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IN THE NAME OF ALLAH, THE MOST BENEFICENT, THE
MOST MERCIFUL
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CoryzaAcute Rhinosinusitis

• Brigadier Nasir Ullah Khan
• Classified ENT Specialist
• CMH Rawalpindi

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• Rhinitis
• Rhinosinusitis

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Coryza
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Coryza
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Classification of RS

• Allergic
• Infectious
• Other ( non allergic non infectious)

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Infectious RS
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Classification of bacterial RS

• Acute RS gt 7 days to lt 4 weeks
• Subacute 4 to 12 weeks
• Rec acute 4 or gt episodes of ARS per year
• Chronic RS 12 or gt 12 weeks
• Acute exacerbation of ch RS

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Ac RS

• Sinus involved - maxillary, ethmoid, frontal,
  sphenoid
• Multisinusitis
• Pansinusitis
• Open / closed

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Factors playing role in the development of ABRS

• Host
• Genetic
• Anatomic
• Systemic diseases
• Environmental
• Trauma
• Tobacco smoke
• Irritants
• iatrogenic

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Aetiology Exciting factors

• Nasal infection
• Swimming/diving
• Trauma
• Dental infection

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Pathophysiology

• Ac urti-mucosal swelling-obst of
  ostia-mucostasis-bacterial colonization-iinfection
  
• Bacteria

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Symptoms / signs

• General
• Local

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Symptoms and signs

• major

• minor

• Facial pain/pressure
• Facial congestion/fullness
• n/obst
• n/disch
• Hyposmia
• Purulence on nasal exam
• Fever (acute)

• Headache
• Fever (non acute)
• Halitosis
• Fatigue
• Dental pain
• Cough
• Ear pain

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Investigations

• X rays
• CT scan
• Culture

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X ray PNS
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Diagnosis

• Symptoms and signs
• Nasoendoscopy
• Culture
• Radiographs

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Treatment

• Medical
• Antibiotics
• Analgesics
• Decongestents
• Surgical

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Complications

• Acute
• Local
• Distant
• Chronic

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Complications Acute local

• Frontal sinus
• Subperiosteal abscess
• Intracranial complication
• Ethmoid orbital cellulitis
• Maxillary swelling of cheek
• Sphenoid
• Cav sinus thrombosis
• intracranial

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ComplicationsAcute distant

• Brain abscess
• Septicaemia
• Toxic shock syndrome

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Complicationschronic

• Subacute, chronic RS
• Mucocoele

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• Thank you