Rhinosinusitis

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Sinusitis

• Sinusitis affects 31 million Americans annually.• Chronic sinusitis is defined as unrelenting

symptoms >12 weeks in duration.

Major Symptoms

Nasal / Post-nasal drainage*Facial pain / pressure*Nasal obstruction / congestion*Hyposmia / anosmiaCough not due to asthma(in children)

*most common symptoms

Minor Symptoms

FeverCoughFatigueMaxillary dental painEar fullness/pressureHeadache

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Sinus Anatomy

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Ethmoid sinusSuperior turbinate

Middle turbinate Inferior turbinate Maxillary sinus

Frontal sinus

Maxillary sinus opening

Sinus AnatomySphenoid sinus

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Sinus Evaluation

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Causes of Sinusitis

• Wide spectrum of responsible causes– Allergy– Immunology– Bacteria– Fungus– Polyps– Anatomic blockage

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Treatment of Sinusitis

• Treat underlying causes– Allergy

• allergy testing• Antihistamine (Claritin, Zyrtec, Allegra)• Nasal steroid spray (Flonase, Nasocort, Rhinocort)• Immunotherapy

– Inflammation• Oral steroids

– Infection• Antibiotics

Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri

Nasal Saline Irrigation

• Moisturizes the nasal passage

• Improves the functioning of nasal and sinus lining

• Helps wash and remove inhaled allergens and irritants

Indications for Surgery

• Chronic sinusitis, >12 weeks duration– Symptomatic– Unresponsive to medical therapy

• Recurrent acute sinusitis?• Sinus tumors/masses/polyps• GOAL: to relieve blockage of sinuses to

establish better drainage. • Medical treatment, especially for allergies,

may still be required after surgery.Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck Surgery

University of MissouriUniversity of Missouri

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Department of Otolaryngology—Head and Neck SurgeryDepartment of Otolaryngology—Head and Neck SurgeryUniversity of MissouriUniversity of Missouri