1. NORAFIDATUL ASNI BT ZAMANI
(2010663124)
NOORASHIKIN BT HAMIZAN (2010272762)
NUR IZZATI BT MD SUBI (2010294592)
NOOR SYAKILA BT NOORUL DIN
(2010833522)
HANISAH BT NASOHA (2010610654)

2.  Hollow spaces in the bone of our face and skull
 Connect with nose through small opening
 Like the nose, they are lined with membrane that
make mucus
 frontal sinuses ~ over eyes in brow area
 maxillary sinuses ~ inside each cheekbone
 ethmoid sinuses ~ just behind the bridge of the
nose & between the eyes
 sphenoid sinuses ~ behind the ethmoids in the
upper region of the nose and
behind the eyes

4.  Infection or inflammation of one or more of the
paranasal sinuses
 Sinusitis is usually preceded by a cold, allergy
attack or irritation from environmental
pollutants

5.  You can have sinusitis that lasts a long time called
chronic sinusitis.
 Short attacks that last for four weeks or less are
called acute sinusitis.
 Bacterial and viral acute sinusitis are difficult to
distinguish.
 However, if symptoms last less than 10 days, it is
generally considered viral sinusitis.
 When symptoms last more than 10 days, it is
considered bacterial sinusitis (usually 30% to 50%
are bacterial sinusitis)

7.  Fungi
 Bacteria
 Allergens

8.  Viruses
 Immune system problems
 Structural problems in the
nasal cavities

9.  Colds and Flu
 An irritation in the sinuses :-result of
extreme weather changes and poor
air quality (smoke, dust and other
air pollutants).
 Asthma sufferers:-more prone to this
condition

10. “Many people enjoy the fall season, when
the leaves start to change colors, but
others suffer from cold and flu-like
symptoms that they can't get rid of. When
your face still hurts, your nose is still
stuffy and you still have a cough weeks
later, you could have sinusitis”

11.  Sinuses are normally lined by
ciliated, pseudostratified
columnar
epithelium, interspread with
mucus-secreating cells.

12. Blockage of OMC
Mucusal congestion or anatomic
obstruction blocks airflow and drainage.
The secreations become stagnant and
thicken within the sinuse cavities.
Bacterial colonization and initiation of
mucusal gas metabolism exchange pH and lowered
oxygen tension
Normally cilia
Cilia damaged clean mucus and
air toward the
OMC ostia
Inflammation and bacterial infection
develop in the sinus cavity

13.  Sinusitis occurs because of a vicious cycle that
lead to further mucosal thickening and
edema, creating further blockage.

14.  Failure of normal mucus transport
 Mucosal edema
 Bacterial or viral infections
 Allergic rhinitis
 Dental infections
 Immunodeficiency states
 Nasal dryness
 Anatomic variations – deviated septum and
turbinate hypertrophy

18.  Nasal obstruction (most common symptom)
 Pain, tenderness, swelling and pressure over
sinus areas
(near the nose, above the teeth, the forehead)
 Purulent or non-purulent nasal drainage
 Either rhinorrhea or post-nasal drip
 Hyposmia/anosmia
 Facial congestion/fullness
 Fever

20.  Halitosis
 Cough, especially at night
 Sore throat (nasal drainage irritate the throat)
 Fatigue
 Malaise - feeling generally unwell
 Painful headache when wake up in the
morning and when bend the head down or
forward
 Aching in the upper jaw and teeth

21.  Also known as rhinosinusitis
 Lasting >12 weeks
 Includes two or more major symptoms
 Or at least one major and two minor symptoms
 With or without findings on physical examination

22.  X-ray : show fluid in the sinuses
 CT scan : the extent & severity of sinusitis
 Endoscopic rhinoscopy : evaluate the upper
nasal airway down to the level of vocal chords

24. Abscess
Osteo
Blood Clot myelitis
General
complicatio
n
Skin
infection meningiti
around s
the eye

25.  Asthma flare-ups. Acute sinusitis can trigger an asthma attack
 Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term
problem known as chronic sinusitis. Chronic sinusitis is sinusitis
that lasts longer than eight weeks.
 Meningitis. This occurs when infection spreads to the lining of the
brain.
 Vision problems. If infection spreads to your eye socket, it can
cause reduced vision or even blindness. This is a medical
emergency that requires immediate treatment to prevent
potentially permanent damage.
 Aneurysms or blood clots. Infection can cause problems in the
veins surrounding the sinuses, interfering with blood supply to
your brain and putting you at risk of a stroke.
 Ear infection. Acute sinusitis may occur along with an ear
infection.
http://melayuboleh.8forum.net/t350-acute-sinusitis

26.  Erosion of the thinning of the bone between the
brain and the sinuses or the eye and the sinuses
can occur if the infection is prolonged.
 Blocked sinuses form mucus and enlarged
become mucocoele (mucus filled cyst)
-headaches, double vision
 Sinus infection may spread bacteria into blood
stream and cause sepsis (systemic blood borne
infection)- make high fever and renal failure

27.  Keep your nose as moist as possible with frequent use of saline
sprays or washes.
 Avoid very dry indoor environments and use a humidifier, if
necessary. Be aware, however, that a humid environment also
may increase the amount of dust mite, or allergens in your home.
this is important only if you are allergic to any of those organisms.
 Avoid exposure to irritants such as cigarette and cigar smoke or
strong odors from chemicals.
 Avoid exposure to substances to which you are allergic.
 If you haven’t been tested for allergies and you are getting
frequent sinus infections, ask your healthcare professional to give
you an allergy evaluation or refer you to an allergy specialist.
 Avoid long periods of swimming in pools treated with
chlorine, which can irritate the lining of the nose and sinuses.
 Avoid water diving, which forces water into the sinuses from the
nasal passages.

29. TRANSILLUMINATION NASAL ENDOSCOPY FINE NEEDLE
(CAT SCAN) This is a narrow, flexible ASPIRATION BIOPSY
It is a diagnostic technique fiber-optic scope that is The sinus is aspirated, the
in which the combined use placed into the nasal cavity contents sent for culture
of a computer and x-rays through the nostrils. It and staining, and the sinus
are passed through the allows the doctor to view may be flushed with a
body at different where the sinuses and saline solution. This is
angles, producing middle ear drain into the technically the most
clear, cross-sectional images nose. accurate way to diagnose
of the nasal cavities. infectious sinusitis.

30. RHINOSCOPY CT OR MRI SCANS CHEST X-RAY
It is a procedure where They both are helpful in If nasal cavity or
the nostril is spread looking at cancers of the paranasal sinus cancer
open with a small bunt nasal cavities and has been
speculum and the nasal paranasal sinuses. MRI diagnosed, one of these
passages can be directly is better than CT in tests may be done to
examined with a distinguishing fluid find out whether the
headlight. This from tumor, and cancer has spread to the
examination gives sometimes they can lungs, which is the
limited view of the help the doctor tell the most common site of
interior of the nasal difference between a spread other than
cavity. benign tumor and a lymph nodes.
cancerous one.

31. CORTICOSTEROIDS
DECONGESTANTS
Reduce
ANTIBIOTICS Reduce the swelling ANALGESICS inflammation in the MUCOLYTICS
Kill bacteria. of the mucous Relieve pain. nasal passages. Thin mucus.
membranes in the
nose.
Examples: Examples: Examples: Example:
amoxicillin , acetaminophen beclomethasone guaifenesin
Examples:
(Tylenol), (Beconase), (Robitussin)
cefdinir Oxymetazoline
(Omnicef). Ibuprofen (Advil). mometasone
(Afrin),
(Nasonex).
Phenylephrine (Neo-
Synephrine).

32. ENDOSCOPIC SINUS SURGERY
This surgery removes anatomical and pathological obstructions associated with
sinusitis in order to restore normal clearance of the sinuses.
BALLOON SINUPLASTY
This method, similar to balloon angioplasty used to unclog arteries of the heart, utilizes
balloons in an attempt to expand the openings of the sinuses in a less invasive manner.
CALDWELL-LUC RADICAL ANTROSTOMY
This surgery involves an incision in the upper gum, opening in the anterior wall of the
antrum, removal of the entire diseased maxillary sinus mucosa and drainage is allowed into
inferior or middle meatus by creating a large window in the lateral nasal wall.

33. NEBULISATION
LASER
MASSAGE
THERAPY
PHYSIOTHERAPY
MANAGEMENT
SHORTWAVE THERAPEUTIC
DIATHEMY ULTRASOUND
RHINOFLOW
THERAPY

35. THANK YOU….
for being so attentive.

36.  Tichenor, W. S. (2007). Sinusitis for Physicians.
Sinusitis: A Treatment Plan That Works. Retrieved
from http://www.sinuses.com/md.html
 Jacewicz, M. (2008). Sinusitis. The Merck Maual
Home Healthn Handbook. Retrieved from
http://www.merckmanuals.com/home/ear_nose
_and_throat_disorders/nose_sinus_and_taste_diso
rders/sinusitis.html
 Torpy, J. M. (2009). Acute Sinusitis. The Journal of
the American Medical Association, (301)17. Retrieved
from http://jama.ama-assn.org/