[<< wikibooks] Ossicle/Nose and Paranasal Sinuses
== Nose and Paranasal Sinuses ==
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===== Rhinitis & Sinusitis =====
Allergic Rhinitis
Vasomotor Rhinitis
The Osteomeatal Complex
Nasal Polyps & Polyposis
Sinusitis, Acute
Sinusitis, Chronic
Sinusitis, Allergic Fungal
Sinusitis, Invasive Fungal
Septal Deviation
Turbinate Hypertrophy
Nasal Valve Prolapse

===== Tumor & Neoplasia =====
Inverting Papilloma
see Head & Neck Squamous Cell Carcinoma
Adeoncarcinoma of the Nasal Cavity
Juvenile Angiofibroma

===== Miscellanea =====
CSF Leak & CSF Rhinorrhea
Granulomatous Disease
Wegener's, SLE, Sarcoid, Tuberculosis, Relapsing Polychondritis, Behcet, Churg-Strauss, IMDD, etc
Nasal Valve Prolapse

=== Sinusitis ===
Orbital Complications of Sinusitis; Chandler's Classfication:

Group I. Periorbital Cellulitis: aka preseptal cellulitis. Extraoccular muscles and globe unaffected.
Group II. Orbital Cellulitis: aka postseptal cellulitis.  Globe/EOM findings.
Group III. Subperiosteal Abscess: Globe displaced inferolaterally; proptosis.
Group IV. Orbital Abscess: Collection of pus within orbit proper; proptosis, chemosis, opthalmoplegia.
Group V. Cavernous Sinus Thrombosis: Bilateral eye findings, opthalmoplegia, meningismus, prostration.  MRI best for diagnosis.  Veins of face are valveless!Intracranial Complications of Sinusitis, in order of prevalence

Epidural Abscess
Subdural Abscess
Intracerebral Abscess
Thrombophlebitis of venous sinusesFrontal Sinus is most commonly implicated in intracranial complications
Foramina Brescht allows frontal sinus to communicate with brainInvasive Fungal SinusitisAspergillus: septated hyphae branching at 45-degrees.  PAS or silver stain.
Mucormycosis: 70% of DKA patients. Broad nonseptated hyphae, variable branch angle.
On pathology angioinvasion and neuroinvasion.
Clinically dusky or blackened necrotic turbinates.
Treatment is aggressive debridement and Amphoteracin B.Sphenoid Sinus has 12 close structures: II, III, IV, V1, V2, VI, Vidian Nerve, Carotid artery, Brain, Dura, Pituitary.

=== Pertienent Sinonasal Anatomy ===

==== Schematic of Cavernous Sinus Anatomy: ====

II = Optic Nerve: 25-50% with bony dehiscence into sphenoid sinus.
III = Occulomotor Nerve
IV = Trochlear Nerve
V1 = Ophthalmic division, Trigeminal Nerve
V2 = Maxillary division, Trigeminal Nerve: exits foramen rotundum, superomedial to V3's foramen ovale.
VI = Abducens Nerve
C = Carotid Artery: often with bony dehiscence into sphenoid.  Together with CN II forms opticocarotid recess.Sinus communicates posteriorly, so thrombosis is bilateral.