eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Allergy
Asthma and Sinusitis: Multimedia
Updated: Jan 27, 2010
Multimedia
 | Media file 1: Lateral sinus wall. Perform nasal endoscopy to reveal patent or closed sinus ostia. Look for purulent areas. |
 | Media file 2: Septal deviation with concha bullosa. CT scan shows the bony anatomy, including the important structures of the maxillary frontal and sphenoid ostia. The cribriform plate, the anatomic position of which is a critical factor in any surgery, is depicted. The surgeon looks for depression at this area and dehiscence. On the image, the septum is deviated to the left, and the concha bullosa is right of the middle turbinate. |
 | Media file 3: Anatomy of the lateral wall on nasal endoscopy. Patent or closed sinus ostia may be revealed. The maxillary, frontal, and sphenoid ostia are shown. Purulent discharge is noted. |
 | Media file 4: Hydro Pulse irrigator. Because bacteria and thick phlegm play a clinically significant role, if pus is present in the nose or sinuses, the physician can reduce asthmatic symptoms due to sinusitis by performing in-office suctioning or irrigation. One technique is to use a vasoconstrictor in the nose, wait 2 minutes, and then irrigate the area with a modified Locke-Ringer or sodium chloride solution with a pulsatile nasal irrigator. A considerable amount of surface and sinus pus is removed, and the pulsatile action at 20 pulses per second stimulates the nasal cilia and sinuses to restore normal ciliary action. The flow of solution past the orifice creates a Bernoulli effect to displace the sinus contents; pulsation also aids this process. |
 | Media file 5: Radiograph in a child. Note the size of the maxillary sinuses. Ethmoids are beginning to develop, but the frontal sinus is not yet present. One useful technique for treating sinusitis in children is Proetz sinus irrigation, which is performed with the child hyperextended over the parent's lap so that the child's head is lowered. |
 | Media file 6: Concha bullosa. A foreign body can block the natural ostia. A deviated septum may compress this area. Hypertrophy of turbinates may be sufficient to block the opening. Concha bullosa refers to a hollow enlargement of the middle turbinate so that it blocks drainage of the maxillary ostia. |
 | Media file 7: Nasal polyps may develop in the opening itself or grow from a distal origin and be positioned to obstruct the ostia. Treatment is directed to ensure sinus patency and to remove obstructive septum, polyps, and tissue. |
 | Media file 8: The most common ear, nose, and throat (ENT) surgery is the correction of a deviated septum. Because of multiple injuries, this septum is no longer in midline. When it blocks breathing (see Image 2), the entire airflow pattern can be upset, or the septum may impact solidly against the sides (septal spur) and cause blockage of drainage from the sinuses. |
 | Media file 9: Hypertrophied turbinates may be the sole cause of nasal obstruction and frequent infections. These can be safely reduced by means of submucous resection of the turbinates. |
 | Media file 10: CSF fistula. The ear, nose, and throat (ENT) surgeon works in the roof of the nose, where the skull and contents are thinly separated. |
More on Asthma and Sinusitis |
| Overview: Asthma and Sinusitis |
| Differential Diagnoses & Workup: Asthma and Sinusitis |
| Treatment & Medication: Asthma and Sinusitis |
| Follow-up: Asthma and Sinusitis |
 Multimedia: Asthma and Sinusitis |
| References |
| « Previous Page |
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Further Reading
Keywords
asthma, sinusitis, respiratory distress, bronchitis, allergic bronchitis, sinus problems, sinus infection, postnasal drip, rhinitis, allergic rhinitis, mucociliary clearance, asthmatic, reactive airway disease, wheeze, bronchiolitis
