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What causes nasal
blockage and discharge ?
Some of the common causes are :
1.
Infection: common 'cold' is usually caused by virus infection.
When nasal mucous turns from clear to yellow or green, it indicates bacterial infection.
2.
Structural Causes like Deviated nasal septum (DNS) and hypertrophied
turbinate, Septum is midline cartilage which separates the nose into 2 halves If
DNS cause obstruction to breathing, they can be corrected by surgery (septoplasty).
It can be combined with rhinoplasty for correction of external deformity also (septorhinoplasty)
3.
In children, enlargement of adenoids (tonsil like tissues which
fill up the back of the nose behind the palate) can cause nasal blockage
4.
Other causes
include nasal polyps, tumours and foreign bodies.
5.
Allergy is an exaggerated inflammatory response
to an allergen like house dust mite, pollen, moulds.
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What is Sinusitis and how it is diagnosed?
Sinusitis is an inflammation or infection
of the lining of one or more air-filled cavities around the nose called the Sinuses.
Acute sinusitis results from blocking of the opening of the sinuses following 'colds'.
Mucous collects in the sinuses and can cause discharge and pressure pain in the
forehead or face, between the eyes or cheeks depending on which sinuses get involved.
Typical
symptoms :
* Nasal congestion and discharge
* Facial pain or pressure
* Headache
* Fever
* Impaired sense of smell
Normally diagnosis of sinusities can be made by thorough clinical history and detailed
nasal examination. Nasal endoscopy is very helpful and in certain situations a sinus
CT scan is required.
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What is the treatment for sinusitis?
IMedical treatment in form of antibiotics,
antihistamines, decongestants, may help in eliminating symptoms and disease. If
problems persist or are recurrent, a CT Scan and diagnostic nasal endoscopy is usually
performed to elicit more information. If these studies indicate extensive disease
surgical treatment in the form of correction of septal deformity, or endoscopic
sinus surgery may be required.
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What is functional endoscopic
sinus surgery (FESS)?
Endoscopic sinus surgery is the use
of nasal endoscopy for siuns surgery. Fibreoptic telescopes with good illumination
and magnification is inserted through nose
which enable the ENT. Surgeon to visualize directly the blocked nasal passages and
sinuses for removing infection, polyps, or diseased mucosa to help the sinuses to
drain properly.
Nasal endoscopy
is commonly done for sinusitis, nasal polyps, in cases of bleeding from nose, for
diagnosis and follow up of tumors, for sinus headaches. It is also being used for
neurosurgical operations like CSF leakage, optic nerve damage, pituitary tumors
and ophthalmic conditions like dacryocystitis.
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What are the benefits
of the endoscopic operation?
a) A more
precise evaluation of patients with sinusitis, nasal blockage, headache, decreased
smell, bleeding from nose is possible
b) There is better visualization of the structures and
hence less chances of complications and damage to vital structures during surgery.
c) More
precise surgery of diseased mucosa leaving normal mucosa untouched thus faster recovery.
d) The stay of the patient
in hospital is reduced.
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What are the risks
involved in endoscopic sinus and nasal surgery?
Bleeding is a possibility in any
nasal surgery because of numerous blood vessels in the nose. Any extensive sinus
surgery runs the risk of cerebrospinal fluid leak or loss of vision. Although these
problems are extremely rare with endoscopic sinus surgery, especially in the hands
of trained ENT. Surgeons.
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What are the causes
of nose bleed?
The bleeding could occur
from either one or both nostrils and may result from a variety of events like sinus
infection, trauma, hypertension or tumours.
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What can be done to stop nasal
bleeding at home?
1. Sit up or stand up, this reduces the pressure on the veins in the nose, making it easier to stop the
bleeding.
2.
Gently pinch the nose near the tip using the thumb and index finger for 5 minutes.
Breathe through the mouth.
3. Apply ice to nose and cheeks.
4. Always consult your doctor for correct diagnosis and specific
treatment.
What is the medical
treatment for allergic rhinitis?
A) Avoidance of allergen:
B) Drugs :
1) Anti-histamines
: are very effective in controlling sneezing, itching and watery rhinorhoea.
2) Decongestants : Systemic decongestants in combination with anti-histamines
are useful in relieving nasal obstruction.
3) Corticosteroids : Use of corticosteroids especially the topical
form is highly effective in treatment of allergic rhinitis.
C) Topical therapy for long term relief :
D) Immunotherapy:
specific immunotherapy involves the use of subcutaneous injection of allergen extract
in increasing concentrations and decreasing frequency.
E)
Surgical treatment of allergic rhinitis: In patients with allergic rhinitis,
the symptoms of nasal obstruction are often compounded due to the presence of anatomical
abnormalities including bony and cartilaginous deformities of the septum, hypertrophic
turbinates or polyps, which may need surgery.
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What are the causes
of snoring?
The noisy sounds of
snoring occur when there is an obstruction to the free flow of air through the passages
at the back of the mouth and nose.
Persons who snore have
at least one of the following problems:
1) Poor muscle tone (lack of tightness) in the muscles of the tongue and throat.
2) Excessive bulkiness of tissues of the throat, the large tonsils and adenoids,
Overweight persons also have bulky neck tissues.
3) Excessive length of the soft palate and uvula.
4) Obstructed nasal airways: Deformities of the nose or nasal septum frequently
cause such obstruction.
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Effects of snoring?
It disturbs the sleeping
patterns of the snorer.
The most exaggerated
form of snoring is known as obstructive sleep apnea, when loud snoring is interrupted
by frequent episodes of totally obstructed breathing.
Persons with obstructive sleep apnea
may spend little of their night-time hours in the deep-sleep stages that are essential
for a good rest. Therefore, they awaken unrefreshed and are sleepy much of the day.
They may fall asleep while driving to work or while on the job.
OSA is serious if the episodes last
over 10 seconds each and occur more than 5 times per hour. During the obstructive
episodes, the heart must pump harder to circulate the blood
This can cause irregular heartbeats, may lead to elevated blood pressure
and heart enlargement.
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What are
the treatment option for snoring?
Adults who are mild
or occasional snorers should try the following:
- Regular exercise
to develop good muscle tone and lose weight.
- Avoide tranquilizers,
sleeping pills, and alcohol before bedtime.
- Avoide heavy meals
within 3 hours of retiring.
- Sleep on the side
rather than on the back.
- Place bricks under
the bedposts at the head end of the bed to keep head high.
The heavy snorer should
undergo a thorough examination of the nose, mouth, palate, throat, and neck. Studies
in a sleep laboratory are valuable to determine how serious the snoring is ?
Treatment depends on the caus. It may be managing a
nasal allergy or infection, surgically correcting a nasal deformity (septoplasty),
or removing tonsils and adenoids. Or, surgery on the throat and palate to tighten
up flabby tissues and expand the air passages, an operation called
UvuloPalatoPharyngoPlasty (UPPP). This can also be performed by Laser
Surgery.
If surgery is too risky, unwanted or unsuccessful, the patient may sleep every night
wearing a nasal mask which delivers air pressure into the throat ("CPAP").
Every chronically snoring child should also be thoroughly examined. Medical evidence
suggests a tonsillectomy and adenoidectomy will probably
make an important difference in the health and well-being of the child. Snoring
means obstructed breathing, and obstruction can be serious.
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