Acute and Chronic Sinusitis

Objectives
•    Be knowledgeable of the causes of and risk factors associated with sinusitis
•    Differentiate acute from chronic sinusitis
•    Evaluate patients by history, physical exam, appropriate laboratory and imaging studies, and when indicated screen patients for allergy
•    Prescribe appropriate medication regimens for acute and chronic sinusitis
•    Know of the relationships between upper airway (rhinosinusitis) and lower airway disease (asthma)

Medical Management of Nasal Polyposis

Background
► The term nasal polyposis comprises all types of nasal polyps which emerge as blue-gray protuberances in the area of
 the ethmoid bone,
 middle meatus,
 nose and
 middle turbinate

Tonsillitis, Tonsillectomy, and Adenoidectomy

Embryology

• 8 weeks: Tonsillar fossa and palatine tonsils develop from the dorsal wing of the 1st pharyngeal pouch and the ventral wing of the 2nd pouch; tonsillar pillars originate from 2nd/3rd arches

• Crypts 3-6 months; capsule 5th month; germinal centers after birth

• 16 weeks: Adenoids develop as a subepithelial infiltration of lymphocytes

Ototoxicity

Introduction

• Definition

– Damage to the cochlea or vestibular apparatus from exposure to a chemical source

• Many sources

– Mercury

– Herbs

– Streptomycin (1944)

• Dihydrostreptomycin (1948)

– Gentamicin (1965)

– Others

Congenital Laryngeal Anomalies

Outline

• Laryngeal Anatomy, Embryology & Function

• Laryngomalacia

• Laryngoceles & Saccular Cyst

• Vocal Cord Paralysis

• Congenital Laryngeal Web & Atresia

• Congenital Subglottic Stenosis

• Laryngeal & laryngotracheoesophageal clefts

• Subglottic Hemangiomas

Migraine

Prevalence

► Familial

► Young, healthy women; F>M: 3:1

 17 – 18.2% of adult females

 6 – 6.5% adult males

► 2-3rd decade onset… can occur sooner

► Peaks ages 22-55.

► ½ migraine sufferers not diagnosed.

► 94% pt’s seen in primary care settings for HA have migraines

Unilateral Sensorineural Hearing Loss

Introduction

• What dilemmas?

– Increasing number and complexity of tests

– Increasing costs of medical care

– What do tests results mean?

– At what point does cost of testing outweigh value of “rule out” diagnosis?

– How far do we go to diagnose etiology?