Paranasal sinus

Sinusitis, or inflammation of the paranasal sinuses, is better described as rhinosinusitis that also involves inflammation of contiguous nasal mucosa, which occurs in virtually all cases of viral respiratory infections. Acute rhinosinusitis is characterized by symptoms that resolve completely in less than 4 weeks, whereas chronic rhinosinusitis typically persists as cough, rhi-norrhea, or nasal obstruction for more than 90 days. Acute bacterial rhinosinusitis (ABRS) refers to an acute bacterial infection of the sinuses that can occur independently or be superimposed on chronic sinusitis. The focus of this section will be on ABRS and appropriate treatment. 

Paranasal sinus puncture "Gold standard" not performed routinely but can be useful in complicated or chronic cases. 

The onset of symptoms may be delayed for several minutes after initial exposure (especially with DM) effective exposure may, therefore, occur before the presence of the smoke is suspected. The paranasal sinuses are irritated and fill with secretions and severe frontal headache results. Prolonged exposure may cause retrosternal pain, dyspnoea, and asthma-like symptoms. Symptoms reach their climax after 5-10 min and disappear 1-2 h after cessation of exposure. 

Aspergillosis is generally acquired by inhalation of airborne conidia that are small enough (2.5 to 3 mm) to reach the alveoli or the paranasal sinuses. 

Sinusitis is an inflammation and/or infection of the paranasal sinus mucosa. The term rhinosinusitis is used by some specialists, because sinusitis typically also involves the nasal mucosa. The majority of these infections are viral in origin. It is important to differentiate between viral and bacterial sinusitis to aid in optimizing treatment decisions. 

F. M. Baroody. Nasal and paranasal sinus anatomy and physiology. Clin Allergy Immunol 19 1-21 (2007). 

Hayes RB et al Cancer of the nasal cavity and paranasal sinuses and formaldehyde exposure. IntJ Cancer 37 487M-92, 1986... 

Early epidemiological studies suggested an association between the manufacture of isopropyl alcohol and paranasal sinus cancer/ The risk for laryngeal cancer may also have been elevated in these workers. The increased cancer incidence, however, appears to be associated with some aspect of the strong-acid manufacturing process rather than the isopropyl alcohol itself It is unclear whether the cancer risk is due to the presence of diisopropyl sulfate, which is an intermediate in the process, to isopropyl oils, which are formed as byproducts, or to other agents, such as sulfuric acid. ... 

Controversy as to whether nickel carbonyl causes cancer arose from observation of increased incidence of cancer of the paranasal sinuses and lungs of workers in nickel refineries. Suspicion of carcinogenicity focused primarily on nickel carbonyl vapor, although there were concurrent exposures to respirable particles of nickel, nickel subsulfide, and nickel oxide. Subsequent studies have shown an increased risk of lung and sinus cancer in nickel refineries where nickel carbonyl was not used in the process. Furthermore, the incidence of respiratory cancer decreased greatly by 1930 despite continued exposure of workers to the same levels of nickel carbonyl through 1957. 

Nasopharynx paranasal sinus 53% (13 patients) 63% (21 patients) 21% (97 patients) (UCSF)... 

An increased incidence of cancer of the paranasal sinuses and laryngeal cancer was observed in workers at factories where isopropanol was manufactured by the strong-acid process. One case-control study investigated the risk associated with occupational exposure to isopropanol, but for none of the investigated cancer sites was a significant increase in risk observed. 

Jones, N. 2001. The nose and paranasal sinuses physiology and anatomy. Adv Drug Deliv Rev 51 5. 

Littman MS, Kirsh IE, Keane AT. 1978. Radium-induced malignant tumors of the mastoid and paranasal sinuses. Am J Roentgenol 131 773-785. 

This condition causes an inflammation of the upper respiratory tract, eyes and often the paranasal sinuses and throat. 

SAFETY PROFILE Chromate salts are suspected human carcinogens producing tumors of the lungs, nasal cavity, and paranasal sinus. Chromic acid and its salts have a corrosive action on the skin and mucous membranes. The lesions are confined to the exposed parts, affecting chiefly the skin of the hands and forearms and the mucous membranes of the nasal septum. The characteristic lesion is a deep, penetrating ulcer, which, for the most part, does not tend to suppurate, and which is slow in healing. Small ulcers, about the size of a matchhead, may be found, chiefly around the base of the nails, on the... 

The eyelid and adnexal tissues should be carefully examined for the presence of pimcture wounds, tramna, or infectious lesions of the skin. Facial tenderness, nasal discharge, and malodorous breath are signs of paranasal sinusitis. Focal medial canthal tenderness and tearing may indicate acute dacryocystitis. 

Selected Case-Control Studies. Luce et al. (1993b) attempted to detennine whether occupational exposure to fonnaldehyde was associated with an increased risk of sinonasal cancer in humans. Case subjects were patients with primary malignancies of the nasal and paranasal sinuses. Odds ratios for squamous cell carcinomas in formaldehyde-exposed workers, when adjusted for wood dust and glue exposure, were not significantly elevated. The odds ratio for adenocarcinomas was confounded by the frequent co-exposure to wood dust, a known carcinogen. However, in those exposed to wood dust, an increased odds ratio was noted in those also exposed to formaldehyde. The authors concluded that the data did not support an increased risk of nasal cancers due to formaldehyde alone. 

Brinton LA, Blot WJ, Becker JA, et al. 1984. A case-control study of cancers of the nasal cavity and paranasal sinuses. Am J Epidemiol 119 896-906. 

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