1 C J Mieny, U Mennen: Principles of Surgical Patient Care - Volume ...

ComplicationsThe adverse results of otitis media may be:- Chronic otitis media- Facial palsy- Labyrinthitis and vertigo- Otogenic intracranial complications, i.e. meningitis- Petrositis with sixth nerve palsy and diplopia- Complications of mastoiditis.Acute Upper Respiratory Aerodigestive Tract InfectionsRhinitisAcute rhinitis seldom occurs in isolation and is usually part of a rhinosinusitis.The common cold is a typical example of an acute rhinitis. The cause is a viralinfection with secondary bacterial invasion. Viruses include influenza, parainfluenza,respiratory syncitial and "picorna" viruses. Secondary organisms are Streptococcus influenzae,Pneumococcus and Staphylococcus.The pathogenesis is a transient ischemia which rapidly changes to hyperaemia,congestion and rhinorrhoea. Based on the above, four categories of symptoms and signs areto be found:- Firstly a widely patent nose with burning sensation in the ischaemic phase.- This is followed by a blocked runny nose during the congestive stage.- Secondary infection characterizes the third phase in which there is a thick profusemucopurulent discharge.- The fourth phase is one of resolution.Systemic treatment of rhinitis consists of bedrest, analgesics, pseudo-ephedrine andantibiotics.Local therapy includes vasoconstrictor sprays for the acutely obstructive phase.Acute SinusitisAs in the case of rhinitis, the initial cause of acute sinusitis is most often viral.Suppurative sinusitis results when there is a bacterial infection with the formation of pus inone or several sinuses.Each of the paranasal sinuses drains via ostia into the nasal cavity. Any swelling ofthe nasal mucosa will lead to obstruction of the sinus opening and a cessation of drainage andaeration.12