Rhinosinusitis pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
===Pathogenesis=== | ===Pathogenesis=== | ||
====Acute | ====Acute Rhinosinusitis==== | ||
The [[sinuses]] are air-filled spaces in the [[skull]] (behind the [[forehead]], [[nasal bones]], [[cheeks]], and [[eyes]]) that are lined with [[mucus membranes]]. Healthy [[sinuses]] are well-aerated and contain no [[bacteria]]. Usually, [[mucus]] is able to drain out and air is able to circulate. When the [[sinus]] openings become blocked due to swelling of the nasal mucosa, it provides a medium for an inflammatory response to ensue. Inflammation is mediated by protease in granulocytes and if the amount of protease overwhelms the amount of protease inhibitors available, tissue destruction will take place.<ref name="pmid6580734">{{cite journal| author=Lundberg C, Engquist S| title=Pathogenesis of maxillary sinusitis. | journal=Scand J Infect Dis Suppl | year= 1983 | volume= 39 | issue= | pages= 53-5 | pmid=6580734 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6580734 }} </ref> | The [[sinuses]] are air-filled spaces in the [[skull]] (behind the [[forehead]], [[nasal bones]], [[cheeks]], and [[eyes]]) that are lined with [[mucus membranes]]. Healthy [[sinuses]] are well-aerated and contain no [[bacteria]]. Usually, [[mucus]] is able to drain out and air is able to circulate. When the [[sinus]] openings become blocked due to swelling of the nasal mucosa, it provides a medium for an inflammatory response to ensue. Inflammation is mediated by protease in granulocytes and if the amount of protease overwhelms the amount of protease inhibitors available, tissue destruction will take place.<ref name="pmid6580734">{{cite journal| author=Lundberg C, Engquist S| title=Pathogenesis of maxillary sinusitis. | journal=Scand J Infect Dis Suppl | year= 1983 | volume= 39 | issue= | pages= 53-5 | pmid=6580734 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6580734 }} </ref> | ||
====Chronic | ====Chronic Rhinosinusitis==== | ||
Biofilms are complex aggregates of extracellular matrix and inter-dependant [[microorganism]]s from multiple species, many of which may be difficult or impossible to isolate using standard [[medical microbiology|clinical laboratory]] techniques. [[Bacteria]] found in biofilms may show increased [[antibiotic resistance]] when compared to free-living bacteria of the same species. It has been hypothesized that biofilm-type [[infection]]s may account for many cases of [[antibiotic]]-refractory chronic sinusitis. While biofilms have been implicated in the pathogenesis of chronic sinusitis, more research needs to be done in order to understand their role in causing inflammation and disease. <ref name="pmid17432062">{{cite journal| author=Harvey RJ, Lund VJ| title=Biofilms and chronic rhinosinusitis: systematic review of evidence, current concepts and directions for research. | journal=Rhinology | year= 2007 | volume= 45 | issue= 1 | pages= 3-13 | pmid=17432062 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17432062 }} </ref><ref>{{cite journal |author=Palmer JN |title=Bacterial biofilms: do they play a role in chronic sinusitis? |journal=Otolaryngol. Clin. North Am. |volume=38 |issue=6 |pages=1193-201, viii |year=2005 |pmid=16326178}}</ref><ref>{{cite journal | author = Sanclement J, Webster P, Thomas J, Ramadan H | title = Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. | journal = Laryngoscope | volume = 115 | issue = 4 | pages = 578-82 | year = 2005 | id = PMID 15805862}}</ref> | Biofilms are complex aggregates of extracellular matrix and inter-dependant [[microorganism]]s from multiple species, many of which may be difficult or impossible to isolate using standard [[medical microbiology|clinical laboratory]] techniques. [[Bacteria]] found in biofilms may show increased [[antibiotic resistance]] when compared to free-living bacteria of the same species. It has been hypothesized that biofilm-type [[infection]]s may account for many cases of [[antibiotic]]-refractory chronic sinusitis. While biofilms have been implicated in the pathogenesis of chronic sinusitis, more research needs to be done in order to understand their role in causing inflammation and disease. <ref name="pmid17432062">{{cite journal| author=Harvey RJ, Lund VJ| title=Biofilms and chronic rhinosinusitis: systematic review of evidence, current concepts and directions for research. | journal=Rhinology | year= 2007 | volume= 45 | issue= 1 | pages= 3-13 | pmid=17432062 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17432062 }} </ref><ref>{{cite journal |author=Palmer JN |title=Bacterial biofilms: do they play a role in chronic sinusitis? |journal=Otolaryngol. Clin. North Am. |volume=38 |issue=6 |pages=1193-201, viii |year=2005 |pmid=16326178}}</ref><ref>{{cite journal | author = Sanclement J, Webster P, Thomas J, Ramadan H | title = Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. | journal = Laryngoscope | volume = 115 | issue = 4 | pages = 578-82 | year = 2005 | id = PMID 15805862}}</ref> | ||
Revision as of 16:49, 26 September 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Pathophysiology
Pathogenesis
Acute Rhinosinusitis
The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses are well-aerated and contain no bacteria. Usually, mucus is able to drain out and air is able to circulate. When the sinus openings become blocked due to swelling of the nasal mucosa, it provides a medium for an inflammatory response to ensue. Inflammation is mediated by protease in granulocytes and if the amount of protease overwhelms the amount of protease inhibitors available, tissue destruction will take place.[1]
Chronic Rhinosinusitis
Biofilms are complex aggregates of extracellular matrix and inter-dependant microorganisms from multiple species, many of which may be difficult or impossible to isolate using standard clinical laboratory techniques. Bacteria found in biofilms may show increased antibiotic resistance when compared to free-living bacteria of the same species. It has been hypothesized that biofilm-type infections may account for many cases of antibiotic-refractory chronic sinusitis. While biofilms have been implicated in the pathogenesis of chronic sinusitis, more research needs to be done in order to understand their role in causing inflammation and disease. [2][3][4]
Genetics
Associated Conditions
Gross Pathology
Microscopic Pathology
References
- ↑ Lundberg C, Engquist S (1983). "Pathogenesis of maxillary sinusitis". Scand J Infect Dis Suppl. 39: 53–5. PMID 6580734.
- ↑ Harvey RJ, Lund VJ (2007). "Biofilms and chronic rhinosinusitis: systematic review of evidence, current concepts and directions for research". Rhinology. 45 (1): 3–13. PMID 17432062.
- ↑ Palmer JN (2005). "Bacterial biofilms: do they play a role in chronic sinusitis?". Otolaryngol. Clin. North Am. 38 (6): 1193–201, viii. PMID 16326178.
- ↑ Sanclement J, Webster P, Thomas J, Ramadan H (2005). "Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis". Laryngoscope. 115 (4): 578–82. PMID 15805862.