(耳鼻咽喉头颈外科学)2.1（参考翻译）Acute and Chronic Sinusitis讲解材料.pptVIP

Predisposing factors of CRS CRS的发病诱因 CRS相关因素： 纤毛损伤 过敏 哮喘 阿司匹林敏感症: 有阿司匹林敏感症的患者，36-96%患有CRSwNP。 免疫功能不全 遗传因素 怀孕及内分泌 地方性宿主因素（？）: 没有证据表明一般鼻腔解剖变异与CRS的发病率之间存在因果关联。 生物膜 环境因素 医源性因素 幽门螺杆菌和咽喉逆流症 “骨炎” EPOS 2012 Inflammatory mechanisms of CRSwNP or CRSsNP CRSwNP或CRSsNP的炎症机制 CRS can be typically described as a dysfunctional host-environment interaction at the site of interface, which occurs in the nose and paranasal sinuses CRS一般可以描述为一个发生于鼻和鼻旁窦界面（？）的不正常的宿主环境交互 ‘fungal hypothesis 真菌假说’ ‘staphylococcal superantigen hypothesis 葡萄球菌超抗原假说’ ‘immune barrier hypothesis 免疫屏障假说’ biofilms 生物膜 EPOS 2012 Symptoms and Signs of Acute Sinusitis 急性鼻窦炎的症状与体征 A. General Symptoms 全身症状 Acute Sinusitis malaise 萎靡 mild fever 低热 headache 头痛 B. Local Symptoms and signs 局部症状和体征: a. a stuffy or runny nose 鼻塞或流涕 b. colored discharge 有色成分排出（？）: from the nose 源自鼻腔 c. Pain or headache 疼痛或头痛: persistent dull pain or swelling around the eyes or around the cheekbones, or sensation of pressure in head 眼周或颧骨周持续性钝痛或肿胀，又或感觉头部受压 d. smells bad 异味 Symptoms and Signs Acute Sinusitis Maxillary sinusitis 上颌窦炎 may in the maxillary area of the face, toothache, and frontal headache. 可能在上颌区发生脸,牙痛,额头痛。 Frontal sinusitis 额窦炎 causes frontal pain and headache. 造成额痛和头痛。 Ethmoid sinusitis 筛窦炎 cause pain behind the eyes and frontal headache. 造成眼球后疼痛和额痛。 Sphenoid sinusitis 蝶窦炎 cause pain in the occipital region.在枕叶区域引起疼痛。 Rhinogenic headache 鼻源性头痛 Different sinusitis has different headache 不同类型的鼻窦炎可有不同种类的头痛 Symptoms of chronic sinusitis慢性鼻窦炎的症状 Blocked nose (nasal obstruction) 鼻塞: the most prominent symptom , usually a One or more of the following may also occur: 最突出的症状，通常还伴有下列一个或多个症状同时发生 Runny nose 流鼻涕: the discharge may be green/yellow. 分泌物可为绿色/黄色 Reduced sense of smell. 嗅觉减退 Pain 疼痛: over the affected sinus. However, pain is often not a main feature of chronic sinusitis (unlike acute sinusitis). In many cases, it is more of a feeling of facial fullness or mild discomfort rather than pain