18 Anatomy of the nose-and what are sinuses for anyway 19 ACUTE SINUSITIS Contd
How would you treat acutely
Menthol and steam inhalation
over 80 viral
The art of medicine consists in amusing the patient while nature cures the disease.
but not always
Antibiotics aerobic and anaerobic cover
20 Revenge of Lotta Snotty
Develops unilateral pain swelling redness round her right eye
Diplopia proptosis blurred vision
So.if symptoms severe/systemic/not resolving after about 10d consider antibiotics
Cover H flu strep pneumoniae
osteomyelitis (Potts Puffy Tumour)
cavernous sinus thrombosis
If chronic (over 3w) also need to cover anaerobes G neg staph also fungal
22 CHRONIC SINUSITIS
When should you refer for recurrent sinusitis
Failure of medical therapy
One-sided blood stained nasal discharge
23 Lotta Snotty Uncut
Back from uni returns complaining of chronically blocked nose
Rhinitis asthma persist
24 NASAL BLOCKAGE
3) Nasal collapse
4) Nasopharyngeal obstruction
URTI (infective rhinitis)
25 THINGS YOU MAY SEE ON NOSE EXAM
What can you see
How do you tell the difference between the two
Turbinates look pink
PainFULL if prodded
Polyps look grey
Polyps are painLESS
26 Bride of Lotta Snotty
So Lotta was cured and lived happily ever after except she married a man with obstructive sleep apnoea who fell asleep at traffic lights but thats another story.
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