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ENT
Rhinitis, rhinosinusitis, nasal polyps, sinus surgery, and the complications of sinus infection
Built from Behrbohm — Ear, Nose and Throat Diseases with Head and Neck Surgery
What’s inside
15 sections · 172 slides
Overview
- What this topic teaches you
- The one idea that ties the whole topic together
Infections of the Skin of the Nose
Disease confined mainly to the external nose and its danger zone
- The external nose can catch ordinary skin diseases
- Nasal eczema
- Folliculitis and nasal furuncle
- Nasal furuncle of the nasal tip
- Why a boil on the nose is genuinely dangerous
- Treating folliculitis and furuncle of the nose
- Frostbite, burns, and erysipelas of the nose
- Acute and chronic erysipelas of facial skin
- Rhinophyma: the bulbous 'W.C. Fields' nose
- Rhinophyma of the nasal tip
- Tuberculosis of the nose and lupus vulgaris
- Lupus vulgaris of the nose
- Sarcoidosis of the nose
- Syphilis of the nose
- Syphilitic saddle nose
- Rhinoscleroma and leprosy of the nose
- Rhinoscleroma of the nose
Acute and Chronic Rhinitis
Inflammation of the lining inside the nose
- Acute rhinitis and the common cold
- Cold: pathogens, diagnosis, and treatment
- Purulent rhinosinusitis on endoscopy
- Allergic rhinitis
- Airborne pollen exposure calendar
- Diagnosing and treating allergic rhinitis
- How specific immunotherapy works, and its results
- Idiopathic chronic rhinitis
- Neural regulation of the nasal mucosa
- Foreign bodies in the nose
- Long-retained foreign body of the nose and sinuses
- Non-specific chronic inflammation of the nasal mucosa
- Dry mucosa in chronic atrophic rhinitis
- Treating chronic non-specific rhinitis
- Rhinitis of pregnancy and rhinitis medicamentosa
- Chronic atrophic rhinitis and ozena
- Ozena with crusting of an atrophic nasal cavity
Nasal Vasculitis and Granulomas
Destructive inflammations that mimic infection or tumor
- Granulomatosis with polyangiitis (GPA)
- Granulomatosis with polyangiitis in a young patient
- GPA: diagnosis and treatment
- Cocaine-induced vasculitis
- Lethal midline destructive lesion / T-cell lymphoma
- Midline destructive lesion of the central face
- Rare inflammatory diseases of the nose
Local Conservative Treatment
Physical and medical therapy of the upper airway
- Why the upper airway suits local treatment
- Inhalation therapy: steam versus true aerosol
- Thermal, spa, and saline treatment
- Principles of topical drug application
- The main drug groups used in the nose
Acute Rhinosinusitis
Infection of the sinuses, sinus by sinus
- Why we say 'rhinosinusitis', not 'sinusitis'
- Pathogens and first empirical antibiotics
- Defining acute rhinosinusitis and AECRS
- Ethmoidal sinusitis: the crossroads of sinus disease
- The anterior ethmoid, hub of sinus disease
- Cell formations that cause recurrent sinusitis
- Ethmoidal sinusitis: imaging and treatment
- Ethmoidal sinusitis and its orbital risk in children
- Early orbital complication with ethmoid sinusitis on CT
- Maxillary sinusitis: the downstream cheek sinus
- Track of pus in purulent maxillary sinusitis
- Chronic rhinosinusitis with hyperplastic mucosa on CT
- Treating maxillary sinusitis
- Frontal sinusitis: severe forehead pain
- Frontal sinus empyema and blocked anterior ethmoid
- Frontal sinusitis: treatment
- Sphenoid sinusitis: the hidden deep sinus
- Polyp in the sphenoethmoidal recess
- Sphenoid sinusitis: diagnosis and treatment
- Pansinusitis: all the sinuses at once
- Endoscopic pansinus surgery for diffuse polyposis
Chronic Rhinosinusitis and Polyps
Long-standing inflammation, endotypes, and polyp disease
- Chronic rhinosinusitis vs acute
- Endotypes of chronic rhinosinusitis
- Biologics for chronic rhinosinusitis
- Indications for biologic therapy in CRSwNP
- Chronic hyperplastic rhinosinusitis: the immune model
- Why surgery alone cannot cure CRS
- Nasal polyps: what they are and where they come from
- How common are nasal polyps?
- Phases in the development of a nasal polyp
- The eosinophilic granulocyte
- Nasal polyps: mechanisms and the united-airway link
- Various types of nasal polyp
- Diagnosing nasal polyps
- Treating nasal polyps: a stepwise strategy
- Topical steroid effect on a large nasal polyp
- Decision algorithm for the treatment of nasal polyposis
- Endoscopic sinus procedure for polyp removal
- EGPA (Churg-Strauss) and rhinosinusitis in HIV
Rhinogenous Headache and Facial Pain
Telling sinus pain from the many mimics
- Rhinogenous headache
- Rhinogenic headache from a blocked ethmoid
- Chronic facial pain: a careful, structured history
- Is the pain sinogenic or not?
- Neuralgias that cause facial pain
Principles of Sinus Surgery
Endoscopic and external approaches to the paranasal sinuses
- Functional endoscopic sinus surgery (FESS)
- Mucociliary transport through the lateral nasal wall
- Confluence of secretion tracks at the maxillary ostium
- Indications and the logic of mucosa-sparing surgery
- Nasal endoscopy revealing minimal mucosal pathology
- Navigation-supported endoscopic sphenoid surgery
- Infundibulotomy: opening the ethmoid gateway
- Resection of the uncinate process (infundibulotomy)
- Mucosal findings inside the maxillary sinus
- Surgical approach routes to the maxillary sinus
- Caldwell-Luc and intranasal antrostomy
- Radical surgery of the maxillary sinus (Caldwell-Luc)
- Endonasal frontal sinus drainage: the Draf types
- Drainage pathways from the frontal sinus (Draf)
- Endoscopic frontal sinus drainage, Draf I to III
- External frontal sinus surgery
- Surgical approaches to the frontal sinus
- Osteoplastic surgery of the frontal sinus
- Problem regions of the frontal sinus
- Reconstructing the frontal sinus floor (CIM)
- Mucoceles of both frontal sinuses on MRI, and repair
- Traditional (historical) frontal sinus operations
- Principles of the external frontal sinus operations
- Sphenoid sinus surgery and lasers in rhinology
- Osteoma and mucocele of the sphenoid sinus
- View into an operated sphenoid sinus
- Contact and non-contact techniques in laser use
Rhinosinusitis in Children
Different anatomy, immunology, and clinical picture
- Why childhood sinusitis is different
- Development of the paranasal sinuses in children
- Immunology and clinical features in children
- Concha bullosa and narrow ethmoid in a child on CT
- Treating rhinosinusitis in children
- Palpebral edema and subperiosteal abscess in a child
Fungal Diseases of the Sinuses
From harmless colonisation to invasive disease
- A framework for fungal sinus disease
- Non-invasive fungal forms: saprophytic and fungus ball
- Fungus ball in a hypoplastic maxillary sinus
- Invasive fungal disease
The Sinuses and the Rest of the Body
United airways, cystic fibrosis, and ciliary dyskinesia
- United airway disease (sinobronchial syndrome)
- Cystic fibrosis and primary ciliary dyskinesia
Mucoceles and Cysts
Expanding, bone-eroding lesions of the sinuses
- Mucoceles: a slowly expanding trapped mucus sac
- Bilateral frontal sinus mucoceles
- Mucopyocele of the right frontal sinus
- Mucoceles: clinical features and treatment; sinus cysts
- Cyst within the maxillary sinus
Complications of Sinus Infections
When sinusitis breaks out into the orbit, skull, and brain
- Spread to the external soft tissues
- Orbital complications: the Chandler stages
- The main orbital complications arising from the ethmoid
- Periorbital cellulitis versus orbital cellulitis
- Subperiosteal and orbital abscess
- Orbital abscess with hard swelling around the globe
- Related orbital syndromes
- Intracranial complications: routes of spread
- Genesis of intracranial complications of sinusitis
- Epidural and subdural abscess
- Rhinogenous brain abscess
- Purulent leptomeningitis following frontal sinusitis
- Cavernous sinus thrombosis and rhinogenous meningitis
- Bony complications: Pott's puffy tumor
- Genesis of osteomyelitis of the flat skull bones
- Osteomyelitis of the frontal bone and its repair
- Upper-jaw osteomyelitis and facial swelling
Key Takeaways
Pulling the topic together
- The big picture in three ideas
- High-yield facts to carry away
- Consensus documents and named references
- Ear, Nose, and Throat Diseases: With Head and Neck Surgery