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SINUSITIS

Nabila Natasya
Ni Nyoman Fitria Octaviani
IGA Bella Jayaningrum
Kogeela

Introduction

SIGN AND
SYMPTOMS

SIGN AND SYMPTOMS

(UMHS Rhinosinusitis Guideline August 2011)

SIGN AND SYMPTOMS


5 best predictor for sinusitis (William et al, 1992)
1.
2.
3.
4.
5.

maxillary toothache
purulent secretion by examination
poor response to decongestants
abnormal transillumination
history of colored nasal discharge.

SIGN AND SYMPTOMS

If the symptoms are persist after an appropriate


treatment or recurrent, a limited CT scan may be
helped.

The first picture show the normal paranasal sinuses. The cavities are clear and no sign of mucus edema in the cavities. The second picture show the
The first
picture
show
the
normal
paranasal
Thearecavities
are clear and no sign of
paranasal
sinuses
of ethimoid
sinusitis
patient.
We can see
the cavity ofsinuses.
ethimoid sinuses
filled wih mucus.

mucus edema in the cavities. The second picture show the paranasal sinuses of ethimoid
sinusitis patient. We can see the cavity of ethimoid sinuses are filled wih mucus.

Table 2. Interpretation of CT-Scan Report Regarding Sinusitis


Red Flags*

Abnormal

Unilateral disease

Sinus opafication

Sinus expansion

Air fluid level


(>minimal)

Bone erosion

Marked mucosal
thickening
Polyps

* Indicate need for immediate refferal

Not Generally
Concerning
Retention cyst
Concha bullosa and
other anatomic
varians
Minimal mucosal
thickening

SIGN AND SYMPTOMS


The Centers for Disease Control and
Prevention recommends reserving the
diagnosis of Acute Bacterial Rhinosinusitis for
patients with:
1. Symptoms lasting at least 7 days and
2. Purulent nasal secretions and
3. 1 of the following: Maxillary pain,
tenderness in the face (especially
unilateral), tenderness of the teeth
(especially unilateral)

TREATMENT AND
MANAGEMENT

TREATMENT &
MANAGEMENT

SELF-HELP
STEPS
MEDICINES

SURGERY

TREATMENT &
MANAGEMENT
SELF-HELP STEPS

Rest
Drink warm fluids
Boost humidity
Gargle
Rinse your nose by the saltwater sprays
or nasal irrigation kits
Use over-the-counter remedies
cautiously

TREATMENT &
MANAGEMENT
MEDICINES

Antibiotics ()
sinus infections
caused by viral infection, not a bacterial one
and antibiotics dont work against viruses.
Amoxicillin ()
if the sinusitis do not
resolve within 10 days.
Intranasal corticosteroids () for
uncormined acute sinusitis.

TREATMENT &
MANAGEMENT
SURGERY

For chronic or recurring sinusitis,


referral to an otolaryngologist specialist
may be indicated, and treatment options
may include nasal surgery.
Surgery should only be considered
for those patients who do not experience
sufficient relief from optimal medication.

SUMMARY

There are two types of rhinosinusitis, they are acute


rhinosinusitis and chronic rhinosinusitis
Infection of sinus is caused by some agent such as
bacterial, fungi and viral. Viral rhinosinusitis is far
more common than bacterial sinusitis.
Acute Rhinosinusitis (ARS) is the initiation of an
inflamatory responses due to bacterial infection,
while Chronic Rhinosinusitis is more multifactorial
(systemic host factors, local host factor, and
environmental factors).
Chronic sinusitis and acute sinusitis have similar
signs and symptoms, but acute sinusitis is a
temporary infection of the sinuses often associated
with a cold.

There are several ways to treat and manage sinus


infection, such as : several self-help steps may
bring some relief (by taking some rest, drinking
warm fluids, boosting humidity, gargling, rinsing
nose, and using over the counter remedies
cautiously), medicines (antibiotics and/or
corticosteroids), and surgery.
The complication of rhinosinusitis is infection that
can be occured in bone (bone errosion), brain, eye
socket, and visual problem (blurred vision,
proptosis, headaches). Rhinosinusitis can also
induce orbital complication. This implication can
be divided into five group: Group I. Group II,
Group III, Group IV, and Group V.

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