sinus paranasal
DESCRIPTION
dokumenTRANSCRIPT
![Page 1: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/1.jpg)
SINUS PARA-NASALSINUS PARA-NASAL
DEPARTEMEN THT – KL FK USU / DEPARTEMEN THT – KL FK USU / RSUP. H.ADAM MALIK RSUP. H.ADAM MALIK
MEDANMEDAN
![Page 2: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/2.jpg)
Sinus para-nasalSinus para-nasal
• “Nasal asessory sinuses”
Rongga dalam tulang kepala berisi udara
• Sinus maksila
• Sinus frontal
• Sinus etmoid
• Sinus sfenoid
![Page 3: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/3.jpg)
Perkembangan sinusPerkembangan sinus
• S. Maksila dan etmoid mulai fetus 3-4 bulan invaginasi mukosa rongga
hidung• Epitel: Pseudo stratified kolumnar bersilia (epitel torak berlapis semu)• S.Frontal dari s. etmoid anterior 8 th• S.Sfenoid dari pneumatisasi posterior- superior rongga hidung 10 th
![Page 4: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/4.jpg)
Sinus maksilaSinus maksila
• Sinus para-nasal terbesar
• Anak dasar sinus setinggi ostium jarang infeksi
• 9-12 th dasar sinus = dasar hidung
• 25 th dasar sinus rendah dari dasar
hidung mudah infeksi
![Page 5: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/5.jpg)
![Page 6: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/6.jpg)
Batas sinus maksilaBatas sinus maksila
• Anterior : Fosa canina
• Posterior: permukaan infra temporal
maksila
• Media : dinding lateral rongga hidung
• Superior : dasar orbita
• Inferior : Prosesus alveolaris dan palatum
![Page 7: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/7.jpg)
Persarafan sinus maksilaPersarafan sinus maksila
• N. Infra orbitalis Foramen infra orbital
Bagian atas sinus
• N. Alveolaris superior Dasar sinus
![Page 8: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/8.jpg)
Klinis sinus maksilaKlinis sinus maksila
• Dasar sinus dekat akar gigi P1, P2, M1, M2 kadang2 C dan M3 Caries sinusitis
• Komplikasi ke orbita
• Sinus yang paling sering terinfeksi
![Page 9: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/9.jpg)
Klinis sinus maksilaKlinis sinus maksila
• Ostium sinus maksila:
Lebih tinggi dari dasar sinus (gravitasi)
letak pada Hiatus semilunaris (sempit)
gangguan drainase
![Page 10: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/10.jpg)
![Page 11: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/11.jpg)
![Page 12: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/12.jpg)
Sinus frontalSinus frontal
• Terletak dalam os frontal kiri dan kanan• Dinding tulang tipis membatasi orbita dan fosa serebri anterior komplikasi• Biasanya tidak simetris, dipisah oleh septum• Orang dewasa: 15 % satu sinus frontal 5 % rudimenterOstium: Duktus frontonasal rongga hidung
![Page 13: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/13.jpg)
Sinus etmoidSinus etmoid
• Sel-sel terletak di lateral os etmoid,antara konkha media dan dinding orbita (sarang lebah)
• Grup anterior : kecil, banyak
ostium meatus media
Grup posterior: besar, sedikit
ostium meatus superior
Sel etmoid terbesar: Bula etmoid
![Page 14: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/14.jpg)
Batas sinus etmoidBatas sinus etmoid
• Superior : rongga tengkorak
• Atap : Fovea etmoid
• Posterior : Sinus sfenoid
• Lateral : Lamina papirasea
![Page 15: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/15.jpg)
Batas sinus sfenoidBatas sinus sfenoid
superior : fosa serebri media hipofisa inferior : atap nasofaring lateral : sinus kavernosus a. karotis intr posterior : fosa serebri posteriorTerletak dalam os sfenoid
![Page 16: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/16.jpg)
![Page 17: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/17.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Inspeksi: pembengkakan muka, pipi
sinusitis maksila akut.
pembengkakan kelopak mata
atas sinusitis frontal akut
![Page 18: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/18.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Palpasi: nyeri tekan/ketok gigi sinusitis
maksila.
nyeri tekan medial atap orbita
sinusitis frontal
nyeri tekan cantus media
sinusitis etmoid
![Page 19: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/19.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
Rinoskopi anterior
Rinoskopi posterior
![Page 20: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/20.jpg)
![Page 21: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/21.jpg)
![Page 22: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/22.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Transiluminasi:
Penggunaan: s. maksila dan s. frontal
bila fasilitas radiologik
tidak ada.
Sumber cahaya: lampu senter/batrei
Tempat : ruangan gelap
![Page 23: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/23.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Transiluminasi:
Cara untuk sinus maksila: Masukkan sumber
cahaya ke rongga mulut
Penilaian: Terang pada pipi infra orbital
normal/ kista sinus maksila
Gelap pus, penebalan mukosa,
neoplasma, jaringan lunak menutupi
antrum, sinus tidak berkembang.
![Page 24: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/24.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Transiluminasi: untuk sinus frontal
Cara : sumber cahaya didasar sinus
Penilaian: terang sinus berkembang
baik
gelap sinus tidak
berkembang baik
![Page 25: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/25.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Radiologi: posisi Waters, PA, Lateral
dan Cald well-Luc.
• CT.Scan potongan koronal
• MRI
![Page 26: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/26.jpg)
![Page 27: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/27.jpg)
![Page 28: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/28.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Endoskopi Naso-endoskopi
Sumber cahaya
kabel optik Teleskop 0°,
30° dan 70°
Penilaian: dinding lateral hidung,
nasofaring.
![Page 29: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/29.jpg)
Pemeriksaan sinus para-nasalPemeriksaan sinus para-nasal
• Naso-endoskopi Dinding lateral hidung:
Konkha inferior / media
Prosesus unsinatus
Ostio Meatal Complex (OMC)
Frontal-reses
Sfeno-etmoid reses
![Page 30: Sinus Paranasal](https://reader034.vdokumen.com/reader034/viewer/2022042507/55cf8fa8550346703b9e7ed0/html5/thumbnails/30.jpg)