Fisiología Anomalías de La Cavidad Nasal, Radiología, CT Scan

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Anatomia, Fisiologa, Nasal , Anomalas de la EW Cavidad nasal. ! Anatoma radiolgica,CT Scan
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Fisiologa Nasal
Clnica de Asma y Alergia
Nasal Aerodynamics Author: Samuel J Lin, MD; Chief Editor: Arlen D Meyers, MD, MBA
Overview Nasal Resistance Clinical Evaluation of
Revisin Dr. Juan Herrera Salazar
2 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513
the Nose Flow Mechanics of Airflow Rhinomanometry Clinical Causes of Nasal Obstruction Rhinoplasty and 13/04/2012
Dr. Juan Herrera Salazar

Foro Mdico Nicaragense Portales Mdicos Medbook Mi blog de Asma y Alergia
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Bibliografa
Atlas Netter II edicin.
Atlas Netter IV edicin Interactiva. Atlas, Anatomy,Carmine de Clemente 3rd ed.. Gray s Anatomy Ed. Longman 1973. Emedecine collection Nasal Cavity Anatomy, Physiology, and
Author: Belachew Tessema, MD; Chief Editor: Arlen D Meyers, MD, MBA. Updated: Mar Seminarios Anatoma Clnico Radiolgica 29, 2011 13/04/2012
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Anomalies on CT Scan
Bibliografa Emedecine
Nasal Physiology Author: Sanford M Archer, MD;
Chief Editor: Arlen D Meyers, MD, MBA more...

Olfactory System Anatomy Author: Amir
Vokshoor, MD; Chief Editor: Arlen D Meyers, MD, MBA more... Nasal Aerodynamics Author: Samuel J Lin, MD; Chief Editor: Arlen D Meyers, MD, MBA more...
Nasal Reconstruction
Author: Ali Sajjadian, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA more...
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Lo ms dificil es ver lo que esta delante de tus ojos W.

Goethe
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Anatomia radiolgica
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Radiografa Craneo Rx. . Lateral
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Anatomia y fisiologa
Favor leer notas al
pie de pagina..

o .. o .. o ..
Gracias
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Definicin de Sinusitis
Sinusitis is an inflammation of the mucosal lining
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of the paranasal sinuses. As the mucosa of the sinuses is continuous with that of the nose, rhinosinusitis is a more suitable term.[1, 2] Sinusitis can be subdivided into acute, subacute, and chronic disease. Acute sinusitis is defined as disease lasting less than 1 month. Subacute disease lasts 1-3 months, and chronic sinusitis lasts longer than 3 months and is generally related to suboptimally treated acute or subacute disease. Acute and subacute sinusitis are treated medically, whereas chronic sinusitis may Seminarios Anatoma Clnico Radiolgica Tel. 13/04/2012 22781169,22703359,surgical intervention. require 88825513
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Radiografa de los Senos Nasales

Waters
(occipitomental) Caldwell (occipitofrontal)

Vista Lateral Vista basilar (
submento-vrtice) Polypoid mucosal thickening in the right maxillary sinus with a mucous retention cyst in the left on a Waters view.
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Derrame del seno maxilar

Air-fluid levels,
as shown in the image below, generally indicate bacterial sinusitis.

Tratamiento antibitico
Levofloxacin,
moxifloxacin, and amoxicillin/clavulanate - Greater than 90%

High-dose amoxicillin,
Clindamycin,
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cefpodoxime proxetil, cefixime, cefuroxime axetil, and trimethoprimsulfamethoxazole 80-90% Seminarios Anatoma Clnico Radiolgica Tel.
22781169,22703359, 88825513
doxycycline, cefprozil, azithromycin, clarithromycin, and erythromycin - 7080%

Cefaclor - 50-60%
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Otros medicamentos Rinosinusitis

Decongestionantes
Ver notas Limpieza con solucin salina ver docs jhs Nasal 2 spray
Expectorants
Corticosteroids Anticholinergics
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Diagnostico diferencial
Allergic Fungal Sinusitis
Sinusitis, Chronic, Medical Treatment

Sinusitis, Ethmoid, Acute, Surgical Treatment Sinusitis, Frontal, Acute, Surgical Treatment Sinusitis, Fungal Sinusitis, Maxillary, Acute, Surgical Treatment Sinusitis, Maxillary, Chronic, Surgical Treatment Sinusitis, Sphenoid, Acute, Surgical Treatment
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CT Scan Anatomia y Fisiologa

CT scan, nasal cavity.
Normal anterior
ostiomeatal complex anatomy. The anatomy of the ethmoid infundibulum and the uncinate process is demonstrated here.
CT Scan Anatoma The uncinate process (UP) and lateral wall of y Fisiologa the nasal cavity form
the ethmoid infundibulum (EI). The above sinuses drain into the EI via various ostia. The maxillary sinus ostia and the frontal sinus recess or duct drain into the anteriormost portion of the OMC and are consistently identifiable on CT scan. Normal frontal recess/duct. Frontal sinus empties into the middle meatus just lateral to the more anterior portion of the 13/04/2012 middle turbinate. The
COM Complejo Osteo Meatal

CT Scan Anatoma y Fisiologa
Stammberger and
Messerklinger Drainage
Normal posterior
Complejo Osteo Meatal Posterior Normal

ostiomeatal complex. The vomer separates the two ostia into the sphenoid sinus. These ostia are located in the sphenoethmoid recess. The vomer is 13/04/2012 normally
CT Scan Anatoma y Fisiologa
A normal sagittal
reconstruction of the OMC, showing the curved edge of the semilunar hiatus with the inferior mucosal edge covering the UP, can be seen in the image below. The frontal recess is also shown.
Complejo Osteo Meatal Posterior Normal

El septo nasal
Desviacin del Septo
Fisiologa de las desviaciones del Septo Nasal Factor predisponente. Sinusitis Ver el papel de las alergias
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Septo Nasal Estructura Osea y Cartilaginea.
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Anomalas de la Cavidad Nasal

Fusion (apparent) of
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uncinate process to the ethmoid floor. Note the normal uncinate process on the other side. Airway flow is compromised from the sinuses to the middle meatus because of the functionally occluded semilunar hiatus. Because the maxillary sinus is patent and aerated, this is not13/04/2012 a

Congenital or true
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fusion of the uncinate process to the orbit floor. The maxillary sinus is hypoplastic and not aerated. The ethmoid infundibulum does not exist or ends blindly as the recessus terminalis. The UP tip can also fuse directly to the lateral wall or lamina papyracea of the orbit. This anomaly produces the same imaging findings as inferomedial 13/04/2012 fusion.

Bilateral pneumatization of the uncinate tips. Expansion of the tips can compromise the ethmoid infundibulum, the semilunar hiatus, or the middle meatus.
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Anomalas de la cavidad nasal
Concha bullosa of the
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left middle turbinate with expansion and narrowing of the ethmoid infundibulum and the middle meatus. Note absence of the right uncinate process, another anatomic variant.
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Turbinatos
paradjicos Duplicados Accesorios Fusin turbinatoturbinato
Anomalias del
proceso uncinato.
Conchae (
anomalas)
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Large Haller air cell clearly narrowing the ethmoid infundibulum.
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Overexpansion of the
ethmoid sinus floors
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Anomalias de la Cavidad Nasal

Polipos nasales Absence of basal or
Polipos coanales
Turbinatos accesorios Fracturas
Ciruga FESS
ground lamella Absence of the basal or ground lamella is problematic only if FESS of the posterior OMC is being considered.. Bony septa: N.Videano Lesiones lagrimeo.
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Caractersticas radiolgicas de la sinusitis

El Nivel Hidro-aereo, en el seno maxilar sugiere sinusitis.
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Patrones radilogicos al CT Scan
Right-sided sphenoethmoidal pattern of sinusitis.
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Patrones radilogicos al CT Scan
Bilateral ethmoid sinusitis on an MRI.
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Hiatus semilunaris
Es el espacio delimitado
El infundibulum maxilar
entre el proceso uncinato anteoinferior y la bula etmoidal

Las celdas etmoidales
anteriores drenan anteriormente en el hiatus semilunaris atraves del ducto fronto nasal.The middle group drains into the hiatus semilunaris on or above the ethmoidal bulla.
El seno frontal drena por
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medio del ducto frontal o a travs de las celdas etmoidales anteriores en el hiatus semilunaris. Seminarios Anatoma Clnico Radiolgica Tel.
22781169,22703359, 88825513
drena en la regin posterior del hiatus semilunaris. El seno frontal, maxilar, las celdas anteriores y mediales drenan en el hiatus semilunaris. Cualquier obstaculo mecanico en esta reginm causa inflamacin de los senos mencionados. Esto se le conoce como patron osteomeatal. Sindrome del meato 13/04/2012 medio.
El Complejo Osteo Meatal

Anatomia: Turbinate Medio
Para evaluara el
Bulla Etmoidal
Proceso Uncinato Infundibulo Maxilar Hiatus semilunaris
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patron de una sinusitis debemos conocer primero el deraje de los senos nasales. Unidad Osteomeatal: esta no es una estructura morfologica unica sino una combinacin Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 de estructuras:
(espacio debajo del turbinato) Hueso Maxilar os
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Complejo Osteomeatal
Mucosal thickening in the left anterior ethmoid and maxillary sinuses and in the region of the infundibulum. This indicates an ostiomeatal pattern of sinusitis
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Estructura Osea pared lateral de la cavidad nasal, reseccin parcial turbinatos
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Pared lateral de la cavidad nasal
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Drenaje del seno esfenoidal

The sphenoid sinus drains posterior to the
superior turbinate into the sphenoethmoid recess through the sphenoid ostium. The posterior ethmoid air cells also drain through the superior meatus into the sphenoethmoid recess.
An obstruction in this region gives rise to the
sphenoethmoid pattern of sinusitis.

Conca Bulosa
Concha bullosa of the right middle turbinate.
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Celdas de Haller
Paradoxical curves of
both middle turbinates cause narrowing of the ostiomeatal units.
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CT Scan Metodo Preferido
Computed tomography (CT) scanning is the examination of choice in sinusitis, particularly in cases of chronic sinus disease, providing excellent detail of sinus anatomy. However, CT is usually not useful in acute sinusitis, as diagnosis in acute cases is primarily based on clinical findings. Good anatomic definition is desirable before surgical intervention.
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Coronal CT imaging is the preferred initial procedure. Bone-window views provide excellent resolution and good definition of the complete ostiomeatal complex and other anatomic details that play a role in sinusitis. In addition, the coronal view is best correlated with findings Seminarios Anatoma Clnico Radiolgica Tel. from sinus surgery, with anatomy 22781169,22703359, 88825513 in a plane and pathology visualized
CT provides an excellent anatomic display of soft-tissue attenuation. This depiction includes fluid levels and polypoid masses within the normally air-filled cavities of the sinuses, nasal cavity, and postnasal space. Most important, disease extending beyond the bony perimeters of the sinuses into the adjacent soft tissue of the orbit,[7] brain, and infratemporal fossa can be imaged. In general, nonenhanced CT scans suffice in cases of uncomplicated sinusitis. Multisection CT seems to have the potential to replace primary coronal CT of the paranasal sinuses without any loss of image quality, and it may even improve the overall 13/04/2012 diagnostic value. However, the
CT scan
Spiral CT scan
1mm cuts Magnetic Resonance Imaging
The exclusive use of coronal CT scans for sinus imaging could result in the failure to diagnose nasal cavity neoplasms. In the absence of bone destruction, an esthesioneuroblastoma or other neoplasm may be mistaken for a nasal polyp on a CT scan, whereas on MRI, the nature of this tumor is quite apparent. Beyond anatomic variants, any suspicious findings should be imaged by
Despite advances in MRI technology, insufficient tissue, plus the problems of susceptibility due to the air-containing passages, make MRI a less effective study for nasal cavity sinusitis problems, unless of course the sinusitis turns out to be related to squamous cell carcinoma (SCCa). To date, no new MRI contrast agents that have an affiliation for SCCa have been released
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means of MRI Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513
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Prxima serie
Magnetic Resonance
III parte
Imaging
Ultrasonography Nuclear Imaging
Angiography
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Gracias !
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13/04/2012
Gracias por la oportunidad
Desde la Clnica de Asma y Alergia
Managua , Nicaragua. Tel 22781169, 22703359, 88825513 Dr. Juan Herrera Salazar Favor ver la II Parte

Fisiología Anomalías de La Cavidad Nasal, Radiología, CT Scan

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Anatomia, Fisiologa, Nasal , Anomalas de la EW Cavidad nasal. ! Anatoma radiolgica,CT Scan

Seminarios Clnica de Asma y Alergia

notas al pie de las diapositivas

Overview Nasal Resistance Clinical Evaluation of

Revisin Dr. Juan Herrera Salazar

2 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Dr. Juan Herrera Salazar

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Chief Editor: Arlen D Meyers, MD, MBA more...

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Lo ms dificil es ver lo que esta delante de tus ojos W.

Seminarios Anatoma Clnico Radiolgica 7 Tel. 22781169,22703359, 88825513

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Radiografa Craneo Rx. . Lateral

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Radiografa de los Senos Nasales

(occipitomental) Caldwell (occipitofrontal)

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Derrame del seno maxilar

as shown in the image below, generally indicate bacterial sinusitis.

moxifloxacin, and amoxicillin/clavulanate - Greater than 90%

doxycycline, cefprozil, azithromycin, clarithromycin, and erythromycin - 7080%

Otros medicamentos Rinosinusitis

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Sinusitis, Chronic, Medical Treatment

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

CT Scan Anatomia y Fisiologa

COM Complejo Osteo Meatal

CT Scan Anatoma y Fisiologa

Complejo Osteo Meatal Posterior Normal

CT Scan Anatoma y Fisiologa

Complejo Osteo Meatal Posterior Normal

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Septo Nasal Estructura Osea y Cartilaginea.

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la Cavidad Nasal

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la Cavidad Nasal

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la Cavidad Nasal

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la cavidad nasal

Concha bullosa of the

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la cavidad nasal

paradjicos Duplicados Accesorios Fusin turbinatoturbinato

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la cavidad nasal

Large Haller air cell clearly narrowing the ethmoid infundibulum.

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalas de la cavidad nasal

ethmoid sinus floors

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Anomalias de la Cavidad Nasal

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Caractersticas radiolgicas de la sinusitis

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Patrones radilogicos al CT Scan