Sinusitis: Pathogenesis and clinical findings

Sinusitis: Pathogenesis and clinical findings
Authors: Amanda Marchak Reviewers: Nicola Adderley Jim Rogers Danielle Nelson* * MD at time of publication
URTI – Upper respiratory tract infection
Nasal obstruction/ congestion
Facial pain/pressure
Maxillary tooth pain
Ear pain/ fullness
Osteomyelitis of frontal bone
Chemical irritants
Cystic Fibrosis
Direct toxic effect on cilia
Viral URTI Allergies
Inflammation of paranasal sinuses
Edematous passageways
Septal deviation Adenoid hypertrophy Polyps
Turbinate hypertrophy Tumors Foreign body
Dysfunctional cilia
Congenital and/or craniofacial abnormality Obstruct sinus ostia
Cilia unable to clear mucus from sinuses
Mucus unable to drain through ostia
Post-nasal drip Mucus overflows from the sinuses Cough
Mucus accumulates in sinuses
Occupies a larger volume
Applies ↑ pressure to sinus walls
Mucopurulent discharge
Bacterial1 overgrowth in sinuses Bacterial infection spreads to adjacent structures
Halitosis Pharyngitis Throat clearing
Dental root infection
Irritates the back of the throat
Perforation of the Schneiderian membrane2
Passage of bacteria into the sinuses
Subperiosteal orbital abscess
Orbital abscess Orbital edema
↑ susceptibility to bacteria
1. The most common bacteria are Streptococcus pneumoniae, Haemophilus influenza, and Moraxella catarrhalis. Staphylococcus aureus and Group A Streptococcus may be seen, but are less common. However, in cases of dental root infection, oral anaerobes become more common, while Pseudomonas species are associated with foreign bodies.
2. The Schneiderian membrane is the membranous lining of the maxillary cavity.
Cavernous sinus thrombosis
Meningitis Cerebral abscess
Subdural abscess Epidural abscess
Periorbital or orbital cellulitis
Sign/Symptom/Lab Finding
Published November 5, 2018 on