Obstruction/Congestion
tarix 07.03.2017 ölçüsü 478 b. #10727
Obstruction/Congestion Obstruction/Congestion Discharge/Purulence +/- Pain/Pressure +/-Hyposmia/Anosmia Moderate-severe Moderate-severe . abnormal sleep . impairment of daily activities, sport, leisure . abnormal work and school . troublesome symptoms History is often very suggestive History is often very suggestive “no published prospective reports on the incidence of infective rhinosinusitis in populations with and without clearly defined allergic rhinosinusitis” EPOS 2007 Acute
Obstruction/Congestion Obstruction/Congestion OR Discharge/Purulence +/- Pain/Pressure +/-Hyposmia/Anosmia Obstruction/Congestion Obstruction/Congestion Discharge/Purulence +/- Pain/Pressure +/-Hyposmia/Anosmia 54% Sensitivity and 46% Specificity in sinusitis (Kuhn, 1986) 54% Sensitivity and 46% Specificity in sinusitis (Kuhn, 1986) 75% of Plain X-Rays do not correlate with CT (McAlister and Lusk, 1989) Aspergillosis Blastomycosis Aspergillosis Blastomycosis Rhinosporoidosis Cryptococcosis Phycomycosis Actinomycosis Candidiasis Hisptoplasmosis Sporotrichosis Mucormycosis Non-invasive Non-invasive Fungal ball (mycetoma) Allergic fungal sinusitis (AFS) Invasive Non-invasive Non-invasive Fungal ball (mycetoma) Allergic fungal sinusitis (AFS) Invasive Chronic invasive (indolent) fungal rhinosinusitis Acute invasive (fulminant) fungal rhinosinusitis Type I Hypersensitivity Type I Hypersensitivity 80% of Patients Have Diffuse Polyps Thick Greenish Secretions with Fungal Hyphae Sinus opacification Sinus opacification Expansion Bony erosion No tissue invasion Acute
Dextrocardia Dextrocardia Rhinosinusitis Bronchiectasis Infertility Infective Rhinosinusitis (Pseudomonas) Infective Rhinosinusitis (Pseudomonas) 37% of Patients Have Polyps Polyps in Children Deviation of nasal septum Deviation of nasal septum Nasal polyps Hypertrophy of inferior turbinates Enlarged adenoids Foreign bodies Choanal atresia Nasal obstruction Anosmia Postnasal drip Gray-pink glistening structures Insensitive 36% of Patients Have Diffuse Polyps 36% of Patients Have Diffuse Polyps Bone Expansion High Recurrence Rate Idiopathic Idiopathic NARES Occupational Hormonal Drugs Food Irritants Emotional Nasal Hyperactivity to Nasal Hyperactivity to Cold air Temperature changes Tobacco, pollutants Perfumes, bleach Neuronal markers in allergic rhinitis: expression and correlation with sensory testing. Neuronal markers in allergic rhinitis: expression and correlation with sensory testing. S O’Hanlon, P Facer, K Simpson, G Sandhu, HA Saleh , P Anand. Laryngoscope 2007 Sep;117(9):1519-27.Increased Nerve Fiber Expression of Sensory Sodium Channels Nav1.7, Nav1.8, and Nav1.9 in Rhinitis. SM Keh , P Facer, K Simpson, G Sandhu, HA Saleh , P Anand. Laryngoscope . 2008; 118(4):573-9.The role of neuronal mechanisms in allergic rhinitis. S O’Hanlon, SM Keh, HA Saleh Otorinolaringologia. 2008;58: 17-30.Non-atopic Females > males Eosinophilia Steroid responsive Symptoms improve in weekends and holidays Allergic Non-allergic storage mites storage mites grain latex glues and guar gum rats, mice, guinea pigs basilis subtilis wood dust e.g. mahogany, western red cedar isotonic acid hydrazine/trimellitic anhydride Pregnancy Pregnancy Puberty Premenstrual Hypothyroidism Acromegaly Old man’s drip Local Local Systemic Antihypertensives Aspirin Contraceptive pill Benzoates, salicylates Benzoates, salicylates Tetrazine Colourings Pollution
Dostları ilə paylaş:
