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Rhinosinusitis

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Rhinosinusitis Dr. Abdullah S. Al ... stress, foods and chronic health conditions. ... Bacterial (H.Influenza, Strep Pneumonia) Fungal Other ( Allergies, Tumor, ... – PowerPoint PPT presentation

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Title: Rhinosinusitis


1
Rhinosinusitis
  • Dr. Abdullah S. Al Yousef

2
Allergic Rhinitis
  • Definition
  • An inflammatory disorder of the nose which occurs
    when the membranes lining the nose become
    sensitized to allergens
  • -Sensitization to an allergen results in the
    production of immunoglobulin (Ig) E which is
    specific to that allergen. This IgE binds to the
    surface of mast cells in the lining of the nose.
  • -Re-exposure to the allergen results in allergen
    binding to IgE on the surface of mast cells. This
    triggers the release of histamine and other
    inflammatory mediators from the mast cells.
  • -Histamine and other inflammatory mediators act
    on cells, nerve endings, and blood vessels to
    produce symptoms.

3
Types
  • Allergic rhinitis may be categorized into
  • Seasonal allergic rhinitis/hay fever this occurs
    at certain times of the year. When due to tree
    pollen or grass it is known as hay fever. Other
    allergens include mould spores and weeds.
  • Perennial rhinitis ( persistent) this occurs
    throughout the year. Allergens commonly include
    house dust mites and domestic pets.

4
Symptoms
  • Itchy nose, mouth, eyes, throat, skin, or any
    area
  • Problems with smell
  • Runny nose
  • Sneezing
  • Tearing eyes

5
  • Symptoms that may develop later include
  • Stuffy nose (nasal congestion)
  • Coughing
  • Clogged ears and decreased sense of smell
  • Sore throat
  • Puffiness under the eyes
  • Fatigue and irritability
  • Headache
  • Memory problems and slowed thinking

6
Signs
  • Nasal signs
  • Transverse nasal crease (allergic crease)
  • A black transverse line across the middle of nose
  • Occurs due to constant rubbing of the nose in the
    upward direction resembling a salute allergic
    salute
  • Swollen turbinates
  • Pale, oedematous, bluish nasal mucosa
  • Thin watery discharge

7
Allergic Crease
8
  • Otologic signs
  • Retraction of tympanic membrane and serous otitis
    media due to eustachian tube dysfunction

9
  • Pharyngeal signs
  • Granular pharyngitis due to hyperplasia of
    submucosal lymphoid tissue
  • Laryngeal signs
  • Hoarseness of voice
  • Oedema of vocal cords

10
Diagnosis
  • History ( Symptoms, Past History, Drugs, Family
    History )
  • Examination
  • -Nose, for swollen nasal mucous membranes and
    structural defects.
  • -Ears, for fluid in the middle ear and the
    appearance of the eardrum.
  • -Sinus areas, for tenderness and signs of
    infection.
  • -Mouth, to see whether you have changes from
    breathing only through your mouth.
  • -Back of throat, for signs of postnasal drip or
    infection, such as red, raised, bumpy tissue.
  • Allergy Testing (Skin Prick Test, Blood Test)

11
Complications
  • Sinusitis
  • Otitis Media
  • Asthma
  • URTI
  • Nasal Polyps

12
Treatment
  • Education (Avoidance, Salt Water Solution)
  • Mild Antihistamines, Decongestants
  • - Antihistamines, Decongestants, Nasal
    corticosteroids
  • Severe Injected Corticosteroids, Immunotherapy
    (Allergy Shots)

13
Vasomotor Rhinitis
  • Non Allergic
  • Causes may include odors, medication, changes in
    the weather, stress, foods and chronic health
    conditions.

14
Pathophysiology
  • Nonallergic rhinitis occurs when blood vessels in
    your nose expand (dilate), filling the nasal
    lining with blood and fluid.

15
Symptoms
  • Stuffy nose
  • Runny nose
  • Mucus in the throat (postnasal drip)

16
Diagnosis
  • Diagnosed by ruling out other causes of allergy.
  • -Skin Test and Blood Test.

17
Complications
  • Nasal polyps
  • Chronic sinusitis.
  • Middle ear infections.

18
Treatment
  • Avoidance
  • Saline nasal sprays, Corticosteroid nasal sprays,
    Antihistamine nasal sprays, Anticholinergic nasal
    sprays, Oral decongestants , Decongestant nasal
    sprays

19
Acute Suppurative Rhinitis
  • Definition
  • Acute sinusitis (acute rhinosinusitis) causes the
    cavities around your nasal passages (sinuses) to
    become inflamed and swollen. This interferes with
    drainage and causes mucus to build up.

20
Pathogenesis
  • Viral (Rhinovirus)
  • Bacterial (H.Influenza, Strep Pneumonia)
  • Fungal
  • Other ( Allergies, Tumor, Deviated Nasal Septum )

21
Symptoms
  • Yellow or green discharge
  • Nasal congestion
  • Pain, tenderness, swelling and pressure around
    your eyes, cheeks, nose or forehead
  • Aching in your upper jaw and teeth
  • Reduced sense of smell and taste
  • Cough, which may be worse at night

22
Non-specific symptoms
  • Ear pain
  • Headache
  • Sore throat
  • Bad breath (halitosis)
  • Fatigue
  • Fever

23
Diagnosis
  • Nasal endoscopy
  • Imaging studies (CT,MRI)
  • Nasal and sinus cultures
  • Allergy testing

24
Complications
  • Asthma flare ups
  • Chronic sinusitis
  • Meningitis
  • Vision problems
  • Ear infection

25
Treatment
  • Saline nasal spray
  • Nasal corticosteroids
  • Decongestants
  • Pain relievers
  • -Antibiotic treatment is generally needed only if
    you have a bacterial infection, especially if the
    infection is severe, recurrent or persistent

26
  • Thank you
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