Thursday, December 29, 2011

What is Capsaicin in intra nasal application?

Capsaicin is a phenolic chemical contained within the oil of the Capsicum pepper.

Capsaicin has been used clinically with moderate success as a topical treatment for the pain of rheumatoid and osteoarthritis, psoriasis, diabetic neuropathy, and postherpetic neuralgia.

When used intra nasal, capsaicin irritates nasonasal area. However, the area becomes desensitized to the irritation after repeated use. Nerve endings responsible for rhinorrhea, sneezing, and congestion become desensitized when capsaicin is applied to the nasal mucosa. Capsaicin use has been targeted to patients presenting with congestion, rhinorrhea, sneezing, or a combination of these symptoms.




Clinical studies revealed a 60% reduction in nasal airway resistance. In most patients, effectiveness continued for more than 4 months after study completion. In most patients, scores on visual analog scales significantly improved. However, no significant difference was documented for nasal blockage, rhinorrhea, sneezing, coughing, mucous production, or eye irritation before, during, or after study completion. Documented adverse reactions were limited to initial nasal irritation and increased nasal airway resistance.

The majority of studies on capsaicin intra nasal application have been addressed to nasal mucosa pathologies (idiopathic rhinitis, allergic rhinitis, chronic rhinopathy, etc.).

A double-blind, randomized, placebo-controlled pilot study on capsaicin nasal spray was recently completed (publication pending). The study was designed to evaluate the effectiveness and safety of capsaicin for the treatment of sinus and nasal congestion in patients suffering from non-allergic rhinitis. It study measured the improvement in nasal congestion, sinus pressure, and pain. It also evaluated speed of action and safety parameters.

Wednesday, December 28, 2011

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, December 27, 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.

Thursday, December 22, 2011

Chronic cough’s triad

Chronic cough’s triad

Post nasal dripsyndrome (PNDS), gastro-oesophageal reflux (GOR) and asthma form the pathogenic triad of chronic cough. If the cough is ascribed to more than one factor, the pathogenic triad is used for complete diagnosis. If a non-smoker is suffering from chronic cough, but the patient’s chest radiograph is normal and patient is not administered angiotensin-converting enzyme (ACE) inhibitors, one of the triad conditions may be causing the cough.






PNDS-induced cough

Diseases affecting paranasal sinuses, pharynx and nasal fossae cause post nasal dripsyndrome. For example, chronic and / or acute sinusitis, rhinitis because of medication or environmental irritants, post infectious rhinitis, vasomotor rhinitis, allergic rhinitis, common cold or other upper respiratory tract disorders may cause PNDS. Since these upper respiratory tract conditions have some common symptoms, the diseases are collectively referred to as rhinosinusitis.

Various scientific studies concluded that the post nasal drip syndrome is one of the common causes of chronic cough, especially in patients who do not smoke. The number of PNDS incidences is high in the US as compared to that recorded in the European countries.

Since there are no distinct characteristics (pathognomonic) of PNDS, a number of factors are taken into account to diagnose the disease. For instance, interpretation of radiographic material, physical examination, symptoms and effect of the selected PNDS therapy are studied simultaneously for the diagnosis. The response to the therapy is considered as the most suitable diagnosis technique. A sinus coronal CT scan, 4-view sinus radiograph and nasolaryngoscopy may also be useful in the diagnosis.

Mechanical or chemical irritation of pharynx and / or larynx receptors may cause cough in the patients suffering from PNDS. When endpoints of pharyngeal branch nerve are stimulated, cough occurs in the upper respiratory system.

The patients suffering from PNDS-induced cough may have mucus in oropharynx, oropharyngeal mucosa resembling a cobblestone, nasal discharge and strong desire to clean throat frequently.

Nasal steroids, nasal cromolyn and oral antihistamines are effective in case of allergic rhinitis-induced PNDS. A saline nasal wash is also helpful.

Cough because of GOR

Gastro-oesophageal reflux (GOR) is also known as gastrooesophageal reflux disease (GERD). A number of patients having cough may have regurgitation, heartburn, sour taste and other gastrointestinal (GI) symptoms. If reflux is high, dyspnea, wheezing, purulent sputum or other pulmonary symptoms may occur.  Patients may also complaint about hoarseness and sore throat, laryngeal disorders.

Asthma related cough is difficult to diagnose due to minimum wheezing or breathlessness. Atypical or bacterial bronchitis or a viral respiratory disorder may cause the cough in asthma patients. This nonproductive cough occurs during night and day.

Wednesday, December 21, 2011

4 types of nasal sprays

4 types of nasal sprays

There are four types of intranasal medications, known as nasal sprays. The medication may contain cromoglycate- a nasal mast-cell stabilizer, ipratropium- anticholinergics and / or natural extracts from plants. For instance, grapefruit seed extract nasal spray is effective for both acute and chronic sinusitis. Colloidal silver is also used in the sprays prescribed for both the conditions.




A nasal decongestant spray reduces nasal tissue swelling in the patients suffering from acute sinus infection. The nasal spray offers immediate relief from the congestion. However, do not use the spray for more than five days because congestion rebounds due to excessive usage. During rebound, initially, the spray shrinks the nasal tissues but then swelling reappears. This condition is referred to as rhinitis medicamentosa. Do not use vasoconstrictive nasal sprays for long, because abuse of the spray results in the rebound.

Afrin, an oxymetazoline hydrochloride nasal spray, is used to treat acute sinusitis. Afrin is administered 20 minutes prior to endoscopic frontal sinusotomy. Xylometazoline, a sympathomimetic decongestant, is a major ingredient of the spray that effectively treats allergic rhinitis. Some physicians also prescribe a decongestant nasal spray prior to computed tomographic (CT) scan.

A nasal steroid spray reduces inflammation slowly in chronic sinusitis. The nasal spray delivers a strong dosage of steroids on the affected nasal tissue surface. Daily use of the spray is must to get the desired results, but effect of the spray will be visible after a week or so. The spray may be used twice a day. The spray is safe to use over a long period. A steroid spray is administered after endoscopic frontal sinusectomy.

The topical corticosteroid nasal spray causes irritation because of fluorocarbon used to propel the steroid. Even contact with the tip of the spray can cause irritation. Thus, use of fluorocarbon-based propellants in the nasal spray has been banned since late 1990s.

A nasal antihistamine spray reduces nasal membrane’s response to inflammatory cells, but the spray may have some side effects. Incorrect use of the spray may lead to nose bleeding. The azelastine nasal spray, an antihistamine spray, is an innovative anti allergy treatment. The Astelin N. S. spray is useful to treat seasonal allergic rhinitis. Levocabastine spray is another example of the antihistamine spray.

A nasal saline spray reduces congestion by moisturizing the nasal cavity. Irrigate the nose with these sprays to open up the nasal passage without any side effects. The spray is used after endoscopic drainage of a subperiosteal orbital abscess.

Since nasal sprays are addictive, avoid its overdose or wrong usage, and consult the doctor before using the spray.

Tuesday, December 20, 2011

Nasal polyps’ origin

Nasal polyps’ origin

A nasal polyp is a mucosal sac filled with inflammatory cells, vessels, edema and / or fibrous tissues. Recently formed glands, changes in epithelial regrowth and presence of edema and eosinophilia are characteristic of the nasal polyps unlike the normal nasal mucosa. Eosinophilia is the most commonly found inflammatory cell in the polyps.

The polyps were observed and recorded even forty centuries ago in Egypt. Since then many developmental strides have been made to understand the polyps better and invent advanced treatments and techniques. For instance, now-a-days, microscopic and endoscopic surgical methods are popularly used to treat nasal polyps.  




In the late nineteenth century, scientists suggested that the polyps began from the nasal wall located in the ethmoidal cleft region. Detailed studies of etiology, structure, histopathologic review, autopsy and surgeries of the polyps have revealed some unique features. However, the polyp origin is still a mystery.

Evaluation of functional endoscopic sinus surgery records concludes that the polyps commonly grow from the infundibulum, uncinate process and middle meatal. The second most common place from where polyps originate is the hiatus semilunaris and ethmoidal bulla.  Autopsy studies found out that the most of the polyps were linked with ethmoidal clefts and recesses, and were unilateral.

The lifecycle of the polyps begins as solitary and small structures in the osteomeatal regions’ slim channels. Multiple factors initiate nasal polyp formation. The polyp size depends on a number of factors, such as level of edema and inflammation, age and growth rate of polyp. The meatus anatomy, available space and size and number of the existing polyps define its shape. A stalk connects the polyp apex or body to the polyp’s base. The length and thickness of the stalk also vary.

Each polyp consists of numerous tissues. The polyp stroma surrounds the amorphous substance featuring inflammatory cells, glands, blood vessels and fluid.  An epithelium layer covers the polyp surface. Both epithelium layer and inflammatory cells may evolve as the polyp develops and grows.

Some nasal polyps may have scores of intraepithelial glands, the pathologic structures. Mucous glands found in the polyps play a crucial role in growth and pathogensis of the polyps. By examining the gland shape, you can decide whether the gland grew within the nasal polyp or in the nasal mucosa, because the glands form when the polyp is still in development and growth stage. As polyp length increases, the gland length also increases.

Monday, December 19, 2011

21 interesting facts about nasal treatments

21 interesting facts about nasal treatments

  1. The 1500 BCE records reveal that Egyptians mastered the art and skill of removing the cranial material through the nose to avoid any disfiguration of the face while mummifying the bodies.



 

  1. Records of various rhinologic procedures practiced during 700 BCE are found in the Egyptian and Indian medical books.
  1. In 5th century, Susruta, the famous Indian surgeon, invented nasal reconstructive flaps and rhinoplasty that are still used.

 

  1. Do you know that physicians examined the anterior of the nose in candlelight until 16th century?
  1. In 1744, Boerhaave introduced a ground-breaking idea: nasal polyps are elongated sinus membranes.

 

  1. The German doctor Hirshberg reported aspirin sensitivity in 1899.
  1. In 1933, Shenck and Kern suggested that nasal polyps were related to allergy. The polyps were commonly found in the ethmoid air cell system.

 

  1. In 1940s, advancements in immuno-biology and  immuno-histochemistry techniques enabled description of lymphocyte and eosinophil present in the polyps.
  1. In 1959, Lurie discovered relationship between the polyps and cystic fibrosis for the first time.

 

  1. In 1969, Beer and Samter threw light on the triad of asthma, nasal polyps and aspirin sensitivity.
  1. In the end of the twentieth century, the first rigid and flexible fiber-optic endoscope was discovered. The invention changed the way upper aero-digestive tract was examined.

 

  1. Since Hippocrates influence was strong during golden age of the Greek civilization, he is remembered as the father of medicine and rhinology. However, Susruta used highly advanced surgical techniques to treat nasal disorders. Hippocrates recorded disorders related to nasal polyps and fractures. He named the nasal growth as polypus, as it resembled to the polyps found in the sea.  He defined polyps as “the sacs of phlegm that cause nasal obstruction and derange the sense of smell.”
  1. Hippocrates knew that nasal polyps are recurrent in nature.

 

  1. The world-famous physicians like Fabricius Hildanus, Paulus Aegineta and Claudius Galen also treated the polyps dexterously.
  1. Egyptian physicians believed that a bad smelling nose confirmed presence of polyps.

 

  1. Celsus said, “Large polyps dangled into the pharynx and on cold and damp days strangulate a man.”
  1. A crude nasal speculum was used by Hippocrates, Haly Abbas- an eminent Islamic medicine expert, and the Indian Ayurvedic physicians in bygone eras. In fact, these speculums were an improvisation of the instruments employed for rectal and gynecological examinations.

 

  1. Fabricius Hildanus invented an aural speculum, which resembles the modern speculum.
  1. Alfred Kirstein pioneered use of artificial light for nasal examination. He invented first headlight that inspired the modern headlights.

 

  1. In Greece, tampons and nasal packs soaked in copper salts and honey were used to prevent reoccurrence of polyps.
  1. The Roman physicians used turpentine and other irritating substances, calf tallow, goose fat and oily products to treat the polyps.

Friday, December 16, 2011

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.

Thursday, December 15, 2011

Sphenoid Sinusitis

Development of the sphenoid sinus begins at the age of three years.  The sinus sits in the sphenoid bone. Capacity, size and shape of the sinus vary from person to person. The sphenoid sinus walls are located next to the cavernous sinuses, dura mater, optic canals and pituitary gland. The walls can be ultra thin. The infection and / or obstruction of the sinus is called sphenoid sinusitis, which is not common. However, sphenoid sinusitis is generally misdiagnosed. This infection-sinus may lead to sub acute or acute sphenoid sinusitis.




Acute sphenoid sinusitis is uncommon. Acute sphenoid sinusitis generally occurs with pansinusitis. Central, frontal, occipital or vertical headache is common during acute sphenoid sinusitis. The headache may increase while bending forward. Staphylococcus aureus is the common cause of the acute sphenoid sinusitis. Chronic sphenoid sinusitis leads to uneasiness in retro-orbital area or a headache.

The sphenoid sinus is prone to neoplastic, infectious, inflammatory or expansile processes. The neoplastic process means abnormal growth of a tissue or a tumor. Accumulation of pus in the sinus is pyocele, which is infectious. The inflammatory process is referred to as Wegener granulomatosis. The sphenoid sinus inflammation accompanied by mucormycosis increases severity of the sinusitis.

Diagnosis

Patients of solitary sphenoid sinusitis may not have nasal problems, diagnosing becomes difficult. Generally, this infection-sinus is diagnosed when complications begin.  CT scan is the most suitable method to diagnose sphenoid sinusitis.

Symptoms

  • Fever
  • Loss of vision
  • Purulent discharge
  • Sleep related problems
  • Progressive headache
  • Headaches in temporal region (bitemporal), back of the head (occipital) or eye-socket (retro-orbital) are characteristic to the isolated sphenoid sinusitis.
  • Headaches may become severe.
  • Headaches worsen with movement of the head and disturb sleep. Aspirin does not relieve these headaches.

 

Complications

If the infection-sinus is not diagnosed appropriately or treated properly, deadly complications may occur. Likely complications include orbital abscess, orbital cellulites, orbital edema, cerebral abscess, cavernous sinus thrombosis, meningitis, mucocele, pituitary insufficiency and superior sagittal sinus thrombosis. Although mucoceles are rare, they affect vision of the patient.

A mucocele is a kind of cyst containing mucus. Adhesions, tumors and polyps may obstruct drainage from the sinus system, resulting in formation of mucoceles. Continuous inflammation in sinus ostia for long time may also cause mucoceles. The mucoceles exert pressure on the walls of the sinus, eroding the surrounding bone and causing headaches.

Wednesday, December 14, 2011

Are migraine & sinus headaches similar?

Migraine and sinus headaches have some common symptoms that create confusion and make diagnosis difficult. Proximity of the structures affected during migraine to the sinuses is another reason for the confusion. However, these two conditions also have some unique signs.  Read on to know more about headache-sinus and migraine headache for correct diagnosis.




Headache-sinus may vary from mild to extremely painful, so that the patient feels physically weak. Sinus headache improves as the day progresses after severe pain in morning. Weather change, cold or beginning of menstruation usually causes sinus headaches.

A migraine headache generally occurs on one side of the head, but the patient may feel it on both the sides. The headache develops over a period of time through four phases: prodrome, aura, headache and postdrome (post headache). The dilation and constriction of the brain’s blood vessels result in a migraine headache.  The head pain, throbbing in the temples and head, pressure in the facial sinus or back of eyes may aggravate the migraine headaches.

When the migraine headache is situated over the sinus area, the headache is confused with sinus headache. Since change in weather is also one of the main causes of migraine, a migraine headache is mistaken for headache-sinus.

In many cases, migraine and sinus headaches do not occur simultaneously. However, if pressure on the sinus cavity’s blood vessels builds, sinus headache may trigger migraine headache.

During sinus headaches, patients may also have migraine symptoms, such as sensitivity to noise and light, and / or nausea.

Migraine headaches generally respond to antihistamines treatment, therefore, these headaches may be confused with headache-sinus.

If sinus headache symptoms like purulent discharge and acute imaginative illness are absent, the headache is due to migraine.

Usually migraine specific symptoms like phonophobia, photophobia, pulsatile quality and vomiting do not occur during sinus headache.

Common symptoms of acute bacterial sinusitis or allergic rhinitis also occur during a migraine attack, thereby causing confusion in sinus and migraine headaches.

Some times sinus x-ray shows mucosal thickening in patients suffering from headache but not having rhinosinusitis symptoms. This is a migraine symptom, but it is mistaken for sinus headache.

Generally, other symptoms of sinus diseases also occur during sinus headache unlike the migraine headache. However, sinus disease symptoms may accompany the migraine headache that is a result of a sinus headache. Nasal sinus disorder may stimulate migraine headache. A patient suffering from both sinus disease and migraine may complaint about both types of headache symptoms, thereby confusing the patient about headache type.

Consult a doctor for correct diagnosis. Do not delay the headache treatment because the delay may aggravate the problems.

Tuesday, December 13, 2011

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.

Monday, December 12, 2011

9 Factors Causing Infection-Sinus

Gunge accumulated in the sinuses is an ideal place for harmful germ growth. These germs cause infection-sinus. Acute sinus infection is attributed to a number of factors, which are discussed below:

  • Chronic medical conditions, including cystic fibrosis, HIV and diabetes, weaken the immune system, causing swelling of the airways. As a result, thick mucus may develop that in turn leads to infection-sinus.
  • Anatomical abnormalities, structural defects, such as cleaved palate, tumor, deviated septum and thin drainage channels, interfere with mucus drainage. Disease-spreading bacteria and viruses can easily grow in the mucus build up, setting the stage for infection.
  • Polyps, benign growths in the sinuses and the nose, may block the sinus spaces and thereby hinder mucus drainage. The mucus build up will lead to infection. If these growths obstruct the airway channels, headaches may develop.
  • Smoking is an irritant that may cause inflammation in the nose and make you more prone to infection-sinus. Indeed, smoking interrupts and disrupts natural cleaning process of the sinuses. More gunge, thus, gathers into the sinuses, blocking the nasal passages.
  • Fungi may even infect the sinuses of a healthy person. However, mostly people with a weak immune system get fungal sinusitis. Fungi grow easily in dark and damp environs, which are found in the sinuses. So weak immune system and right environment encourage growth of disease-causing fungi.
  • Frequent air travel may worsen the infection-sinus. Reduced air pressure in an airplane may build up pressure in the head. The pressure, especially during landing and takeoff, may clog the air passages and the sinuses, aggravating signs of cold and sinusitis.
  • Adventure activities like diving and swimming worsen symptoms of sinusitis in the people already suffering from the disease. Do not spend too much time in the swimming pools, because chlorine irritates the sinuses and the nasal lining. Water may enter into the sinuses due to pressure change while diving and inflammation of sinus tissues may occur.
  • Air-borne pollutants, including dust, perfume, and other strong odors, cause irritation in the nose and inflammation, making you more susceptible to sinusitis. Try to avoid these pollutants and reduce the risk of developing sinus infection.
  • A viral infection in the upper respiratory system may lead to sinus infection. The viral infection damages the sinus membrane cells, causing inflammation and thickening of the membrane. The thick membrane clogs the nasal passages connecting to the sinuses. In the absence of proper removal of bacteria, infection develops.

 

Friday, December 9, 2011

Sinus

What is a Sinus?

Sinus is an air-filled cavity located behind cheeks, eyes and forehead in the cranial (skull) bones. A mucus membrane lines the sinus. The membrane has cells with very fine hairs, ciliated epithelium that pushes out the mucus from the cavity, enabling circulation of the air. The mucus traps pollutants, including dirt particles, found in the air that is inhaled. A healthy sinus is free from germs, including bacteria. Each cavity features an ostium, a channel opening into the nasal passages for easy exchange of mucus and air. The sinus grows into a walnut-size pocket from a pea-size space.




Types of Sinus

These cavities are found in pairs and also called “paranasal sinuses”. Ostia, a thin channel, connects the sinuses to the throat and nose. All sinuses are interconnected. Human skull features four pairs of sinuses: ethmoid, frontal, maxillary and sphenoid. The sinuses are named after the four skull bones in which they are located. The bones are referred to as the ethmoid, the frontal, the maxilla and the sphenoid.

The pyramidal ethmoid sinuses lie between the eyes, behind the nose bridge and at the nose root. All newborn babies have clearly demarked ethmoid that grows with age. The sinus cavities above the eyes in forehead are called frontal sinuses. The maxillary sinuses in cheekbones are located on the side of nostrils. The maxillary cavity, the largest sinus, develops before other sinuses. The cavity, generally filled with fluid at the time of birth, grows in two phases: up to three years of age and between seven and twelve years of age. The maxillary sinus resembles a pyramid in an adult.  The sphenoid sinuses, situated behind the eyes and the ethmoid sinuses, are found deep in the skull. These cavities reach their full-size during adolescence. The ethmoid and maxillary sinuses are a birth feature whereas funnel shaped frontal develops at the age of five. 

Functions of Sinuses

Sinuses reduce skull weight, particularly weight of the facial bones. So, if the cavities are blocked, the head becomes heavy and drowsiness and tiredness occur during sinusitis.  

Sinuses add resonance to the voice.

Sinuses warm, moisten and filter the air that we inhale and remove redundant air particles.

Sinuses produce mucus that protects against microbiologic organisms, pollutants, dirt and dust.

Sinuses may facilitate pressure damping and air conditioning.

Sinuses increase the olfactory area.

Sinuses insulate eyes, dental roots and other sensitive structures against quick temperature changes in the nasal cavity.

Wednesday, December 7, 2011

Types of Rhinitis

Nasal inflammations,
rhinitis
, can take various forms depending on the symptom triggers, severity of the symptoms and time period for which the symptoms last. Read on to know more about different types of rhinitis:




Allergic rhinitis is also referred to as hay fever, which is seasonal. During fall, spring and summer seasons, the fever is common.  People with sensitive immune system are prone to hay fever on inhaling dust, grass, mold spores, pollens, trees and other outdoor allergens. Release of antibody during the fever produces mucus and causes swelling and itching. Common symptoms of the fever include stuffy or runny nose, sneezing and watery eyes. The rhinitis is the most common form of allergy related disorders.

Infectious rhinitis caused by bacterial or viral infection includes bacterial sinusitis and common cold lasting more than one week. Thick yellow-green color nasal discharge increases and nasal congestion causes problems.

Hormonal changes trigger hormonal rhinitis. The disorder generally occurs during hypothyroidism, menses, puberty and pregnancy. Nasal congestion reaches a significant level.

Mechanical obstruction, a form of rhinitis, creates one-sided nasal obstruction. Enlarged adenoids and deviated septum are peculiar features of the disorder.

Non-allergic rhinitis means runny nose which is not because of allergy. It could be inflammatory and non-inflammatory. Not much is known about this type of rhinitis. The symptoms may resemble to that of allergic rhinitis. Nasal polyps may be associated with this ailment.

Ozena, primary atrophic rhinitis, is a chronic nasal disorder. Bone resorption, mucosal atrophy, nasal obstruction, strong fetid odor, thick crusts and anosmia are characteristic to the rhinitis.

Persistent rhinitis is a form of rhinitis that persists for a long-period of time. The symptoms may come and go in some cases. The symptoms are present on all days but not for the whole day in other cases. The symptom severity may vary from patient to patient. Persistent rhinitis may be allergic or non-allergic.

Cocaine consumption for recreation and over use of decongestant nasal sprays may cause rhinitis medicamentosa. Postnasal drip and nasal congestion are common symptoms of the disease. Rhinitis sicca is a form of rhinitis in which nose’s mucus membrane becomes extremely dry.

Vasomotor rhinitis is an example of non-allergic non-inflammatory rhinitis, but some times patients of allergic rhinitis may also suffer from vasomotor. Dust, fumes, strong smells- perfumes, smokes, emotional upsets, fluctuations in humidity and temperature and other non-allergic objects and conditions trigger vasomotor. The common symptoms of the rhinitis include postnasal drip and nasal congestion.

Monday, December 5, 2011

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.

Friday, December 2, 2011

8 Things You Should Know about Infections-Sinus

Timely Examination

Germs may cause various types of skull infections. The infections-sinus, affecting air-filled spaces in the cranial bones, impact lives of millions of people across the world. To treat these infections, the sinuses should be examined well in time.





Cause of Infection

Allergies, bacteria, fungi, structural deformities and viruses trigger signs of sinus infections. Haemophilus influenzae and Streptococcus penumoniae bacteria are responsible for more than 65% of cases of acute sinusitis. Most of the patients suffering from extreme asthma conditions also suffer from chronic rhinosinuisitis. Numerous eosinophils, the white blood cells with strong inflammatory properties, reside in the tissues lining the nasal passages and the sinuses of the patients suffering from chronic rhinosinusitis, particularly the patients with polyps.

Appropriate Diagnosis

Distinguishing between infections-sinus and non-sinus infections is necessary for appropriate diagnosis that ensures timely healing. Identify cause of sinus infections, as different sinus symptoms require different therapies. For instance, viral sinusitis does not respond to antibiotics, whereas bacterial sinusitis may respond to a course of antibiotics. Acute sinusitis, a short-term disorder, lasts up to 28 days. However, chronic sinus infection may drag on until three months.

Do not Abuse Nasal Sprays

Nasal sprays give you quick relief from sinus infections. However, continuous and overuse of nasal sprays result in rebound congestion and addiction. Swelling of nasal lining may reappear even though infection signs might have subsided.

Do not Take Medicines without Prescription

Since some of the medicines used to treat sinus problems may react with other drugs, patients, especially those suffering from other diseases, should consult their doctor. During physical checkup, doctor will examine ear, nose and throat for accurate diagnosis. The doctor will also examine the face for redness and swelling if any.

When is Surgery Required?

If the best medications fail to cure the sinusitis, you may need surgery. With the help of doctor, you can choose from traditional and endoscopic surgeries.

Home Remedies

Warm compresses may relieve pain in the sinuses and the nose. Inhale steam, warm moist air, to clear sinus congestion. Use humidifiers with clean filters. Avoid contact with allergens and irritants causing signs of sinus infections.

Impact of Untreated Sinus Infections

Untreated sinus infections will cause discomfort and pain. The sinus infections may lead to bone infection or meningitis in rare cases. So, why take chances? Visit the doctor as and when symptoms appear.

Thursday, December 1, 2011

Symptoms of Sinus Headaches

Symptoms of Sinus Headaches

Inflamed sinuses cause sinus headaches, which are generally confused with other types of headaches. For instance, vascular headache symptoms are similar to that of sinus headaches, causing confusion. Most of the people who believe that they have headache of the sinus origin are in fact suffer from vascular headaches. Therefore, consult the doctor to confirm that the headache is because of infected sinuses. Some of the common symptoms of the sinus headaches are explained below.




  • Constant, deep and dull pain in the sinus region, comprising bridge of the nose, forehead and cheekbones, denotes headaches. The pain, the main symptom of the headache, increases with straining, sudden movement of the head, leaning over or bending down. The pain may be accompanied by facial swelling, fever, fullness / sensation in the ears and nasal discharge. The pain may increase during damp and cold weather. Sudden changes in temperature further worsen the pain. The pain during sinus headaches feels like pressure. Sinus pain and other nasal signs may accompany the headache.
  • Intensity of pain may vary from person to person. It could range between minor nagging pain and unbearable pain that hinders normal sleep process.
  • The pain in the head may resemble to a tension headache.
  • Pressure sensation in affected area increases.
  • Local swelling, redness and tenderness in the facial area may occur.  Tenderness over the infected sinus is associated with sinus headaches.
  • The headaches generally occur in the morning and improve by afternoon. The pain is severe in the morning because of overnight mucus collection.
  • Symptoms associated with sinusitis, such as sore throat, postnasal drip, green or yellow discharge from the nose, nasal congestion, fever and fatigue may also appear.
  • In some cases, sinus headaches may not be accompanied by sinusitis signs.
  • Fever with sinus headache is a quite common sign.
  • Purulent or pus-like nasal discharge may lead to sinus headaches.
  • Rarely, sinus headaches may be associated with pain in the back or the top of the head.
  • Sinus headaches may be felt on both sides of the head or on either side of head.
  • Neck is generally not affected during the headache.
  • Headaches with congestion
  • Feeling of ache in the upper teeth
  • Cold shivers
  • Coughing or throat irritations
  • Light-headedness
  • Achy muscles (myalgias)
  • Lymph nodes in the neck may swell.