General Thermography
James Stewart Campbell, M. Nathaniel Mead in Human Medical Thermography, 2023
Sinusitis is an inflammation of the mucosa of one or more of the paranasal sinuses. Acute sinusitis lasts up to four weeks and is almost always of viral or allergic origin; it may develop into chronic bacterial sinusitis, which typically lasts at least 12 consecutive weeks and may persist for years. The disease progresses in the following manner: The ostium of the sinus becomes obstructed from mucosal swelling due to a virus or allergy. The air within the sinus is then absorbed by the mucosal surface, creating a painful negative pressure in the sinus. If the ostium is not reopened, a transudate fluid begins to fill the cavity, providing a medium for bacterial growth. The bacteria attract an exudate of white blood cells and serum, which creates a painful (and dangerous) positive pressure within the sinus.72 Bacterial sinusitis is not a benign disease. Serious complications may arise such as periorbital infections, meningitis, and brain abscess.73
Head and neck
David A Lisle in Imaging for Students, 2012
Chronic sinusitis is defined as sinus inflammation of over 12 weeks’ duration. Clinical presentation may include facial pain, nasal obstruction and reduced sense of smell. Chronic sinusitis may be bacterial, allergic or fungal. Functional endoscopic sinus surgery (FESS) is used to treat cases that do not respond to medical therapy. Imaging is performed to quantitate disease and to define relevant underlying anatomical anomalies that may restrict sinus drainage, as well as to assist in presurgical planning and postoperative follow-up. CT is the investigation of choice. The key images in assessing chronic sinusitis and planning FESS are coronal CT scans of the osteomeatal unit, i.e. the region of the drainage pathways of the maxillary, frontal and anterior ethmoid sinuses (Fig. 11.8).
Otolaryngology
Philip Stather, Helen Cheshire in Cases for Surgical Finals, 2012
A 37-year-old female presents to her GP, complaining of a frontal headache, which is made worse on leaning forwards. A diagnosis of sinusitis is suspected. State four functions of the paranasal sinuses. (4 marks)Describe three clinical features of sinusitis, other than pain and headache. (3 marks)On viewing her medical records, you realise that this patient has previously presented with episodes of sinusitis in the past and you wish to investigate further in view of her recurrence. State two ways you could do this. (2 marks)Further investigation reveals no structural abnormality.Name two treatment options for this patient. (2 marks)
Presentation and Management of Life-threatening Lesion in Left Orbit Complicated by Granulomatosis with Polyangiitis
Published in Ocular Immunology and Inflammation, 2022
Iyad Majid, James B. Martel, Brandon Martel, Melanie Martel
The patient’s longstanding GPA complicated the handling and treatment of the orbital lesion and sinusitis. Typically, when a patient is presented with sinusitis, they are administered antibiotics to combat the infection. However, in this case scenario, antibiotics may treat the infection but do not play a role in GPA therapy. Steroids are in turn used to treat GPA, but the anti-inflammatory drug can make the sinus infection more severe. As a result, the choice of antibiotics administered were carefully selected. In addition, the patient’s autoimmune disorder damaged the structure of his left frontal sinus and eroded his orbital wall, granting access for the sinusitis to spread into the orbital cavity and infect tissues and muscles. The sinus and orbital defect also left the patient vulnerable to recurrences of spread of infection and prone to sinusitis relapses. The patient was fortunate enough the infection did not spread far deep into his sinuses and reach the brain, or cause any permanent vision loss and eye damage.
Orbital schwannoma management: a case report, literature review, and potential paradigm shift
Published in Orbit, 2022
Jennifer Lopez, Eric B. Hamill, Michael Burnstine
When orbital schwannomas involve the orbital apex and cause compressive optic neuropathies, surgical decompression may be considered. Given many important structures encompass the orbital apex, traditional surgical approaches may risk injury to these structures in addition to risk of injury to the brain and cavernous sinus.36 Because of this, endoscopic or external decompression can be done in an attempt to avoid injuries during total resection that could affect one’s visual acuity or extraocular movements.37 While the literature is limited and there are no current guidelines for when orbital decompression should be pursued over total surgical resection, two groups have published studies showing surgical decompression is a viable option for these benign tumors.36,37 Almond et al found of the five patients who underwent endonasal endoscopic decompression, four had improvement or stabilization of their vision. One experienced worsening visual loss, though this was secondary to insufficient decompression and interval increase in the size of the tumor on imaging. Complications included diplopia and sinusitis.37 Kloek et al. found that all five patients who underwent transnasal endoscopic orbital decompression had improved visual acuity postoperatively. One subject required further orbital decompression due to compressive optic neuropathy 4 years after undergoing the first one.36 Complications of endoscopic orbital decompression include ptosis and diplopia.36
Impact of sinus surgery on type 2 airway and systemic inflammation in asthma
Published in Journal of Asthma, 2021
Kazuki Hamada, Keiji Oishi, Ayumi Chikumoto, Keita Murakawa, Yuichi Ohteru, Kazuki Matsuda, Sho Uehara, Ryo Suetake, Shuichiro Ohata, Yoriyuki Murata, Yoshikazu Yamaji, Maki Asami-Noyama, Kosuke Ito, Nobutaka Edakuni, Tsunahiko Hirano, Kazuto Matsunaga
There are several limitations to our study. First, the sample size was small and further studies in larger samples might be required to strengthen our result. Second, many details of the underlying cytokine network in the upper and lower airway remain unknown, and we did not measure the serum and sputum concentrations of type 2 cytokines such as IL-4, IL-5, and IL-13. Third, we measured serum IgE only at baseline, and our study did not measure serum IgE in the same period of the year. Therefore, it cannot be denied that seasonal variation of serum IgE affected our results. Further immunological and pathological studies are needed to clarify the underlying pathophysiology of CRSwNP and asthma in detail. Forth, our study had no control groups of CRSwNP subjects without asthma, since asthma patients with CRSwNP were enrolled for treatment to improve nasal, and this was a purely observational study. However, it was difficult to compare CRSwNP patients with and without asthma, because CRSwNP is frequently associated with asthma. Finally, our study did not evaluate the number of asthma exacerbations and the CRS clinical parameters such as the 22-item Sino-Nasal Outcome Test (SNOT-22) and Lund-Mackay score and did not evaluate whether nasal polyps relapsed after ESS. Management of severe asthma with sinusitis is an unresolved issue and further studies are needed in this field.
Related Knowledge Centers
- Fever
- Hyposmia
- Inflammation
- Nasal Mucosa
- Orofacial Pain
- Paranasal Sinuses
- Sore Throat
- Headache
- Nasal Congestion
- Phlegm