《耳鼻喉科学 Otolaryngology》课程教学课件（PPT讲稿）nose_6 actue and chronic sinusitis

Acute sinusitis

Acute sinusitis

Anatomy of the noseturbinate(meatus):superior,middle,inferiorSinus:maxillary,frontal,ethmoidal,sphenoid一膜沟中鼻甲R中鼻道中一鼻中隔下鼻甲一总鼻道下鼻道

Anatomy of the nose ➢ turbinate(meatus):superior,middle,inferior ➢ Sinus:maxillary,frontal,ethmoidal,sphenoid

paranasal sinusesThey are air-containing cavitiesin certain bones of skullfour pairs of paranasal sinuses

paranasal sinuses They are air-containing cavities in certain bones of skull four pairs of paranasal sinuses

Anterior group of sinuses: frontal sinuses,anteriorethmoid group sinuses,and the maxillary sinuses.theiropenings are situated in the middle meatus.Posterior group of sinuses: posterior ethmoid groupsinuses,which opens in the supeior meatus andsphenoid sinus,which opens in the sphenoethmoidrecess

Anterior group of sinuses: frontal sinuses,anterior ethmoid group sinuses,and the maxillary sinuses.their openings are situated in the middle meatus. Posterior group of sinuses: posterior ethmoid group sinuses,which opens in the supeior meatus and sphenoid sinus,which opens in the sphenoethmoid recess

Characteristic of paranasal sinusesSmall ostiumsMucous membrane is continuouswiththe nasal mucous membrane>Ostiums are adjacent to each otherEachparanasalsinuseshasitscharacteristic

Characteristic of paranasal sinuses ➢ Small ostiums ➢ Mucous membrane is continuous with the nasal mucous membrane ➢ Ostiums are adjacent to each other ➢ Each paranasal sinuses has its characteristic

蒂板游冠Lamine cribrosaCrista galli佛小房Cellulae ethmoidalesOrbita主泰甲Concha nasalis superior.垂直板Lamina perpendicularis上界滩Meatus nasisuperior.钩突Processus uncinatus中鼻甲Concha nasalis media中鼻范Meatus nasi medius上领家Sinus maxillaris下象甲下鼻道Concha nasalis inferiorMeatus nasi inferior车性康仔VomerMaxilla31颜骨冠状切的后面观（示筛小房）Posterior aspect of coronal section of the skull.Showing the ethmoidal cellule

3Frontal SinusEthmoid SinusMaxillary Sinus

Frontal Sinus Ethmoid Sinus Maxillary Sinus

Acute sinusitis definitionAcuteinflammationof sinusmucosaiscalled acute sinusitis.The sinus mostcommonlyinvolvedis the maxillaryfollowedinturnby ethmoid,frontal andsphenoid.Very often,more than onesinus is infected (multisinusitis).Sometimes,all the sinuses of one orbothsides are involved simultaneoudly(pansinusitisuniltateralorbilateral)

Acute sinusitis definition • Acute inflammation of sinus mucosa is called acute sinusitis. The sinus most commonly involved is the maxillary followed in turn by ethmoid , frontal and sphenoid. Very often , more than one sinus is infected (multisinusitis). Sometimes, all the sinuses of one or both sides are involved simultaneoudly (pansinusitis uniltateral or bilateral)

Three types of infectionBacterial.Viral? fungal

Three types of infection • Bacterial • Viral • fungal

Etiological factorof adult acute bacterial rhinosinusitisStaphylococcusaureusOtherbacteria0-8%4%Anaerobes0-9%S.pneumoniaeOtherstreptococci3-9%20-43%2-10%Moraxellacatarrhalis22-35%H.influenzaeSAHP.OtolaryngolHeadNeckSurg.2004130:1-45

SAHP. Otolaryngol Head Neck Surg.2004;130:1-45. 20-43% 22-35% Anaerobes 0-9% Staphylococcus aureus 0-8% Other bacteria 4% Moraxella catarrhalis Other streptococci 3-9% 2-10% S. pneumoniae Etiological factor of adult acute bacterial rhinosinusitis H. influenzae