Thursday, October 27, 2011

Causes and Remedies for Nasal Congestion

Causes and Remedies for Nasal Congestion

A stuffy nose is called nasal congestion in medical terminology. The stuffiness interferes with airflow from and outside of the nose. The congestion mainly occurs due to swelling of the tissues lining the nose. The swelling is attributed to inflammation of the blood vessels. And, in some cases, excessive secretion of thick mucus may be the culprit. Sometimes, structural deformities also lead to the congestion. One side stuffiness may occur due to a foreign substance inserted into the nose. The congestion is associated with sinus infection, flu, common colds, vasomotor rhinitis, pregnancy, nasal polyps, over use of nasal drops or sprays, and hay fever. In some cases, people suffer from congested nose without any reasons. This is referred to as non-allergic rhinitis.

Nasal congestion in infants can affect nursing. Although a stuffy nose is an annoyance in adolescents and older children, sometimes it may result in serious problems. For instance, congestion may hinder the sleep and lead to problems related to speech development and hearing. The congestion may cause snoring as the patients having stuffy nose breathe from the mouth instead of the nose while sleeping. During breathing from the mouth, negative pressure behind the soft palate and uvula develops, increasing the vibrations.



Generally, a stuffy nose heals itself within one week. However, you may try the following remedies for better healing:

  • Put saline nose drops into both nostrils to remove the mucus.
  • Consume sugar-free fluids. Keep the sinuses and nasal passages moist. Vaporizers and humidifiers will retain room air moisture. Irrigate the nose with saline.
  • Warm compresses will reduce the congestion. Use a warm, wet clean cloth for the compresses. Inhale steam.
  • Over-the-counter (OTC) drugs- antihistamines, decongestants and painkillers- may give some relief. Decongestants may relieve congestion by reducing the swelling, whereas antihistamines bring down the level of mucus. However, seek help of a doctor in choosing a right OTC.
  • Keep the head raised, as the stuffiness aggravates when you lie down. Sleeping with raised head will ensure comfortable breathing.
  • Do not swim in chlorinated pools.
  • Use neti pot to clear away the congestion.
  • Do consult the doctor if the congestion is accompanied by persistent coughing, yellow-green / gray mucus, pain in the throat, blurred vision and swelling of the cheeks, eyes, forehead and the nose.
  • If you want supplements, consult the doctor.
  • If medications do not help, surgery, especially in the case of chronic nasal congestion, may be required.
  • Pungent and spicy foods may help in relieving the congestion.

 

Wednesday, October 26, 2011

Treatment for Sinusitis Headache

Treatment for Sinusitis Headache

Scuba diving, swimming, air travel and other activities during which air pressure changes may trigger the sinusitis headache, requiring an appropriate treatment. Medication given for sinusitis headache has twofold role: treating the sinus infection and relieving the sinus symptoms. Doctors may prescribe antibiotics for less than two weeks to alleviate the infection. Decongestants or antihistamines may be administered for short period to get rid of the symptoms. However, decongestants may worsen your headache if it is not because of sinusitis. Thus, do not take any medicine without consulting your doctor. Decongestants constrict headache causing blood vessels, relieving the symptoms. However, decongestants are addictive.




Pain relievers (analgesics) are a part of the sinusitis headache therapy. If the pain relievers do not reduce the pain, corticosteroids are administered to bring down the inflammation. If an allergen is causing the sinus disorder, allergy medication is required.

Avoid over use of decongestants or analgesics, as overuse will lead to rebound headache.

Nasal sprays with steroids and antihistamines may be useful to treat headaches associated with allergic sinusitis.

Vasoconstrictors may be given to reduce nasal congestion.

Detailed medical examination and review of medical history is required to treat the headache. Doctor may advise for CT, MRI scans or X-rays for precise diagnosis. Physical examination of the nose and ear may help in identifying the signs.

If prescription is not followed properly, the headache may persist.

Do not self-diagnose and self-treat. However, adequate intake of water and other fluids ensures proper drainage of secretions. Alternate cold and hot compresses may give some relief. Nasal irrigation helps in clearing the congestion. Consult the physician if headache persists. If symptoms last for more than 10 days, visit a doctor.

To reduce sinus headache, inflammation of the sinuses and swelling of the mucus membrane should be reduced, and drainage of materials trapped in mucous area should be improved. Breathe in humidified air to encourage drainage. With improved drainage and reduced inflammation, headache will subside.

If headache is not treated in timely manner and properly, some complications may develop. Untreated sinus infection may seep into the walls of the sinuses and spread in the adjacent areas, including the orbit. As a result redness, swelling and pain of the eyes may occur.  The infection may enter into the blood vessels in the surrounding areas and produce blood clots and inflammation.

Tuesday, October 25, 2011

Treatment for Mastoid Sinus Infection

Treatment for Mastoid Sinus Infection

Mastoiditis, a mastoid sinus infection, was fatal prior to invention of antibiotics. Now-a-days, mastoiditis is uncommon and a less dangerous disease. Thanks to antibiotics!

However, treating mastoiditis is still difficult because medication may not reach the affected area. The curable condition may reappear after the treatment. Thus, it may need long-term therapy or treatment more than once. Initial antibiotic injections are followed by a course of oral antibiotics. Antibiotics are given through an intravenous (IV) catheter to children. Most of the cases, including chronic conditions, can be treated by effective antibiotics.

If antibiotic does not heal the symptoms, mastoidectomy-surgery of the mastoid- may be required. During the surgery, infected part is removed and the mastoid is cleaned. Acute mastoid sinus infection may require immediately after surgery. During myringotomy, a surgical technique, a small opening is made to drain the infected fluid out from the middle ear, relieving pressure on the ear. Fluid draining process restores hearing ability in the patient.

Appropriate treatment of ear infections in timely fashion can prevent mastoiditis or reduce the chances of mastoiditis. If antibiotics are used to treat ear infections, chances of developing mastoiditis will be less. Consult a doctor if ear infection persists. Patient specific treatment, determined by doctor, depends on a number of factors, such as overall health of the patient, age group, medical history, level / stage of disease, patient’s tolerance to therapies, procedures or medications, and guardians’ preferences.




Although some times young patients may be hospitalized for the treatment, most of the mastoiditis incidences can be treated successfully within one and a half week. However, if symptoms of mastoid sinus infection are ignored or not treated properly, complications may occur, such as

  • It may damage the mastoid bone.
  • Patients may feel vertigo or dizziness.
  • Epidural abscess, pus accumulated between the bones of the spine or skull and the outer membrane of the brain, may develop.
  • Paralysis of the face may occur.
  • The infection may lead to meningitis.
  • Loss of hearing may be complete or partial.
  • The infection may spread to the whole body or the brain.
  • Untreated acute mastoiditis may also cause blood poisoning and deafness.
  • Other complications include thrombosis, citelli abscess and osteomyelitis. For instance, thrombosis of the lateral or transverse sinus may occur.

 

So do not ignore signs of mastoiditis.

Monday, October 24, 2011

Infection of Mastoid Sinuses: Causes and Symptoms

Infection of Mastoid Sinuses: Causes and Symptoms

Mastoiditis, a bacterial infection of mastoid air cells, could be acute or chronic. Acute otitis media’s complication is referred to as acute mastoiditis. Acute otitis media, an infection and inflammation of the middle ear, is common in children. Acute disorder can be diagnosed clinically, but sometimes computed tomography (CT) scan is required. Chronic mastoiditis is usually ascribed to chronic suppurative otitis media. Chronic mastoiditis is middle ear’s infection affecting the mastoid bone comprising several interconnected air-cells. Infected cells contain fluid that supports bacteria growth. Since the mastoid is middle ear cleft’s extension, all patients of chronic middle ear inflammation or acute otitis media suffer from mastoiditis.  The middle ear infection may rupture eardrums and infect mastoid air cells.




 

The infection may damage honeycomb structure of the mastoid sinuses. Chronic inflammation of the middle ear may result in tissue growth that may reach the mastoid bone and antrum. Coalescent mastoiditis occurs when inflammation and other symptoms of the disease persists over 2-4 weeks. This infection may obliterate mastoid sinusesand destroy lining around the bone. Cholesteatoma, a skin cyst in the middle ear, can also disrupt the ear drainage system, causing mastoiditis.

Mastoiditis generally occurs in infants and young children whose eardrums are ruptured and not treated.  Ears are irreplaceable assets. Take care of your kids’ ears. The condition generally develops in children of 1-2 years old. Some times, it may be found up to age of 8 years. Children who have history of middle ear infections that reoccur and ear infections are prone to mastoiditis. However, incidences of mastoiditis in adults are very less in number.

Common Symptoms

  • Discomfort or pain in the ear may occur.
  • Discharge from the ear is common. The source of discharge may be located in the perforated eardrum.
  • Entire ear or back of the ear may become red.
  • Swelling may occur behind the ear. A tender and painful abscess may occur due to mastoid bone’s damaged cortex. Abscess may burst. Swelling may push the ear downward and forward. The ear lobe may also swell.
  • Patients may suffer from high fever, which may increase suddenly.
  • Mastoiditis affects ability to hear.
  • Headache and irritability are two other common symptoms of the disease.

 

Friday, October 21, 2011

Inflammation of Mastoid Sinus

The mastoid process, one of the four integral parts of the temporal bone, is the prominent rounded knob behind the ear. The knob occurs behind both the ears. The temporal bones are located on the sides of the human skull. The mastoid process is found on the inferior and the posterior border of the bone.




The process features scores of air-filled spaces, which are called mastoid air cells or mastoid sinus. The spongy air cells are located on the back of the middle ear. The middle ear is a small cavity within the temporal bone. The size and the number of the cells differ from person to person. A mucous membrane lines the mastoid sinus. Small cells may be filled with bone marrow, whereas the big one contains air. The sinus, connected to the middle ear, improves resonance in the ear and sound amplification and perception. The mastoid process also helps in maintaining balance of the head.

The skin over the process is smooth and fine. The skin does not have hairs either. The process is more prominent in adults than in children. It is less prominent in men than in women. The knob in old people is the largest. The most interesting fact about the process is that a blow or fall cannot fracture it. However, there are cases of bullet-induced fractures in the process.

Mastoiditis

Inflammation / infection of mastoid sinus or the mastoid bone is called mastoiditis that develops in five stages:

  1. hyperemia of the mastoid sinus’ mucosal lining,
  2. exudation and transudation of pus and / or fluid within the sinuses,
  3. bone necrosis,
  4. loss of the cell wall and
  5. spreading of inflammation to bordering areas.

Diagnosing Mastoiditis

An x-ray of skull, a CT scan of the head or CT scan of the ear will help in diagnosing mastoid sinus infection if no symptoms were found during the examination of patient’s head. If signs of intracranial problems or brain abscess are found, doctor may ask for a computed tomography scan (CT scan) or magnetic resonance imaging (MRI). Doctor may also recommend blood and culture tests.

Doctor may use otoscope to examine eardrums and outer ears of children. S/he may also perform a physical examination and go through medical history of the patient. So carry all records while visiting the doctor.

Doctors may perform tympanometry test to check functioning of the middle ear, including pressure changes. The test requires patients to sit still. Thus, it is difficult to perform the test on children. 

Thursday, October 20, 2011

3 Decongestants Recalled in 2010

3 Decongestants Recalled in 2010

A decongestant is useful in treating symptoms of sinus infection. However, consult a doctor before using a decongestant to ensure that you take approved and safe medication. Recently, some decongestants were voluntarily recalled from the U.S. market considering customers’ safety.  This article focuses on three of these decongestants.

PediaCare Decongestant 4oz.

After consulting with the U.S. Food and Drug Administration (FDA), Blacksmith Brands, Inc. voluntarily recalled its four PediaCare products, designed for children, in May 2010. The products include PediaCare Decongestant 4oz., PediaCare Allergy and Cold 4oz, PediaCare Long Acting Cough 4oz. and PediaCare Multi-Symptom Cold 4oz. All the four products were exclusively distributed within the United States of America. McNeil Consumer Healthcare, a part of Johnson & Johnson Company, manufactured these products for Blacksmith. Recall was a precautionary measure in response to FDA’s inspection report that concluded that McNeil Consumer Healthcare Fort plant in Washington (Pennsylvania) was not following the latest production standards.

VapoSpray 4-Hour Decongestant Nasal Spray by Sinex

In June 2010, the Procter & Gamble Company (PG) recalled its VapoSpray, which was sold in the U.S. market. This voluntary recall was a precautionary measure, as the product formulation was not pursuant to the expiry date stamped on the spray package. The company offered refund or replacement coupons for recalled products. PG was selling VapoSpray as Sinex Nasal Spray in Ultra Fine Mist and spray forms before June 2009.

Over-the-Counter Cold Decongestant Tablets

Reese Pharmaceutical Company, based in Ohio, recalled lot#091612 of 60-count size bottles of cold decongestant tablets in December 2010. These tablets contained 325 mg of acetaminophen, 2 mg of chlorpheniramine maleate and 5 mg of phenylephrine. However, they were mislabeled. The faulty labels read that the tablets contain 200 mg of guaifenesin. The voluntary recall was initiated to ensure that consumers do not ingest the tablets and do not get any side effects of either of three ingredients. As faulty labels did not carry a warning that acetaminophen may damage the liver. High dose of acetaminophen can damage the liver. Chances of liver damage increase in patients who are already suffering from liver disorders.

The recalled tablets included Leader Cough Tabs Expectorant, QC Medifin Expectorant, Refenesen Expectorant and Select Brand Mucus Relief Expectorant.  The tablets were sold in the United States of America. The recall decision was taken after consulting the U.S. Food and Drug Administration.

Next time, when you buy a decongestant ensure that you do not use banned products that may aggravate your problems.

Wednesday, October 19, 2011

Tests That Determine Allergies’ Causes

Tests That Determine Allergies’ Causes

A number of laboratory tests helps in determining causes of allergies. The tests identify the substance causing allergic reactions / allergens. Commonly used allergy tests include  blood tests, elimination tests and skin tests.

Blood tests are conducted if patients are unable to undergo skin tests. Enzyme-linked immunosorbent assay (ELISA, EIA), a blood test, counts allergen-specific immunoglobulin (Ig) E antibodies found in the blood of the patient. Other examples of blood tests include absolute eosinophil count, immunoassay capture test (ImmunoCAP, UniCAP, or Pharmacia CAP) and radioallergosorbent (RAST) test.



Absolute eosinophil count test calculates the number of eosinophils, the white blood cells, as the cells become active when you have allergies and infections. If the result of a blood differential test is abnormal, absolute eosinophil count test is done. The eosinophil test helps in assessing severity of an allergic reaction. A high count of eosinophil may be ascribed to hay fever, asthma or leukemia. RAST method is used if the result of skin testing is inconclusive or skin testing cannot be done.

Elimination tests use an elimination diet to determine allergies to a food item. The diet means stopping consumption of foods causing allergic reaction for many weeks and re-introducing these food items one by one to observe and monitor allergy symptoms.

The most common allergy test is a skin test that is used to diagnose allergic contact dermatitis, food allergy, penicillin allergy, venom allergy and animal, mold and pollen allergies causing asthma and allergic rhinitis. Skin tests are preferred to blood tests as they are reliable, quicker and cheaper. There are different types of skin tests, such as intradermal skin test, patch testing and prick test.

During intradermal skin test, a small quantity of an allergen is injected into the skin and reaction signs are observed. The test is usually performed to determine whether patient is allergic to penicillin and bee venom. This test is done if a prick test fails. In the prick test, a small quantity of a likely allergen is placed into the skin surface through needle pricks or scratches and reaction to the allergen is watched for up to 20 minutes.

Patch testing means placing allergens on the skin and taping them to the skin for up to three full days. The test is carried out to diagnose contact dermatitis, a skin allergy caused due to chrome found in leather items, nickel used in coins, jewelry and watch buckles, and fragrances.

Tuesday, October 18, 2011

Can Animal-induced Allergens Cause Allergic Rhinitis?

Can Animal-induced Allergens Cause Allergic Rhinitis?

Yes, animal-induced allergens may cause allergic rhinitis.

For instance, pet dander, small skin scales shed by the animals, may trigger perennial or episodic allergic rhinitis. As dander and hair exist in the air, pets living indoors cause more problems. Air borne dander can move within the home through the air-circulation system. Some times wool also contains tiny dander that may trigger allergy.

Some people are allergic to feathers or furs of the animals, while others are allergic to saliva of animals. If your pet licks you, you may be exposed to its saliva. If you touch objects chewed or licked by animals, it may increase chances of touching the saliva. Cats’ saliva, for example, has a protein that causes allergy.

Cats have more allergens than dogs. Wash pets at least once every week to get rid of allergic-substances. You may try dry shampoos that are easy to use to remove allergic substances from the fur and skin of the pets. Although cats and dogs are common source of allergies, ferrets, hamsters, horses and rabbits may also cause allergies.




Remove pets from the home. But if you do not want to do that, thorough cleaning of floors and carpets is necessary. Use vacuum cleaners with high-efficiency particulate air (HEPA) filter. Wash bedding and draperies frequently. Keeping pet food in closed containers will help in reducing cockroaches menace, because these pests are also a source of allergy. Clean humid areas of your home, such as garages, bathrooms and kitchens regularly, because cockroaches love damp places. Cockroaches may affect lung function and trigger asthma. Exterminate the pests. Do not keep food in bedrooms. Store food in closed containers. Use covered dustbins.

Another common allergen is house mice hairs, especially in urban areas. Exterminate the mice and remove dust that may have mouse dander and urine.

To treat pet-induced allergic rhinitis, allergen immunotherapy is useful. However, the best therapy is to avoid pet dander and other animal-induced allergens because it saves money and eliminates chances of side effects of medication. Many times, it is difficult to avoid the allergens.

If you suffer from animal-induced allergies and still love pets, keep the pets outdoor instead of indoors. Do not let them enter into bedrooms. Ensure that pets do not spend time on carpets and furniture covered with cloth.  However, some research studies concluded that exposure to pet-specific allergens during early childhood may make children allergy resistant.

Tuesday, October 11, 2011

How to Use Nasal Sprays Effectively

How to Use Nasal Sprays Effectively

Nasal sprays are available in pressurized canisters and pump bottles. The effects of the spray may be visible within two weeks of its use. Saline nasal spray therapy is generally un-medicated, but medicated sprays are also available. The main purpose of the spray is to moisturize the nostrils and the cilia. Properly moistened cilia, thus, can perform its function of flushing out mucus and bacteria easily. The saline spray is simple and effective method to clear out the sinuses and nose congestion. The spray can also be used for infants and children. Since no medication is added to these sprays, it is safe. The spray is affordable. However, effects of the spray are short-lived.  To maximize the benefits of nasal sprays, consider the following tips:

  • You should be able to sniff before using the spray. If you are unable to sniff, medicine will be released deep into the nose, causing irritation. 
  • Exhale slowly and move the head in proper position. If using the bottle, tilt the head forward. If using the canister, keep head upright.  If the spray drips down the throat’s back or from the nose, the spray container was not in proper position.



 

  • Shake the bottle or canister prior to spraying. Adjust the canister to ensure it is firmly placed in the holder.
  • If you have bought the pump bottle spray, squirt it until a spray of mist is released before using it.
  • Avoid blowing your nose or sneezing immediately after spraying. 
  • Clean the canister spray regularly.
  • Follow the physician’s prescription. Read the instruction on medicine and spray package.
  • Do not store the nasal spray under sunlight.
  • Do not use the spray up to two days, if you have stinging feeling in the nose, nosebleed has started or the spray is hurting the nose.
  • Nasal steroid sprays are mainly used for chronic sinusitis treatment. Some sprays are also used for acute conditions. The spray helps in reducing nose congestion and sinus inflammation. However, these sprays are not a permanent cure. Generally, the symptoms will return after stopping the application of the spray. The long-term use of the spray may cause dryness, itching, irritation and burning inside the throat and nose. It may also trigger nosebleeds, headaches and sneezing.
  • Nasal saline spray is an over-the-counter medication. The saline used in the spray increases moisture level, facilitating removal of infection. The saline sprays are non-addictive.

Monday, October 10, 2011

Causes of Headache-Sinus

Causes of Headache-Sinus

Sinusitis, the inflammation and congestion of the sinuses, causes pain in the head and the face. This pain is referred to as  headache-sinus. Factors causing sinus headaches can be divided into four categories: respiratory, environmental, physical and other.

Respiratory Factors

Since sinus headaches are an outcome of another condition, these are called secondary headaches. Generally, the underlying condition associated with the sinus headaches is common colds. Other infections of upper respiratory system may also lead to sinus headaches.

When the ducts connecting the sinuses with the back of the nose swell, the sinus functioning ability reduces and pressure builds in the infected sinus. Production of inflammatory fluid increases. Ability to drain fluid falls. This leads to pain of a headache-sinus.

Environmental Factors

Allergies and respiratory infection may lead to sinusitis, but do not result in sinus headaches. Allergies may cause sinus congestion that may in turn create headache pain. Patients prone to allergies should seek separate treatments for allergy and headache.

Malignancy, an infection or allergy reaction, may cause the headache. Allergy associated headaches are seasonal. Exposure to allergens – cigarette smoke, pollens and mold- may worsen the headache-sinus and increase its frequency.




Allergic rhinitis may lead to the sinus headache. Allergic rhinitis (hay fever), hormonal rhinitis, inflammatory rhino sinusitis and non-allergic rhinitis contribute to the headache. Hormonal rhinitis associated with pregnancy is nasal stuffiness and congestion due to hormones. The headache disappears after the delivery.

Sinus headache intensifies during winter or fall, the cold and cooler weathers respectively.

Sudden and rapid changes in air pressure may also worsen sinus symptoms, causing sinus headache.

Physical Factors

Nasal deformities and bone injuries may also trigger the sinus headaches. Chronic sinus infections, deviated septum and nasal polyps cause frequent sinus headaches. Deviated septum hinders airflow from the nose and interferes with drainage and breathing. A person with deviated septum is more prone to sinus congestion and infection that results in frequent sinus headaches.

A tumor of the sinuses may also plug up the sinuses, resulting in the headache pain.

Swollen nasal turbinates cause a feeling of nasal stuffiness and sometimes pressure, resulting in the headache.

Other Factors

Some times dental infection may reach the maxillary sinus, which is located within the cheekbones, and cause the headache.

In some cases, the headache aggravates on lying down or bending forward.

Sinus headaches are accompanied by nasal discharge, sore throat and postnasal drip.

Wednesday, October 5, 2011

Complications and Risks Associated with Surgery-Sinus

Complications and Risks Associated with Surgery-Sinus

Avoiding contact with allergens and proper treatment of allergies are the best options to prevent or treat sinusitis. Patients should remember that surgery-sinus is not a substitute for allergy controls. No surgical process is completely safe. There is thus always a chance of complications, which may develop during and / or after surgery-sinus. Some of which are discussed here.

  • Blood transfusion or blood products may rarely be needed to offset the impact of bleeding during the surgery. Advance arrangement for blood will be useful in case an emergency arises. Patients shall seek advice of their surgeons and physicians well in advance.
  • Crusts may form in the nose.
  • The nose may become excessively dry.
  • Chronic nasal drainage may become a cause of concern.


 

  • The surgery-sinus may not resolve the problem of sinus infection. Another round of surgical procedures may be required. A failed surgical attempt may obstruct the nose.
  • Sinus problems and polyps may reoccur even after the surgery.
  • The surgery may not resolve cough, bronchitis, asthma or other respiratory illnesses.
  • Headaches associated with sinuses may not be resolved.
  • Help of a neurologist and other medical specialists may be required.
  • The surgery may damage the eye and related structures.
  • Spinal fluid may leak or brain abscess may develop due to injuries to the skull during the surgery. The membrane covering the brain may swell.
  • Palate or upper teeth permanently becomes numb.
  • Impaired healing and lingering pain may lead to hospitalization of the patient.
  • The sense of taste or smell may worsen and may be completely lost.
  • A sudden increase in the nose bleeding requires doctor’s attention.
  • A fever higher than 38.6 degree Celsius may occur after the surgery.
  • Redness or swelling of the eyes or nose may increase after the surgery.
  • Heavy bleeding may occur.
  • During ethmoidectomy, the optic nerve and the muscle controlling eye movement may damage, as the ethmoid sinuses are located near the eyes. These damages are difficult to repair. If bleeding into the eyes happen, it will affect the vision.
  • Maxillary antrostomy may cause injury to the tear ducts. Tear production may increase. Nose may bleed.
  • Complications and risks may aggravate if the patient already has other medical problems. So, while discussing surgery-sinus with your doctor, do not hide your medical history and current medical conditions.
  • In rare cases, blindness or death may occur.

Tuesday, October 4, 2011

Types of Sinus Surgeries

Types of Sinus Surgeries

When antibiotics, drugs and other medication do not reduce symptoms of chronic sinusitis and complications develop, patients may be benefited by sinus surgery. The surgery removes mucosal tissue that creates obstruction and cleans up the sinus-nasal channels, ensuring drainage of the sinus cavities. Surgeons may also remove nasal polyps and straighten defected nasal septum for better airflow. However, patients may be administered antibiotics periodically and nasal steroids even after the surgery. There are two types of sinus surgeries: endoscopic and traditional.

Endoscopic Surgery

Mostly endoscopic method is used for the sinus surgeries, because it enables accurate visualization of the sinuses and the pathways without any external incision. Thus, bleeding, discomfort and swelling will be less. Recovery period will be shorter. This less expensive surgery has smaller chances of complications. The surgery may remove materials, including bone plugging the openings of sinuses. An endoscope, a slim lighted instrument, is inserted through the nose during the surgery for spotting the problem and removing the material. A set of surgical tools are also inserted to remove polyps and blocking material. Sometimes blocking material is burnt with the laser. A rotating burr may be used to scrape away the tissue. The surgery lasts between ½ hour and 1 ½ hours. It improves sinus symptoms in 90% patients. However, some times a second surgery is required. Some complications may occur during the surgery. Swelling or bruising around the eyes may occur in some patients. Incidences of brain and eye injuries or heavy bleeding are rare.

 


 

Image Guided Endoscopic Surgery

Since the sinuses are located near major arteries, eye and brain, insertion of a fiber optic tube into the sinus area is a cause of concern. To alleviate this concern, image guided endoscope technique is developed. The technique is used to treat extreme case of chronic sinusitis. The image guidance utility uses infrared signals to inform about precise real time location of the surgical tools used with the help of 3D images and CT scans.

Traditional Surgery

Traditional surgery is recommended if brain abscess occurs, pus develops in the sinus or infection spreads into the facial bones. The surgeon will make an incision through the face skin or inside the mouth to access the sinus and remove the blocking material.  The surgery approach may vary from doctor to doctor and location of the sinus infection. In extensive procedures, the opening (incision) may be left open for infection drainage. The surgery may require hospitalization of the patient. Traditional surgery, an effective technique to treat chronic sinusitis, is recommended if endoscopic surgery was not successful and medications were of no use. However, risk associated with the surgery includes blindness, death, inflammation of membrane covering the brain, fluid leakage and heavy bleeding.

Monday, October 3, 2011

Sinusitis Surgery: Pre- and Post- Operative Care

Sinusitis Surgery: Pre- and Post- Operative Care

Both pre- and postoperative precautions enhance the benefits of the sinusitis surgery. However, in many cases of sinusitis surgery, poor follow-up and improper post-operative care minimize or offset the benefits of the procedure, and create complications. To avoid all these problems, patients may follow the instructions listed below and their surgeon’s advices in letter and spirit:

Pre-operative Care

Prior to the surgery, an anesthesiologist must review medical history of the patient.

The surgeon may order pre-operative laboratory studies, which should be done in advance. Patients should carry all the studies on the day of the surgery.

Do not take any medication containing aspirin or nonsteroidal anti-inflammatory medications, or aspirin 7-10 days before the surgery. Consult your doctor before administering any drug.

In many cases, doctors advise not to drink or eat eight hours before the surgery.

Follow preoperative advice given by the doctor.

Patients should not smoke before the surgery to minimize post-operative bleeding and coughing.

If patient has any illness like fever, it should be reported to the doctor prior to the surgery.

Do all paper work properly before the surgery.

Wear loose fitting clothes that can be removed easily. Do not wear jewelry and accessories like watches, earrings, etc. Neither apply cream nor make-up. Avoid hair clips. Wash the face with water and soap before the surgery.

 


 

Post-operative Care

A responsible person should be with the patient on the first night after the surgery.

The surgeon may advice use of saline irrigation and the suitable method of irrigation.

Mostly, patients are allowed to go home as soon as they recover from anesthetic. After reaching home, patient should rest in the bed. Use 2-3 pillows to elevate the head. Raised head will reduce swelling and edema.

Swelling around eyes and of cheeks, nose and upper lip is normal. It may take some days to subside. You can use ice pack on the face to reduce it. The ice pack will also reduce pain and edema if these symptoms appear after the surgery. Use ice pack for 15-minute, then take 15-minute break, then reuse it.

Some nose bleeding is normal. The bleeding will reduce slowly. Use gauze dressing in case of nose bleeding.

Do not take drugs containing aspirin or nonsteroidal anti-inflammatory medications, or aspirin unless prescribed by the doctor. Consumption of these drugs may slow blood clotting and increase bleeding.

Eat cool, soft, light food. Do not consume hot liquids for many days. Eat slowly to avoid postoperative vomiting and nausea.

Take adequate rest.

Complete the course of antibiotics if doctor has prescribed. Or, any other medicines prescribed by the doctor.