What is the nose?
The nose is the organ of smell situated within the middle of the face. The internal part of the nose lies on top of the roof of the mouth.
The nose consists of:
- External meatus- Triangular-shaped projection in the centre of the face.
- External nostrils- Two chambers divided by the septum.
- Septum- composed of cartilage and bone and lined by mucosa.
- The cartilage also gives shape and support to the outer a part of the nose.
- Nasal passages- Passages that are lined by mucous membranes and small hairs that facilitate to filter the air.
- Sinuses- Four pairs of air-filled cavities, also lined by mucous membranes.
What are sinuses?
As within the nasal passage, the sinuses are lined with secretory mucous membranes.
There are four different types of sinuses:
- Ethmoid sinus- This sinus is found within the face, around the space of the bridge of the nose. It is present at birth and continues to grow.
- Maxillary- This sinus is found within the face, around the space of the cheeks. It is also present at birth and continues to grow.
- Frontal sinus- This sinus is found within the face, within the space of the forehead. It doesn't develop until around seven years of age.
- Sphenoid sinus- This sinus is found deep within the face, behind the nose. It does not typically develop fully until adolescence.
CAUSE OF ETHMOID SINUSITIS, CLINICAL FEATURES, TREATMENT
Aetiology
Acute ethmoiditis is often associated with infection of other sinuses. Ethmoid sinuses are more often involved in infants and young children.
Clinical features
Pain- it is localized over the bridge of the nose and deep to the eye. it is aggravated by the movement of the eyeball.
Oedema of lids- both eyelids become puffy and swollen. there is increased lacrimation. orbital redness is an early complication in such cases.
Nasal discharge- on anterior rhinoscopy, pus may be seen in middle or superior meatus depending on the involvement of the posterior group of ethmoid sinuses.
Treatment
- Ampicillin and amoxicillin antibiotics are quite effective. If you are allergic to penicillin then erythromycin or doxycycline or cotrimoxazole are equally effective. Sparfloxacin is also effective and has the advantage of a single daily dose.
- Nasal drops or sprays to encourage drainage.
- Steam alone or medicated with menthol. Steam should be given 15-20 min after nasal decongestion
- Paracetamol or any other suitable analgesic for relief of pain and headache.
- Hot fomentation is often soothing.
CAUSE OF MAXILLARY SINUSITIS, CLINICAL FEATURES, TREATMENT
- Most commonly, it is viral redness which spreads to involve the sinus mucosa. this is followed by bacterial invasion.
- Diving and swimming in contaminated water.
- Dental infections are an important source of maxillary sinusitis. roots of premolar and molar teeth are related to the floor of the sinus and may be separated only by a thin layer of mucosal covering.
- Trauma to the sinus such as compound fractures, penetrating injuries or gunshot wounds may be followed by sinusitis.
Clinical features
- It consists of fever, general malaise, and body ache.
- Headache.
- Pain is situated over the upper jaw but may be referred to as the gums or teeth pain. for this reason, the patient may primarily consult a dentist.
- Tenderness over cheek.
- Redness and oedema of cheek, commonly seen in children. the lower eyelid might become puffy.
- Nasal discharge
- Postnasal discharge
Treatment
- Ampicillin and amoxicillin are quite effective. if you are sensitive to penicillin than erythromycin or doxycycline or cotrimoxazole are equally effective. sparfloxacin is also effective and has the advantage of a single daily dose.
- Nasal drops or sprays to encourage drainage.
- Steam alone or medicated with menthol. steam should be given 15-20 min after nasal decongestion
- Paracetamol or any other suitable analgesic for relief of pain and headache.
- Hot fomentation is often soothing.
CAUSE OF FRONTAL SINUSITIS, CLINICAL FEATURES, TREATMENT
- Usually follows viral infections of the upper respiratory tract followed later by bacterial invasion.
- Entry of water into the sinus during diving or swimming.
- External trauma to the sinus, e.g. fractures or penetrating injuries.
- Oedema of the middle meatus, secondary to associated ipsilateral maxillary or ethmoid sinus infection.
Clinical features
- Frontal headache more in the early morning.
- Tenderness on forehead
- Oedema of the upper eyelid
- Nasal discharge
Treatment
- Ampicillin and amoxicillin are quite effective. if you are sensitive to penicillin than erythromycin or doxycycline or cotrimoxazole are equally effective. sparfloxacin is also effective and has the advantage of a single daily dose.
- Nasal drops or sprays to encourage drainage.
- Steam alone or medicated with menthol. steam should be given 15-20 min after nasal decongestion
- Paracetamol or any other suitable analgesic for relief of pain and headache.
- Hot fomentation is often soothing.
CAUSE OF SPHENOID SINUSITIS, CLINICAL FEATURES, TREATMENT
Aetiology
Isolated involvement of sphenoid sinus is rare. It is often a part of pansinusitis or is associated with infection of posterior ethmoid sinuses.
Clinical features
- Headache
- Postnasal discharge
Treatment
- Ampicillin and amoxicillin are quite effective. if you are sensitive to penicillin than erythromycin or doxycycline or cotrimoxazole are equally effective. sparfloxacin is also effective and has the advantage of a single daily dose.
- Nasal drops or sprays to encourage drainage.
- Steam alone or medicated with menthol. steam should be given 15-20 min after nasal decongestion
- Paracetamol or any other suitable analgesic for relief of pain and headache.
- Hot fomentation is often soothing.
