|
| |
Sinusitis…its Diagnostic perspective
|
| |
|
|
Dr.Shalini.S
Internee
Sree Vidyadhiraja Homoeopathic Medical College
Nemom, Trivandrum-20
09495746599
Email:shalinis@live.in |
|
|
|
Sinusitis is the inflammation
of mucosa of any or all of the Para-nasal Sinuses characterized by thick
mucopurulent secretion, post-nasal discharge and pain over the affected
sinus. It is one of the most common distressing condition in which Homoeopathy
has an excellent field of applicability, thus preventing the use of
Surgeon’s Knife to a very great extent.
Sinusitis can obviously be distinguished from other similar conditions
such as mucocele of sphenoid sinus, neoplasm, by the characteristic
clinical features of sinusitis. Blood stained nasal discharge often
as a sequel of upper respiratory infection is most probably due to sinusitis.
It can also follow dental sepsis.
|
|
|
Haziness of left maxillary
sinus
|
|
Diagnosis
Radiology of Para-nasal sinuses
is the simplest non-invasive investigatory method to confirm the diagnosis.
Usually Waters’view or Occipitomental view is taken and is considered
as the standard one. Over the affected sinus, a hazy opacity or a fluid
level can be observed. Both the frontal and maxillary sinusitis are
well evident from X-rays showing haziness over frontal and maxillary
sinuses respectively. In chronic sinusitis, mucosal thickening is also
evident. Lateral view is useful in sphenoid sinusitis to know the fluid
level.
Facio maxillary CT scan is
needed to visualize the hazy opacity in case of sphenoid or ethmoid
sinusitis. Enlarged or hypertrophied nasal turbinate can also be observed
if nasal allergy is co-existent with Sinusitis. CT scan helps to rule
out organic lesions and also has replaced studies with contrast materials.
Anterior rhinoscopy shows pus in the middle meatus.
On Aspiration and Irrigation, finding of pus in the sinus is confirmatory.
Blood studies also helpful
to asses the basic of etiology. A study on differential count could
differentiate an acute and chronic infection. The neutrophils are raised
in acute and lymphocytes are more in chronic conditions. Eosinophils
are raised in allergic manifestations, further interpreted with immunoglobulin
study IgE.
|
|