SINUSITIS AND SINUS SURGERY
Where do sinuses take place?
Sinuses extending on both sides of the nose, forehead and deep in the nose, backward,
under normal conditions they are filled with air.
What is Sinusitis?
Sinusitis is an inflammatory disease of the sinuses.
How do we get sinusitis?
Sinusitis usually occurs as a result of a viral upper respiratory tract infection, such as a cold, obstruction of the nasal opening of the sinuses, disruption of the sweeping-clearing function of the tissue lining the sinuses, and the production of microbes within the sinuses, as well as the content and consistency of the outbreak caused by the sinuses.
What other reasons can we have sinusitis?
Above is the most common form of sinusitis. The cartilage-bone wall curvatures in the nose, the middle nasal flesh swelling with air and clogging the sinus mouths, some anatomical variations that narrow the sinus mouths, hay fever, the presence of nasal flesh called polyps, which should not be present under normal conditions, especially in children problems, such as nasal tampons, plunge, pressure-changing conditions, rare tumors, foreign bodies, traumas, immune system diseases, or some treatments that suppress the immune system may pave the way for sinusitis.
What are the symptoms of sinusitis?
The most important symptoms of sinusitis are dark nasal discharge, nasal congestion, nasal discharge. In addition, face and headache, facial pressure and feeling of fullness, malodor, toothache, bad breath, especially in children, bad breath, cough, fatigue, ear pain and fullness in the ear, pressure sensation can be listed among the symptoms of sinusitis.
How is sinusitis diagnosed?
The diagnosis of sinusitis is a clinical diagnosis. In other words, it is put together with the complaints of your physician and examination findings. In your oral examination, the ENT specialist can see your nasal discharge and most importantly, you can evaluate the inside of your nose and the areas where the sinuses are opened by using the most commonly used instruments that we call the endoscope today.
Is it necessary to film for the diagnosis of sinusitis?
In the majority of cases, it is not necessary to have a film in order to diagnose sinusitis. Since plain x-ray films, which were frequently used in the past, can be misinterpreted, when computed tomography is performed, computed tomography is mostly used today. Rarely, in some special cases, MR (emar) can be performed.
When do you want a CT?
I want tomography preoperatively in chronic sinusitis and polyp sinusitis that do not respond to medication. This tomography features a 'road map' for the surgical plan. In addition, in some cases of diagnosis, such as those with chronic headache, I can apply to CT to determine whether the headache is related to sinusitis.
I always have a headache. Can I have sinusitis?
Headache is often associated with sinusitis. Contrary to popular belief, however, most headaches are not associated with sinusitis. Many other diseases, such as tension-type headache and migraine, can cause headaches. In the absence of other sinusitis signs and symptoms such as nasal congestion, nasal discharge, nasal discharge, headache is a rare condition due to sinusitis. Tomography is the guide in cases with occasional diagnosis.
Is sinusitis a chronic disease?
Many people believe that sinusitis is a chronic disease. However, when sinusitis-related complaints and examination findings are over 3 months, chronic sinusitis can be mentioned. Contrary to popular belief, the vast majority of sinusitis do not become chronic and heal. So once the sinusitis does not apply to the belief that sinusitis remains for life.
Sinusitis and Sinus Surgery
What is the treatment of sinusitis?
The primary treatment of sinusitis is drug therapy. Antibiotic treatment is applied here for 10-14 days. In chronic sinusitis, this period can be kept longer. In addition to antibiotics, nasal washing with special saline solutions, nasal opener sprays, pills called decongestants, which help to open the mouth of the sinuses and other pain medications are used. Surgery is applied to patients who do not improve with drug treatment.
How is sinusitis surgery performed?
Today, sinusitis operations are commonly performed through the nose, without an incision from outside, and with endoscopes and cameras, which is called endoscopic sinus surgery. The basic principle here is to clean the diseased tissues, inflammation and polyps, if any, to open the mouth of the sinuses, thus ensuring good re-ventilation of the sinuses. In the same session, if there is, the curvature of the bone cartilage of the nose can be corrected, the nasal flesh can be reduced. Although sinus surgery can be performed by making an incision under the lip or an incision through the eyebrow, this has become quite rare with the introduction of endoscopes. Your doctor will explain to you the appropriate surgical procedure.
Is endoscopic sinus surgery performed with general anesthesia?
Although endoscopic sinus surgery can be performed under local anesthesia under sedation, like many surgeons, I prefer general anesthesia.
What are the complications of endoscopic sinus surgery?
Complications of endoscopic sinus surgery include bleeding, infection, odor disturbance, intranasal adhesion, tear canal obstruction, edema around the eyes and bruising. In addition, since the sinuses are adjacent to the eye and brain, some other complications that may occur in the hands of a very rare and experienced surgeon, which may arise from damage to the adjacent regions, may occur. These include nasal cerebrospinal fluid leakage, meningitis, brain abscess, permanent central nervous system damage, blindness, double vision and severe bleeding due to carotid artery damage.
How is the post-operative process?
If spongy tampon is placed in the mouth of the sinuses in surgery, this routine is taken two days later. If a melt buffer is used, there is no need to undo it. Some medications (antibiotics, nasal sprays with cortisone, nasal opener nasal sprays, nasal wash, oily nasal drops) are used as and after your surgery. Crusts may occur in the nose. To be cleaned, the patient should be seen by the physician once a week for 3-4 weeks.
I had polyps in my nose. What is polyp?
Polyp is the flesh of the nose, which is caused by abnormal growth of tissue called mucosa, which covers the nose and sinuses. Sometimes it can cause double-sided enlargement of the nasal cavity, leading to complete nasal congestion and deodorization.
Why do polyps occur?
Despite all the scientific research, the secret of polyps has not been revealed yet. There is an inflammatory process, but the cause is unknown. While polyps are associated with allergy in some patients, no allergies are detected in the majority of patients.
What is the treatment of polyps?
Two main treatments are currently used in the treatment of polyps: drug therapy and surgical treatment. Cortisone treatment is the basis of drug treatment. Cortisone suppresses the inflammatory response, reducing polyps and suppressing postoperative regeneration. When common polyps cause complete obstruction of the nose, cortisone and antibiotic treatments are applied firstly in decreasing doses of cortisone in pills for several weeks. When these polyps are reduced, a tomography is taken to determine the preoperative condition. Endoscopic sinus surgery removes polyps and opens the mouth of the sinuses. Afterwards, regeneration of polyps is tried to be prevented with cortisone sprays and nasal washings for a long time.
Will the polyps repeat?
By nature, polyps tend to relapse. The most important purpose of the surgery is to open up the area where the cortisone sprays will penetrate after the surgery, thus reducing the frequency of the surgery by ensuring as much suppression of polyp formation as possible.
Is cortisone used to treat polyps risky?
Cortisone is a drug that makes many patients uneasy because of possible side effects. When they are in the form of a spray used for polyps, these sprays can be safely used for a long time under the supervision of a doctor, as very few of them will enter the blood. Cortisone, given in pill form, is given in decreasing doses over several weeks. Side effects of cortisone used in this way include elevating blood pressure and blood sugar, adverse effects on the ulcer if present in the stomach, and contributing to bone resorption. Therefore, patients given cortisone in pill form are warned about these issues, as long as they take this drug is recommended to eat salt-free, stomach protection drugs are used to patients. Especially in patients with diabetes, high blood pressure or ulcers, the use of cortisone should be decided according to the severity of these diseases, taking into account the balance of profit and loss.
20AXX
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