Transcript COMPLICATIONS OF SINUSITIS

Complications of sinusitis
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Orbital
Osteomyelitis of Maxilla and Frontal bone
Mucocele
Locoregional complications
 Pharyngitis, laryngitis, otitis media
Intracranial complications
 Meningitis, intracranial abscess, cavernous
sinus thrombosis
Orbital Complications
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Orbital cellulitis
Orbital abscess
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Mode of Spread
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Presentation
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Direct
Thrombophlebitis of vessels
Aching around the orbit
Edema of conjunctiva
Proptosis- later
Blindness
Treatment- IV Abs and Nasal decongestants
Orbital Complications
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Abscess
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Direct spread
Proptosis
 Restriction of eye movements
 Blindness
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Loss of red color vision before other colors and visual
cauity
CT scan
Treatment
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Urgent drainage
Osteomyelitis
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Occurs where there is diploic bone
Maxailla in children and Frontal in adults
Maxilla
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Painful swelling of the cheek and lower eye lid
CT
Treatment
IV ABs and debridement
Osteomyelitis….
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Frontal Bone
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Dangerous and more extensive.
Dull local pain and swelling of the upper eye
lid.
Potts puffy tumor
High risk if intracranial complications
Treatment
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IV ABs and debridement
Mucocele
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Frontal, Ethmoid, Maxillary, Sphenoid
Due to permanent blockage of the drainage
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Presentation
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collection of sterile mucous, gradually expands and
causes erosion of sinus walls from pressure
Headache and swelling
Displacement of the eye ball
Treatment
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Endoscopic vs open techniques for drainage
Open techniques
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Frontoethmoidectomy
Osteoplastic flap operation
Locoregional Complications
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Generalized Pharyngitis
Granular Pharyngitis
Tonsillitis
Laryngitis
Otiis medias
Intracranial complications
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Complications arise form
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Mode of Spread
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Direct
Retrograde thrombophlebitis
Meningitis- commonest
Intracranial abscess
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Frontal
Etmoid
Sphenoid
Extradural
Subdural
Cerebral
Encephalitis
Cavernous sinus thrombophlebitis
Intracranial complications
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Meningitis
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Cavernous Sinus Thrombophlebitis
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LP and C/S
IV Abs
High fever with chills and rigors
Edema of conjunctiva
Proptosis
Ophthalmoplegia
Blindness
Reduced level of conciousness
Death
CT/MRI
High index of suspician
IV Abs
Intracranial Abscesses
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Surgical intervention by neurosurgeon