HelloMD.com: Oto- Rhino-
Laryngology ( Ear , Nose and Throat)
Rhinology ( Nose and
Paranasal Sinuses )
| Among the
commonest of ailments of the nose and paranasal sinuses are : |
| |
Ø Chronic
Rhino-sinusitis |
| |
Ø Chronic
Allegic Fungal Sinusitis |
| |
Ø
Paranasal Tumors |
What causes Chronic Rhino-sinusitis ?
Sinusitis starts as a result of the blockage of the drainage
holes provide in each sinus . This blockage can occur as a result
of the anatomical obstruction, swelling due to a cold or allergy,
drying of the mucus, or a foreign body. When this occurs, the
mucus that normally is expelled from the sinus builds up inside
the sinus and hence causes stasis. This gives excellent
opportunity for the bacteria to grow in this held up mucus and
hence all the mucus turns into a collection of pus (Abscess).
Ideally treatment of this collected pus is to open that sinus to
help pus drain out which is safely and adequately possible in case
of sinusitis only with the help of an endoscope.What are
symptoms of sinusitis ?
Sinusitis causes a variety of symptoms which can often be confused
with the other medical problems or dismissed as being due to a
"Cold". There may commonly b single symptoms such as post nasal
drip, stuffiness ,or pressure around the nose but can also be a
combination of these symptoms associated with the runny nose,
clear or colored mucus, a cough, a sore throat , pain in the
teeth, headache or fever. Additional symptoms which can sometimes
occur are hoarseness, a decreased sense of smell and fullness of
ears |
How sinusitis is diagnosed ?
It is extremely difficult to diagnose a sinus infection early in the
course of the disease. Nasal endoscopy is essential in all cases to
examine all the areas of nose. Depending upon what is found at the
time of endoscopy , an X-Ray or CT Scan may need to be done An
endoscopist can look into your nose without any pain because the nose
is sprayed with local anesthetic before endoscopy. The nasal endoscopy
is a few minutes job and causes slight discomfort only and no pain at
all .
What is medical treatment of Sinusitis?
Antibiotics are very important drugs to use in these cases. Light and
common antibiotics(Tetracyclines , Erythromycin , plain penicillin )
donot work in sinusitis cases as the bacteria are resistant to these.
The suitable antibiotics are Amoxycillin, ciprofloxacin as the first
line of treatment . Higher group of antibiotics are required for
chronic group.
What is Functional Endoscopic Sinus Sugery (FESS) and how is it
different from conventional surgery?
Endoscopic surgery is the most modern and best modality for
treating sinusitis. With the help of nasal endoscope we can reach
every corner of the inside of nose without any incision. It can
provide the most comprehensive clearance of the disease process from
inside the nose . For Chronic sinusitis where the disease process
starts with blockage of the ostia (opening of the sinus), the surgery
required is very precise and limited involving opening up of the ostia
and removing any structural obstruction to achieve drainage of the
sinuses and hence promote recovery with medicines . The conventional
methods, however, provide an alternative but they usually involve
incisions and more extensive procedures and very often fail to clear
the disease comprehensively from all areas inside the nose .
What are common complications ?
The most common complications of endoscopic surgery in expert hands
are Synechia formation , Bleeding and rarely Orbital emphysema -all of
which resolve with adequate measures.
How painful is the endoscopic Surgery and how long is hospital
stay? Endoscopic surgery for Sinuitis is done under local
anaesthesia where patient are sprayed with local anaesthaetic
solutions inside the nose .The surgery lasts for half an hour to 1
hour and the bleeding is minimal in expert hands. The patients can go
home the next morning without any complication . However, the
effectiveness of Endoscopic surgery lies in the strict follow up with
your endoscopist for about 4 weeks.
Ch. Allergic Fungal Sinusitis(AFS)
What is the frequency?
It is estimated that approximately 5-10% of patients suffering
from chronic Rhinosinusitis actually carry a diagnosis of AFS. Allergy
is characteristic of the disease; roughly two thirds of patients
report a history of allergic rhinitis . Many of these patients suffer
from Asthma.
|