Flonase Sensimist Nasal Spray for Allergy Relief, 24-Hour Non-Drowsy Allergy Medicine, 120 Sprays, 0.31 Fl Oz (Pack of 1)

How is sinusitis treated?

How is sinusitis treated?
The first way to try to open the clogged sinuses is drug therapy. Balloon sinoplasty is the most effective method in chronic sinusitis cases. Sinusitis is caused by obstruction of the sinus orifices. Sinusitis also heals when clogged sinus openings are opened. There are 3 ways to open this blockage. Drug therapy, balloon catheter assistance or functional endoscopic sinus surgery can help patients to recover from sinusitis. Drug treatment is very effective in the treatment of sinusitis if it is in the early period. Surgery may be necessary for chronic sinusitis that does not improve despite the appropriate dose and adequate treatment. The purpose of surgery is to open the blocked sinus tracts. Thus, the aeration of the sinuses is provided. Infection regresses and disappears in the vented sinus.

Balloon Synoplasty in Sinusitis Treatment
We can perform this procedure with endoscopic sinus surgery as well as with balloon synoplasty technique. So, what is balloon synoplasty? Bolon synoplasty is the procedure of opening the narrowed sinus channels with the help of a balloon catheter. Tissue damage occurs in all operations performed within the nose. The idea of ​​how to open the sinus mouth without damaging the tissues has resulted in the technique of balloon synoplasty. A balloon catheter is placed in the sinus mouth which is problematic in this technique. The balloon is then inflated to expand the obstructed sinus mouth. Thus, no tissue inside the nose is damaged.

No Tissue Damage
In the balloon synoplasty process, the cannula is first brought through the nose to the sinus mouth and the guide wire passed through it is sent into the sinus. The balloon synoplasty catheter is then passed over the guidewire and inserted into the sinus mouth, where it is inflated. Balloon sinolasti system is removed from the nose after sinus drainage channel is opened and sinus aeration is provided. This completes the process. Balloon synoplasty is not a procedure to be feared or has some benefits compared with standard endoscopic surgical techniques. First of all, balloon synoplasty is an effective and safe method. It does not cause tissue damage during the procedure and the risk of bleeding is very low. In addition, recovery time is very fast, patients can return to work the next day. Finally, this process does not prevent further treatment in the same area.


23AXX
Flonase Sensimist Nasal Spray for Allergy Relief, 24-Hour Non-Drowsy Allergy Medicine, 120 Sprays, 0.31 Fl Oz (Pack of 1)

Vicks Vapoinhaler Portable Nasal Inhaler, 2Count, Non-Medicated Vapors to Breathe Easy

How are the sinuses evacuated? Herbal sinusitis treatment

Sinusitis problem can be very annoying. It also causes pain around the head and eyes. But how is sinusitis prevented? How are the sinuses evacuated? Herbal sinusitis treatment ...

Sinusitis problem can be very annoying. It also causes pain around the head and eyes. But how is sinusitis prevented? How are the sinuses evacuated? Herbal sinusitis treatment ...

Clogging of the sinuses creates huge problems. It is very simple for those who suffer from this condition to avoid summer-winter runny nose or nasal discharge problems.

Taking advantage of the beauties of daisy, all kinds of microbial bacteria in the sinus will come out thanks to the oils and steam inside.

How to apply chamomile?
Boil half a liter of water and add 1 cup of dried chamomile. Thoroughly boil your face closer, a towel on your head, 5 minutes to breathe the vapor.

Then take a 10-minute break and breathe again for 5 minutes. Repeat this process 3 times. At the end of the average 4 days all your sinuses will be discharged.

In addition, plenty of herbal tea to eat and pineapple will also be effective.


22AXX
Vicks Vapoinhaler Portable Nasal Inhaler, 2Count, Non-Medicated Vapors to Breathe Easy

NeilMed Nasogel Drip Free Gel Spray, 1 Fluid Ounce

How to Treat Sinus

It should be noted that the question of how to perform sinus treatment is frequently used by many patients. So, what exactly is the sinus thing, let's explain it first? Sinus is the air gaps in the bones surrounding the nose. 4 of the sinuses are located on the right and 4 on the left. It is necessary to say that the membrane structure called mucosa, which is furnished in it, produces half or one liter of slime in a day and that this epidemic is carried by the small hairs of the epidemic to the discharge channel and transferred to the nose. Sinusitis is exactly the inflammation of the mentioned mucosa. So, there are some ways of treatment for sinusitis that we are with you to this extent.

Symptoms of Chronitis Sinusitis
Frequently asked how to do sinus treatment, we first told you what the sinus is. The microorganisms in the secretions proliferate when the system that carries the secretions produced in the sinus to the channel to discharge is not working properly or is clogged. This will cause sinusitis. Of course, penetrating traumas, dental root infections and bloodborne microorganisms are the causes of sinusitis. How do you know that you have sinusitis so that you can apply for treatment early? If the secretions in the nose turn yellow yellow while clear, you should hurry for treatment.

How to Treat Sinus?

Those who say how to do sinus treatment can be referred to two different methods as medical and surgical. If your sinusitis is diagnosed early, medical treatment may be more appropriate. So, how will sinusitis respond to medical treatment? Clogged discharge channel is opened with medical treatment, then secretions in the sinus are discharged and air is introduced into the sinus. When you look at it, you can see that medical practices between sinus treatments are divided into protective measures, supportive treatments and medication. If we look at surgical treatment, we can say that this treatment is also called endoscopic surgery. This treatment is performed with sensitive instruments with the help of thin cameras inserted directly through the nose without incision from the outside. As a result, you should know that we will be with you whenever you want for sinus treatment.


21AXX
NeilMed Nasogel Drip Free Gel Spray, 1 Fluid Ounce

Boogie Mist Sterile Saline Nasal Spray for Baby and Kids Sensitive Noses Clear Congestion, Fresh Scent, 3.1 Ounce

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
Boogie Mist Sterile Saline Nasal Spray for Baby and Kids Sensitive Noses Clear Congestion, Fresh Scent, 3.1 Ounce

Xlear Nasal Spray for Sinus Relief 1.5 fl oz

How is Hair Transplantation (Plonidal Sinus) Treated? What are the treatment options?

To date, many different treatment options for pilonidal sinus disease have been developed and developed. Some of them are treated surgically, some are non-surgical methods.

Treatment is determined by the general condition of the patient and the extent of hair turnover.

Sinusotomy technique is used nonoperatively. In surgery; open release, primary closure, flap, caridakis and micro sinusectomy.

Non-surgical Hair Loss Treatment
my Sinüsoto
Pilonidal sinus is a disease usually treated with surgical intervention. In fact, a very large incision was performed in classical operations. However, in sinusotomy technique, the procedure is performed by expanding the hair entry holes without surgical incision.

In the sinusotomy technique, the holes under which the hair enters the skin are opened by surgical incision. By localizing, the hair rotation holes are expanded with radiofrequency device or pouch biopsy. In this way, the sinus can be cleaned without applying the incision.

The inside of the sinus is cleaned with spiral wire brushes and then scraped with curette. Substances such as antibiotics, antiseptics and silver nitrates may be administered locally.

Stitches are not removed after treatment. The wound is closed in the form of dressings. Treatment can be completed in 10-15 minutes in total.

What are the advantages of sinusotomy?
It is an alternative and practical option for those who do not want to have surgery.

With no incision, the patient can return to social life on the same day.

In addition, there is no incision and no disturbing marks.

The wound heals within 10-15 days depending on the size of the sinus.

There is little risk of recurrence.

If it repeats, the process is easy to repeat. (With no loss of tissue)

People with Sinusotomy Treatment
Closed dressings should be preferred because the treated holes are not closed. It should also be ensured that the hairs falling from the back and neck do not reach the coccyx. Otherwise, the hairs pass through the hole under the skin and the problem recurs.

Sinusotomy What are the disadvantages?
Sinustomy technique cannot be applied in advanced hair rotations.

Surgical Hair Loss Treatments
Many different treatments have been tried for hair rotation. The aim is the same in all surgeries. Sinus removal from the body Surgical treatments are divided into two groups: contemporary and classical.

The healing process is long and strenuous due to the large amount of incision in classical treatments. However, in modern techniques developed as an alternative, most of the disadvantages are eliminated because of the small amount of incision.

Open Drop Surgery
It is a treatment in classical surgery. It is also referred to as sinus excision. In this surgery, the sinus and surrounding tissue are completely removed from the right and left of the midline with 2 oval 10-15 cm long incisions. Due to the large amount of incision, too much healthy tissue loss occurs.

Once the sinus is removed by incision, it is not closed with sutures. Instead, it is left open by dressing for self-healing. Pain is high after treatment. It is also necessary to stay in a compulsory admission position for a while.

It should be kept clean and dressed until the wound heals. The closure of a wound of this size covers a period of approximately 5 to 6 months. In other words, there is a maintenance and recovery process for about 6 months after the treatment.

Hospitalization is required for 5-10 days after open cessation surgery. Therefore, it causes labor loss. Furthermore, the risk of infection in this process is very high due to the wound being left open.

Primary Closure Surgery
Logic is the same as open release surgery. However, there are some differences in practice. As in the open-release technique, the sinus circumference is cut out widely. However, in contrast to the open release technique, the incision opened after the procedure is closed by stitching.

As the tissue is removed and the stitch is removed, tension occurs in the region. And tension causes severe pain. Sutures can heal in 15-20 days. However, bed rest is generally recommended for 1 month.

The tension continues after the stitches are removed. Expansion due to tension and infection may occur due to opening. In addition, the risk of recurrence is higher than other treatments. (15%)

Flap Surgery
One of the classical operations is flap surgery. In flap surgery, unlike primary closure, sutures are brought with healthy hairless tissue to prevent tension.

Due to the absence of tension in the wound, the healing process is shorter. Recovery takes about 10-15 days.

Depending on the application of the procedure, surgery is named in different ways. The most commonly used flap surgeries are Limberg flap and Z-plasty.

Limberg flap; the sinus is removed with a diamond-shaped tissue piece and the skin is subcutaneously released (flap) and the opening is closed.

Z-Plast; The sinus is removed ovally with the tissue piece and the triangular skin subcutaneous tissue is released (flap) from the upper and lower ends and the opening is closed, leaving a Z-shaped incision. The recurrence rate in these surgeries is 8-10%.

Karidakis Surgery
It is a similar operation to flap surgery but with differences. Skin shifting is performed in Karidakis surgery.

In Karidakis surgery, the incision is made from the side, not from the middle line. Slightly cut the skin of the opposite side of the suture is slid in that way.

It is easier and less scarring than flap surgery. The healing process is shorter compared to classical operations. There is also less post-procedure pain.

Microsinusectomy Surgery
Microsinusectomy is a modern treatment technique that has a very low incision rate as an alternative to classical surgeries.

The aim is to remove hair rotation from the body with minimum incision. In this way, healthy tissues are not damaged, the healing process is shortened and visually undesirable results do not occur.

A 2 * 2 incision is sufficient for microsinusectomy. It can be applied practically under local anesthesia. The incision is closed with hidden and absorbable sutures. In this way, no trace.

Due to the low incision, the pain is very mild after the procedure. In addition, thanks to a practical procedure, the patient can return to daily life after resting for half an hour after surgery. Thus, treatment can be completed without loss of labor.

In classical surgeries, the amount of incision is very high and labor loss is high. However, there is no loss of labor in contemporary and non-surgical techniques. In addition, too much healthy tissue loss occurs in classical methods.


19AXX
Xlear Nasal Spray for Sinus Relief 1.5 fl oz

Navage Nasal Care Starter Bundle: Navage Nose Cleaner and 18 SaltPods, plus New User Starter Gift of 10 SaltPods

Sinusitis

What is a sinus?
Sinuses are air gaps around the nose. They are named according to their location (frontal, maxillary, ethmoid, sphenoid).
The sinuses are opened to the nasal cavities by means of special canals. The nasal cavities and sinuses are covered with the same covering layer (mucosa) as a whole. This layer continuously makes a cleansing secretion and this secretion is discharged to the nasal cavity by means of the fuzzy hairs on the layer.

Sinusitis; sinus infection / inflammation is the name given. It is often referred to as “rhinosinusitis için because the same covering layer is affected as a whole.
The development of infection in the sinuses is the result of some disturbances in the work of the sinuses, which are the obstruction of the special ducts of the sinuses, the malfunction of the wobbly hair, the accumulation of the outbreak of the sinus within the sinus, resulting in a favorable environment for bacterial growth.
The most common cause of sinusitis is upper respiratory tract infections. This is caused by obstruction of the ducts of the sinuses opening into the nasal cavity during infection due to the swelling of the covering layer. The cause of infection may be bacteria or viruses. Allergy is another cause of sinusitis.

Other factors that increase the tendency to sinusitis include; dental root infections, curvature of the nasal middle chamber, polyps occupying space in the nasal cavities, foreign bodies, nasal tampons and tumors.
In addition, pressure changes that may occur during swimming or traveling by airplane may block the channels of the sinuses and cause sinusitis.

What are the symptoms of sinusitis?
Pain: Acute sinusitis can be felt in different regions according to the affected sinus, can be felt on cheeks, upper teeth, forehead, around eyes, between eyes, behind the head. When the head is tilted forward, there is an increase in pain.
Other symptoms are pressure sensation, nasal congestion, runny nose, cough, weakness, fever.

How is sinusitis treated?
In acute sinusitis, drug treatment is generally applied, antibiotics, nasal openers, pain medications are used. The recommendations of the treating physician and the duration of antibiotic use must be strictly followed. In addition, plenty of fluids should be taken, cigarettes and smoke absolutely must not.
In chronic sinusitis, surgical treatment is applied for frequently recurrent acute sinusitis that does not respond to drug treatment. The most common sinus surgery; "functional endoscopic sinus surgery (FESS)". In this surgery, it is possible to reach the diseased sinus and clear the sinus without making incisions in the face and mouth, and if there is a disorder that increases the tendency to sinusitis, it is corrected.


18AXX
Navage Nasal Care Starter Bundle: Navage Nose Cleaner and 18 SaltPods, plus New User Starter Gift of 10 SaltPods

Neil Med SinuFlo Ready Rinse, 8 ounces Bottle

Sinusitis

The paranasal sinuses are four pairs of different sizes, each with the name of the bone in which they reside: the maxillary, ethmoid, frontal, and sphenoid sinuses (Figure 1). Paranasal sinuses have controversial functions such as humidifying respiratory air, secreting mucus, alleviating skull bones, contributing to resonance of sound, and isolation of intracranial heat.



Sinusitis is one of the most common causes of applications to health care institutions and is one of the most frequently prescribed antibiotic diseases. It is also an important source of morbidity and a major cause of economic loss. It has been reported that 50 million people in the United States are affected by sinusitis annually, causing 73 million days of labor loss and $ 2.4 billion in medical (excluding surgical and radiological procedures) treatment and endoscopic sinus surgery in 100,000 patients for sinusitis.



Classification
1 - Acute sinusitis: Sudden onset, less than four weeks in a completely healed sinusitis. It often develops after viral upper respiratory tract infection.

2- Subacute sinusitis: It is used for acute rhinosinusitis for more than four weeks and less than 12 weeks.

3- Recurrent sinusitis: In a year, each of which lasts 7 days or more, more than four episodes are experienced.

4- Chronic sinusitis: Sinusitis lasting 12 weeks or more. Acute attacks may develop during the course of chronic sinusitis.



Ethiopathogenesis:

Because of the close proximity of the paranasal sinuses to the nasal mucosa, sinusitis and rhinitis are often found together, and some authors use the term rhinosinusitis more often than sinusitis. The paranasal sinus and nasal mucosa has defense systems such as mucociliary system activity against infection, mucus coverage in the epithelium, antimicrobial agents in the mucus, and immunoglobulins in the mucus. In particular, disruption of mucociliary activity plays an important role in the formation of sinusitis, leading to accumulation of secretions and infection within the sinus.



The anterior ethmoid, maxillary, and frontal sinuses drain to a region called osteomeatal complex in the middle meatus (Figure 2).



Osteomeatal complex stenosis creates a preparatory environment for sinusitis. The ethmoid sinus is usually the first onset of disease and most commonly involved sinus. Anatomical disorders (septal deviations, polyps, ethmoid sinus and middle turbinate variations, foreign bodies, tumors, lateral wall anomalies), mucosal edema (viral upper respiratory tract infections, allergies, hormonal disorders) can be among the causes of obstruction in the osteomeatal complex. In osteomeatal complex obstruction hypoxia develops, mucociliary activity decreases, sinus drainage deteriorates, secretions thicken, mucus stasis occurs. Accordingly, a suitable substrate for secondary bacterial growth is prepared and sinusitis begins.



The most common causes of acute sinusitis are Streptococcus pneumonia, Hemophilus influenza and Moraxella catarhallis, respectively. Hemophilus influenza, staphylococci and anaerobes are important factors in chronic sinusitis. In recent studies, the term allergic fungal sinusitis has been proposed by considering that a significant portion of chronic sinusitis is secondary to fungus. Presence of nasal polyposis, asthma and atopy, presence of dark mucoid secretion, demonstration of fungus in secretions without mucosal invasion, presence of antibodies specific to fungus in serum, monitoring of calcifications in sinuses, allergic fungal sinusitis should be considered. Invasive fungi are an important cause of sinusitis in diabetic and immunocompromised patients.



symptoms
Sinusitis can cause headache, runny nose, nasal congestion, bad breath, cough, ear pain, toothache, fever, hyposmi-anosmia, fatigue. Chronic sinusitis usually presents with milder symptoms. Symptoms are often more frequent at night and early in the morning (due to increased paranasal edema in the supine position and consequently reduced mucociliary activity).

Diagnosis
Anterior rhinoscopic and nasal endoscopic examination performed by ENT specialist has an important role in the diagnosis of sinusitis. Especially, purulent drainage in the middle meatus suggests sinusitis. Nasal examination also allows the identification of anatomic anomalies that lead to sinusitis, the detection of the affected sinus, the detection of nasal polyps, tumoral formations or fungal infections, and the differentiation of allergic conditions from infective events. In addition, facial edema, fullness, cervical adenopathy, postnasal discharge, pharyngitis may be detected on physical examination.



Routine radiological examinations such as Waters, Caldwell and lateral head radiography have been used for many years as an adjunct to the diagnosis. On radiographs, opacification and air-fluid levels in acute infections of maxillary, frontal and sphenoid sinuses will facilitate diagnosis.



The fact that routine radiographs are open to different interpretations and inadequate evaluation of the ethmoid sinuses and osteomeatal complex limits its usefulness in patients with chronic sinusitis. In chronic sinusitis resistant to treatment, in patients who may need surgery, in the presence of complications, suspected tumoral formation, coronal and axial planar sinus tomography should be used if necessary.



Treatment
Medical treatment of purulent sinusitis includes antibiotic, decongestant, mucolytic, methods of clearing other nasal secretions, and appropriate addition of topical steroids if necessary. Antibiotic selection is often made empirically according to the causative organisms and the clinician's experience.



Considering that two thirds of acute sinusitis develop secondary to Streptococcus pneumonia and Hemafilus influenza, firstly, the selection of antibiotics that may be effective on these microorganisms would be appropriate. The most commonly prescribed antibiotics for this purpose are amoxicillin, amoxicillin clavunate, clarithromycin, trimethoprim / sulfamethaxole, cefuroxime, cefrozil, loracarbef, cefodoxime, ciprofloxacin, levofloxain. Penicillin, cephalexin, erythromycin, and tetracycline do not include major microorganisms involved in sinusitis.



In some populations, the effectiveness of amoxicillin below 70% due to resistance limits its use. The duration of antibiotic treatment in uncomplicated sinusitis is between ten and 14 days.



In addition to antibiotic treatment, decongestants that reduce mucosal edema and open the sinus osteum can be added topically or systemically. It should be kept in mind that long-term administration of topical decongestants should not be used for longer than 4-5 days, as rebound mucosal edema may lead to rhinitis medicamentosa.



Removal of dark secretion from the sinus cavity can be increased by physical cleaning with saline and, if necessary, mucolytic agents are added to the treatment. It is necessary to avoid the use of antihistamines due to their drying effects on secretions except in allergic conditions. Topical steroids may also be added to treatment in cases of chronic sinusitis and atopy.



Subacute and chronic sinusitis resistant to drug therapy and recurrent acute sinusitis attacks are surgical indications. The aim of sinusitis surgery is to improve ventilation, drainage of sinuses and restore normal functions. Correction of obstruction in the osteomeatal complex and removal of pathologies are the basis of surgery. Endoscopic sinus surgery, which has been widely used for the last 15-20 years, can achieve successful results up to 90%.



Nasal polyposis, mucocele, mucopuyocele, invasive or allergic fungal sinusitis, sinus tumors, acute complicated sinusitis (subperiostal or orbital abscess, brain abscess, meningitis) are certain surgical indications. If a sinusitis complication develops, it should be started for broad-spectrum antibiotics and evaluated for immediate surgical intervention.



After the first-line treatment of sinusitis, which is a common disease, is performed by general practitioners, it would be appropriate to evaluate the patient by an ENT specialist in treatment-resistant cases.

complications
Although sinusitis is a very common disease, complications of sinusitis are rare due to the development of effective antibiotics and surgery. However, it should be kept in mind that untreated sinusitis can lead to fatal complications.



Complications of sinusitis can be classified into 3 groups:

1. Local complications: Osteomyelitis, mucocele, pyocele

2. Orbital complications: Inflammatory edema, orbital cellulitis, subperiostal abscess, orbital abscess, cavernous sinus thrombosis

3. Intracranial complications: Brain abscess, meningitis.


17AXX
Neil Med SinuFlo Ready Rinse, 8 ounces Bottle