Treatment Plan and Seminar 2

8/13/2019 Treatment Plan and Seminar 2

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Treatment plan and seminar

Done By :

Haider Maad 200911769Abdullah yasar yousef 200810468



Case

39 year old man presented with swollen cheek

with discomfort and dull ache. O/E: diffuse

hard swelling on LHS cheek, mesial caries on

UL6 which is not ttp . Exam also revealed

spontaneous tearing from L eye and nasal

obstruction along with disturbed sensation of

LHS cheek



Differential Diagnosis

A. Dental abscess

B. Sialadenitis

C. Sinusitis

Final Diagnosis : Sinusitis



sinusitis

Acute sinusitis is a bacterial

infection in one or more

sinuses, which include the

maxillary, ethmoid, andfrontal sinuses



Classifications

• Acute cases, which last for four weeks or less

• Sub acute cases, which last four to twelve

weeks

• Chronic cases, which last more than twelve

weeks and can continue for months or even

years

• Recurrent cases, which involve several acute

attacks within a year



Etiology

• Viral infection : Most cases of acute sinusitis arecaused by the common cold.

• Bacterial infection : When an upper respiratory tract

infection persists longer than seven to 10 days, it'smore likely to be caused by a bacterial infection thanby a viral infection.

• Fungal infection. increased risk of a fungal infection

if patient have sinus abnormalities or a weakenedimmune system

• Tooth infection



Etiology

• Usually the first maxillary molar is involved

because of its location.6 If this is the case, the

radiograph may reveal an obvious periapical

radiolucency, a widened periodontal ligament

space at the apex of a tooth, or a tooth with

extensive restorations and/or caries



Symptoms of acute sinusitis

• Nasal obstruction or congestion, causing

difficulty breathing through the nose

• Pain, tenderness, swelling and pressure

around your eyes, cheeks, nose or forehead

• Foul odor

•

Fever• Tearing in one eye



Complications • Chronic sinusitis. Acute sinusitis may be a flare-

up of a long-term problem known as chronicsinusitis. Chronic sinusitis is sinusitis that lastslonger than eight weeks.

• Meningitis. This occurs when infection spreads tothe lining of the brain.

• Vision problems. If infection spreads to your eyesocket, it can cause reduced vision or even

blindness• Ear infection. Acute sinusitis may occur with an

ear infection.



Risk factors • fever or another allergic condition that

affects your sinuses

• A nasal passage abnormality, such as a

deviated nasal septum, nasal polyps or tumors

• A medical condition such as cystic fibrosis, or

an immune system disorder



Diagnosis

• The most important factors in differentiating

viral from bacterial sinusitis are the overall

symptom. Symptoms of viral infection tend to

peak early and gradually resolve , Thus

symptoms present for less than 10 days point

to a viral infection, whereas symptoms

present for more than 10 days without animprovement suggest a bacterial infection.





Diagnosis

• Imaging studies. Images taken using

computerized tomography (CT) or magnetic

resonance imaging (MRI) can show details of

your sinuses and nasal area. While notrecommended for uncomplicated acute

sinusitis, imaging studies may help identify

abnormalities or suspected complications.



Diagnosis

Waters (occipitomental) view

Caldwell (occipitofrontal) view

Lateral view

Modified basilar view (a submental vertex view)

Ultrasonography





Management

• Nasal Irrigation - this is also known as sinus

irrigation, sinus rinse. It is a home procedure

that involves a salt water rinse to clear the

nasal passages.

Warm compress - if you apply a warm

compress gently to the affected areas of yourface you may have some relief of symptoms.



Management

• Decongestant tablets these may reduceswelling and allow the sinuses to drain

Antibiotics : can provide small improvements insinusitis cases, most patients recover withoutthe drugs within two weeks. However, in

patients with severe symptoms, like high fever,severe pain in cheeks and swelling of face,antibiotic treatment maybe required



Management

antibiotics may be prescribed in some cases

• If symptoms are severe or if the patient very

unwell.

• If patient have another illness such as cystic

fibrosis, heart problems or a weakened

immune system.

• If symptoms are not settling within 7 days, or

are worsening.



Management

• Surgery is normally only considered if medical

treatment fails , most sinus operations are

performed without an external incision.

• Endoscopic surgery



Thank You Questions

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Treatment Plan and Seminar 2

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