCO SMOKE ,NASAL POLYPS,ALLERGY ,ASTHMA.
SINUS OSTIA OBSTRUCTION
MEDICATION SIDE EFFECTS (USE OF TOPIC NASAL VASO CONSTRICTOR DRUGS)
IMMUNO DOFFICIENCY OR MUCO CILITARY DYSFUNCTION
SYMPTOMS
MAJOR SYMPTOMS
1 FACIAL PAIN SWEELING
2 NASAL BLOCK
3POST NASAL DISCHARGE
4 LOSS OF SMELL
5 FEVER (ACUTE CASES ONLY0

MINOR SYMPTOMS
1 HEAD ACHE
2 FEVER
3 BAD BREATH
4 TIREDNESS
5 DENTAL PAIN
6 PERSISTENT COUGH
7 EAR PAIN OR PRESURE
COMPLICATION
SIGNS AND SYMPTOMS WORSEN AND MAY LEAD TO INTRACRANIAL OR INTRA ORBITAL EXTENSION OF INFECTION PATIENT THEN PERSISTENT WITH DOUBLE VISION
PROTRUTION OF EYE BALL
ORBITAL MOVEMENT ABNORMALITES
SEVERE HEADACHE
MENINGEAL SIGNS
ALTERED MENTAL STATUS
HIGH FEVER

DIAGNOSIS
CLINICAL EXAMINATION
NASAL ENDOSCOPY FOR STRUCTURAL ALTERNATIVE OF NASAL CAVITY
XRAY PARA NASAL SINUS
CT SCAN FOR DELINEATING OSTEOMEATUS COMPLEX DISEASE ,POLYPOSIS,ETC IT IS GOLD STANDARD FOR THE SINUS DISEASE.
MRI
MRI IS OVERLY SENSITIVE TO TRABIENT MUCOSAL CHANGAES
LAB STUDIES
TO DETERMINE SUSPECTED ALLERGIES IMMUNE DEFICIENCES ETC

BACTERIAL CULTURE AND SENSITIVE OF THE PUS FROM NASAL CAVITY

MANAGEMENT
1 TO CONTROL INFECTION
2 TO DIMINISH TISSUE ODEMA
TO REVERS SINUS OSTEAL OBSTRUCTION IMMEDIATELY
1.PAIN MANAGEMENT
2 ANTIBIOTIC THERAPY
3 SPEACIAL ATTENTION GIVEN TO DISEASE WHICH IMPEDE NORMAL RECOVERY LIKE DIABETES ,ASTHMA ,IMMUNE DEFICIENCY,CHRONIC OBSTRUCTIVE PULMONARY DISEASE

SURGERY
IF MEDICAL TREATMENT FAILS INFECTION,DECISION IS EMPIRICAL AND ALSO TREATMENT CHOICE DEPENDS ON THE DIAGNOSIS AND TYPE OF RHINOSINUSITIS ,WHETHER MEDICAL OR SURGICAL MANAGEMENT DEPENDS AND DIFFERS FROM PATIENT TO PATIENT.

Labels: RHINOSINUSITIS