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Cysts Removal Procedure
Treatment of Tonsils (Tonsillitis)
Hearing Aid Fitting
Treatment of Throat and Voice Problems
Earlobe Repair Procedure
Treatment of Sleep Disturbance
Nose Reshaping Procedure
Hearing Testing Techniques
Nasal And Sinus Allergy Care
Cochlear Implant Procedure
Ear Micro Surgery
Treatment Of Hearing Deficiency
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Sinusitis: Management and Prevention
Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows:
● acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms
● subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms
● recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which
Recur at intervals of at least 10 days apart
● chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms
● acute bacterial sinusitis superimposed on chronic sinusitis:
New symptoms that occur in patients with residual symptoms from prior infection (s). With treatment, the new symptoms resolve but the residual ones do not.
Physical findings and clinical presentation
● patients often give a history of a recent upper respiratory illness with some improvement, then a relapse.
● mucopurulent secretions in the nasal passage
● purulent nasal and postnasal discharge lasting more than 7 to 10 days
● facial tightness, pressure, or pain
● nasal obstruction
● decreased sense of smell
● purulent pharyngeal secretions, brought up with cough, often worse at night
● erythema, swelling, and tenderness over the infected sinus in a small proportion of patients
● diagnosis cannot be excluded by the absence of such findings.
● these fi ndings are not common, and do not correlate with number of positive sinus aspirates.
● intermittent low-grade fever in about one half of adults with acute bacterial sinusitis
● toothache is a common complaint when the maxillary sinus is involved.
● periorbital cellulitis and excessive tearing with ethmoid sinusitis
● orbital extension of infection: chemosis, proptosis, impaired extraocular movements.
Characteristics of acute sinusitis in children with upper respiratory tract infections:
● persistence of symptoms
● bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● facial pain or pressure
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.
● each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum).
● acute viral infection
● infection with the common cold or infl uenza
● mucosal edema and sinus infl ammation
● decreased drainage of thick secretions, obstruction of the sinus ostia
● subsequent entrapment of bacteria
A. Multiplication of bacteria
B. Secondary bacterial infection
Other predisposing factors
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● parainfluenza virus
● respiratory syncytial virus
● the principal bacterial pathogens in sinusitis are streptococcus pneumoniae, nontypeable haemophilus influenzae, and moraxella catarrhalis.
● in the remainder of cases, fi ndings include streptococcus pyogenes, staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (peptostreptococcus, fusobacterium, bacteroides, prevotella).
Infection is polymicrobial in about one third of cases.
● anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children.
● fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon
Pathogens in the paranasal sinuses. Fungal pathogens include aspergillus, pseudallescheria, sporothrix, phaeohyphomycoses, zygomycetes.
● nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised.
● s. Aureus
● pseudomonas aeruginosa
● klebsiella pneumoniae
● enterobacter spp.
● proteus mirabilis
Organisms typically isolated in chronic sinusitis:
● s. Aureus
● s. Pneumoniae
● h. Infl uenzae
● p. Aeruginosa
● water’s projection: sinus radiograph
● ct scan
● much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses
● recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to
● used for diagnosis of frontal and maxillary sinusitis
● place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses.
● absence of light transmission indicates that sinus is filled with fluid.
● dullness (decreased light transmission) is less helpful in diagnosing infection.
● used to visualize secretions coming from the ostia of infected sinuses
● culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture
● sinus puncture
● gold standard for collecting sinus cultures
● generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis.
Treatment Nonpharmacologic therapy
● sinus drainage
● nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5%
● topical decongestants should not be used for more than a few days because of the risk of rebound congestion.
● systemic decongestants
● nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone
● nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow)
● use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting,
Which blocks the ostia, thus interfering with sinus drainage.
● analgesics, antipyretics.
● most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics.
● current treatment recommendations favor symptomatic treatment for those with mild symptoms.
● antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of
● antibiotic therapy is usually empirical, targeting the common pathogens.
● first-line antibiotics include amoxicillin, tmp-smz.
● second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin.
● for patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the
Costlier second-line agents.
● surgical drainage indicated
● if intracranial or orbital complications suspected
● for many cases of frontal and sphenoid sinusitis
● for chronic sinusitis recalcitrant to medical therapy
● surgical débridement imperative for treatment of fungal sinusitis
1. I have sinus, can I use curd when I take a head bath? 2. Is there a difference between curd and milk itself turning into curd consistency?
I am 50 years old. I am suffering from vertigo and stomach irritation. Stomach irritation is causing vertigo and vomiting.
My left ear is paining from over 3 days and it also discharging the the water like fluid. What should I do?
Yesterday night before sleeping, I talked with my friend on a phone call for 1-2 hours. Mobile was on the right ear. I began to feel a mild headache near my right ear and also when I woke up today, I'm having some dizziness. Is this all due to Mobile radiation? I usually don't use much mobile. But yesterday. I talked for a long time.
Sir / Madam. My name is Arbaz. V. Khan. And I am 19 years. Sir / madam. Today m gone water park n enjoy wid friends. Bt. My both EARS. gone water inside. N. Try all the techniq to remove water from my ears. Bt. Water can not came outside. N. I. Used ear drops also. 3 types of ear drop. Sir / Madam. please give me solution. And I am not listening properly. E. G. IF I WANT WATCHING T AM NOT ABLE TO WATCH LOW VOLUME.
I accidentally hit my left side of the skull above the ear by a sharp and rigid corner of an object (bed) and now that part of my skull is swelled. Is this minor and would be healed automatically if not what should I do?
I am 24 year male, last one year facing tiredness, dull face, feel some weakness, hair loss, some time motion came with dilute like gel, if once I sit avg 30 minutes then stand that time I feel giddy, little memory loss.
Breathe Easy: 6 Natural Remedies to relieve Nasal Congestion
Everyone knows how annoying a stuffy nose can be. The difficulty in breathing even affects your sleep and day to day work. Nasal passages are blocked when the virus causing cold leads to inflammation of the tissues in the nasal cavity. Thankfully there are some simple and non-expensive home remedies that can be used to relieve a blocked nose.
Here are some natural remedies to get rid of nasal congestion during winter months:
1. Garlic :
Garlic is useful in relieving a blocked nose. In addition, it’s anti-bacterial and anti-fungal nature helps to fight with cold virus. You can either chew on 2-3 cloves of whole garlic or boil the cloves in one cup of water and drink the concoction.
2. Apple cider vinegar:
In addition to numerous other health benefits, apple cider vinegar can also help relieve a blocked nose. Mix two teaspoons of apple cider vinegar and one teaspoon honey in a cup of water. Drink this at least 2-3 times a day to clear congestion.
Basil or tulsi is also a great treatment for blocked nose. You can chew on a few leaves at night before going to sleep and in the morning. It is a very effective solution for not only relieving congestion but also to treat other conditions of cold like sore throat and cough.
4. Eucalyptus oil:
Eucalyptus oil is highly beneficial for those suffering from nasal congestion due to its decongestant and anti-inflammatory properties. Put one or two drops of eucalyptus essential oil in a fresh handkerchief and inhale the aroma. Do this few times a day. Alternatively, you can add a few drops of eucalyptus essential oil on your pillow so you can get the benefits of this oil while sleeping.
5. Methi seeds:
Methi is a very good natural ingredient to treat nasal congestion, thanks to its anti-inflammatory properties. It also helps to cleanse the mucous membranes. The heat and moisture from methi tea will help in thinning of mucus.
Mix one or two teaspoons of crushed methi seeds in a glass of water. Boil the solution. Strain and drink it while it is warm. Repeat two or three times a day until you get complete relief from the problem.
6. Lemon tea:
A tea made of hot water, lemon, and honey is one of the best stuffy nose relievers and you should try it if you’re looking to quickly get rid of a stuffy nose. To make this simple tea, just boil a cup of water, add the juice from one fresh lemon, and mix in two tablespoons of honey. Drink this up as many times a day as you would like to get rid of your stuffy nose and help you feel better.
So, go ahead and try these effective remedies to breathe easy this winter season. Stay healthy, stay happy!