Complications of sinusitis

1
Complications of sinusitis

• Orbital
• Osteomyelitis of Maxilla and Frontal bone
• Mucocele
• Locoregional complications
• Pharyngitis, laryngitis, otitis media
• Intracranial complications
• Meningitis, intracranial abscess, cavernous sinus
  thrombosis

2
Orbital Complications

• Orbital cellulitis
• Orbital abscess
• Mode of Spread
• Direct
• Thrombophlebitis of vessels
• Presentation
• Aching around the orbit
• Edema of conjunctiva
• Proptosis- later
• Blindness
• Treatment- IV Abs and Nasal decongestants

3
Orbital Complications

• Abscess
• Direct spread
• Proptosis
• Restriction of eye movements
• Blindness
• Loss of red color vision before other colors and
  visual cauity
• CT scan
• Treatment
• Urgent drainage

4
Osteomyelitis

• Occurs where there is diploic bone
• Maxailla in children and Frontal in adults
• Maxilla
• Painful swelling of the cheek and lower eye lid
• CT
• Treatment
• IV ABs and debridement

5
Osteomyelitis.

• Frontal Bone
• Dangerous and more extensive.
• Dull local pain and swelling of the upper eye
  lid.
• Potts puffy tumor
• High risk if intracranial complications
• Treatment
• IV ABs and debridement

6
Mucocele

• Frontal, Ethmoid, Maxillary, Sphenoid
• Due to permanent blockage of the drainage
• collection of sterile mucous, gradually expands
  and causes erosion of sinus walls from pressure
• Presentation
• Headache and swelling
• Displacement of the eye ball
• Treatment
• Endoscopic vs open techniques for drainage
• Open techniques
• Frontoethmoidectomy
• Osteoplastic flap operation

7
Locoregional Complications

• Generalized Pharyngitis
• Granular Pharyngitis
• Tonsillitis
• Laryngitis
• Otiis medias

8
Intracranial complications

• Complications arise form
• Frontal
• Etmoid
• Sphenoid
• Mode of Spread
• Direct
• Retrograde thrombophlebitis
• Meningitis- commonest
• Intracranial abscess
• Extradural
• Subdural
• Cerebral
• Encephalitis
• Cavernous sinus thrombophlebitis

9
Intracranial complications

• Meningitis
• LP and C/S
• IV Abs
• Cavernous Sinus Thrombophlebitis
• 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
• Surgical intervention by neurosurgeon