sinusistis

CASE PRESENTATION ON
THE TOPIC
SINUSITIS .
CONTENTS:
 Keywords.
Introduction
Etiology .
Symptoms.
Types of sinusitis.
Diagnosis.
Anatomy of para nasal sinus.
Normal anatomy of nasal cavity.
indications.
Contraindications.
Appearance of normal pns ct scan.
History.
Patient preparation.
Scan protocol used.
Scan images.
Findings of CT PNS
After procedure care.
KEYWORDS:
 Stuffy nose: when the tissue inside your nose swell.

 Ostia : an opening into a vessel or cavity of the body.
 Supra orbital: situated above the orbit of the eye.
 Semilunar hiatus: A curved groove in the lateral wall of nasal cavity.
 Epistaxis: it is the medical term for a nosebleed, which occur when a
blood vessel inside your nose bursts.
 Hyperdense: A structure is brighter than normal on a ct cause it is
denser.
 Polyps: A polyps is a projecting growth of tissue from a surface in the
body, usually mucous membrane.
 Opacification: Here, opacification means the sinus is filled with fluid or
soft tissues, making it appear opaque on imaging.
 Infundibulum: the infundibulum is a pyramidal space that helps drain
the sinuses of the face, including maxillary , frontal, and anterior,
ethmoid sinus.
 Ucinate: The ucinate process is a thin, body, semi-circular structure in
the sinus.
SINUSITIS
Rhino sinusiti s is a disorder characterized by the infl ammati on of the
mucosa of the nose and paranasal sinuses.
ETIOLOGY
CAUSES:
VIRAL INFECTIONS: A viral upper respiratory infection that leads to

infl ammation and thick mucus production.
ALLERGIES: An allergic reaction to allergen like dust , pollen or pet

dander can cause nasal tissues to swell and produce more mucus.
BACTERIA: After a viral infection , bacteria can overgrow in the

sinuses, leading to bacterial sinusitis.
Exposure to irritants : Exposure environmental irritants can increase

the risk of chronic sinusitis.
SYMPTOMS:
Thick, yellow or greenish mucus from the nose.

Blocked or stuff y nose.
Headache
Tiredness
Sneezing
No sense of smell.
Itchy nose.
Types of sinusitis :
 Acute:
 symptoms last less than 4 weeks.
Often caused by viral infections.
Chronic:
Symptoms last 12 weeks or longer despite treatment
It may involve structural abnormalities or chronic infl ammatory
conditions.
Diagnosis of sinusitis:
Plain x-ray has been used to evaluate the presence of air-fl uid
levels or mucosal thickening in the paranasal sinus.
A ct scan of the paranasal sinuses can help visualize

infl ammatory , mucosal thickening, air fl uid levels and blockages.
ANATOMY OF PARANASAL SINUS
The para nasal sinuses are air fi lled cavities located within the bones of the
skull and face. They are lined with mucous membrane and communicate with
nasal cavity via small opening called ostia.
The different types of sinuses are:

1. Frontal sinuses:
 Location: within the frontal bone above the eyes and behind the forehead.
 Shape: Usually paired asymmetrical ,but can vary in size and shape.
 Drainage: It drain into the middle meatus via the fronto nasal duct.
 Nerve supply: Supplied by the supraorbital nerve.
 They are absent at birth and develop by 7-8 years of age.
2. Ethmoid sinuses:
•L ocation: within the ethmoid bone, between the eyes and near the nasal bridge.
•S tructure:A collection of multiple air cells rather than a single cavity.
•N erve supply:supplied by the anterior and posterior ethmoidal nerves.
•T hese sinuses are present at birth and are prone to infections due to proximity to the
orbit.
3.Maxillary sinuses:
Location: In the maxilla, beneath the eyes, and the lateral
to the nasal cavity.
It has pyramidal- shaped cavity with distinct walls and
features.
Drainage: Into the middle meatus via the semilunar
hiatus.
Nerve supply: Branches of the infraorbital nerve and
superior alveolar nerves.
4. Sphenoid sinuses:
Location :In the body of the sphenoid bone , posterior to
the nasal cavity.
Drainage :into the sphenoethmoidal recess, located above
the superior nasal concha.
Nerve supply: Branches of the posterior ethmoidal nerve.
Anatomy of nasal cavity.
 The nasal cavity is a hollow space in the nose that allows air to flow
in the and out and is essential for breathing and smell. The nasal
cavity has many complex structures including.

 Nasal septum: A bone and a cartilage that separates the nasal cavity into two
sides.
 Turbinates : folds that warm and moisten air, and help with drainage.
 Olfacftory region: located at the top of the nasal cavity, this is where the
sense of smells occur.
 Cilia: tiny hair-like structure that trap dirt and particles and move them out of
the body.
 Paranasal sinuses: air-filled pockets that produce mucus to keep the nose
moist.
 Nostrils: holes that leads to the nasal cavities.
 Mucous membrane : lines the nasal cavities.
 Nose hairs : trap dirt and dust.
 Cribriform plate : contains nerve associated with smell.
INDICATIONS FOR PARANASAL SINUSES:
Sinus and nasal conditions

Trauma
Tumours and lesions
Congenital and structural abnormalities.
Infections and complications.
CONTRAINDICATIONS
Pregnancy.
Patient of claustrophobia.
Patient weight.
Children.
APPEARANCE OF NORMAL PNS IN CT
PATIENT DETAILS:
HISTORY OF THE PATIENT:
 Epistaxis both nostrils since 3 days.

 Pain.
PATIENT PREPARATION:
 Metal objects: Remove all metal objects, including

jewelry ,eye glasses , dentures, hairpins and hearing aids.
 Medical history: Ask about the patient previous or any
recent illness via to the disease.
 Pregnancy: Female should be asked about her pregnancy
or mentrual period.
 Informed consent: Informed consent should be sign by the
patient or any family members before the procedure.
 Claustrophobia or anxiety: You should ask the patient about
any of his/her previous history of claustrophobia.
SCAN PROTOCOL USED:
Patient position : The patient lie on their back or

face down with their chin raised.
Tube voltage:
Kvp:80-120 kvp.
mAs:50-70 mAs.
Scan extent : The scan extends from the hard pallate
to above the end of frontal sinuses.
Scan direction : The scan direction is caudocranial.
Scan geometry:
FOV:140-160mm
Slice thickness:0.625-1.0
FINDINGS OF CT PNS:
 Chronic right maxillary sinusitis/ polyps with

embedded amorphous hyperdense contents
causing complete opacification of the sinus,
widening of maxillary ostium, complete occlusion
of ostium and infundibulum and remodelling of
uncinate.
 Mildly deviated nasal septum on the right side.
SCAN IMAGES:
AFTER PROCEDURE CARE:
 There’s no specific after care for CT PNS.

 Patient can usually resume their normal
activities and diet.
 The patient can be sent home after procedure.

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CASE PRESENTATION ON

 Stuffy nose: when the tissue inside your nose swell.

VIRAL INFECTIONS: A viral upper respiratory infection that leads to

ALLERGIES: An allergic reaction to allergen like dust , pollen or pet

BACTERIA: After a viral infection , bacteria can overgrow in the

Exposure to irritants : Exposure environmental irritants can increase

Thick, yellow or greenish mucus from the nose.

A ct scan of the paranasal sinuses can help visualize

The different types of sinuses are:

Sinus and nasal conditions

 Epistaxis both nostrils since 3 days.

 Metal objects: Remove all metal objects, including

Patient position : The patient lie on their back or

 Chronic right maxillary sinusitis/ polyps with

 There’s no specific after care for CT PNS.

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