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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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I have sore throat and pain in throat and lumps on both side of tongue. I am not able to sleep during night. Pain in throat and feel like thirst. But after intake of so much water it remains same. What to do? Please suggest me some medicine for it.
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
I am 21 years old. I am snoring a lot with high sound. My friends and my family members are teasing me a lot. So please plz help me with a solution in order to decrease my snoring.
I have throat pain since 2 months I use to smoke but now I have stopped I feel some what some thing is sticked in throat.
Hi doctor .I have very big nose. The nostrils and nose bone is big. Is rhinoplasty possible and how much time is required for rhinoplasty and what are the side effects. Best hospitals for rhinoplasty in India ?and what is the cost of rhinoplasty ?please answer my query doctor. Thank you.
Hi Doctor, Thanks in advance, for taking out time to answer my query. Actually, I've been experiencing sore throat, with difficulty in swallowing and occasional white mucus. It's been 2 weeks now. As per my research online, it must've got away by now. But, it's not, it's still there. Kindly help.
HI all, From last Thursday I am affected with throat infection. I tried all home remedies like. Milk pepper and turmeric. Salt Walter googling. Still nothing helps cure.
The common reason why most of us get throat infections is because they are viral in nature. This means that if one person gets a throat infection then he transmits it to others by touching, coughing and sneezing etc.
Viral throat infections can be managed easily. There are several home remedies that can alleviate your viral infection. However, it is suggested to consult an ENT specialist if the home remedy is not providing any relief to you.
- Gargling: It is one of the most popular methods of treating viral throat infection. All you need to do is mix one tablespoon of salt in 200 ml of water and warm the solution. When the water becomes lukewarm, take a small portion of it and rinse your throat with the solution. Take care that the solution remains within your throat and does not reach your stomach. Rinse your throat for 5 minutes and repeat the procedure after a rest of 2 minutes. Ensure that the water remains lukewarm for effectiveness.
- Inhalation: Another common method of ridding yourself of viral throat infections is to inhale steam. Boil some water mixed with eucalyptus oil. When the water starts developing bubbles, take your face near it, cover it and the pot containing water with a dry towel and inhale the steam. This procedure is inconvenient for many people because inhalation results in sweating, but the result is perceptible. You must inhale steam for at least five minutes. Once you are done with inhalation, avoid taking cool fluids like cold water etc., else the effect would be reversed and your infection might get more severe.
- Take lots of fluids: Strange as it may sound, viral throat infection can also be treated by taking lots of hot fluids. The warm temperature helps in neutralising the viruses, while the fluids prevent the dehydration of the body. Take hot tea, coffee etc. when you have an infected throat.
- Drink hot milk and turmeric: Many mothers administer this solution to their kids to treat throat infections caused by viruses. This concoction is best taken before sleeping in the night. Turmeric has been found to carry several anti-microbial properties.
- Avoid smoking: If you are a smoker, you must avoid smoking to alleviate your viral throat infection.
- Use decongestants and nasal sprays: These substances make breathing easier by contracting the swollen mucous membranes. Nasal sprays also help relieve runny noses and post-nasal drips, which are so irritating and inconvenient to many. However, avoid administering this remedy to small children. Since these sprays contain synthetic drugs, it is advisable to stick to prescribed dosages for different age groups.
In case you have a concern or query you can always consult an expert & get answers to your questions!