I am Dr. Sanjay Bhatia, ENT specialist and neuro-otologist. Today we are going to speak on nasal obstruction; the common cause what I see in my clinical practice. If we start, nasal obstruction most commonly seen in paediatric age group is nose block, mouth breathing and nasal discharge. These are predominantly seen with a small adenoid growth at the end of the nose. Deviated nasal septum, hypertrophic reactive turbinates or allergic colds are treated with medications. Adenoids usually do subside with medication but persistent and recurrent episodes of adenoiditis will require surgical management. As the age progresses, around teenage, adolescent ages we see buckling of the nasal septum called deviated nasal septum causing nasal obstruction. The correct age would be around 15, 16 to 18 years if there is a persistent nasal obstruction causing difficulty in breathing, mouth breathing, snoring.
So, the surgery for that is septum correction called septoplasty which can be done in a conventional way or an endoscopic septoplasty. As we go further, we have this constant environmental agent which causes sneezing, watery nose and persistent nasal discharge which chokes the nose causing nasal blockages. These are known as allergic rhinitis which can also have a resulting in nasal obstructions and frequent episodes of allergic rhinitis can lead to soreness of nasal lining leading to nasal polyposis. The early treatment is medication, nasal sprays and anti-allergic tablets. If the symptoms persist and there are nasal polyps which are not regressing in spite of good medications and systemic steroids one has to undergo sinus surgery to remove the nasal polyposis. Another factor for nasal obstructions can be recurrent rhino-sinusitis, bacterial infections and masses in the nostrils.
So this can be tumors, can be in adolescent ages in males we see is vascular masses called as angiofibromas, there can be other tumor factors in the nose which has to be addressed according to the lesion. How effective are the nasal surgeries for the above symptoms? This is a common question asked and discussed with my patients. Now depending on the etiology, the recurrence rates are known. If it is allergic symptoms, we do not control the allergies by surgery. Allergies are controlled by medications only. How severe is the response of your lining to the allergy will show us the recurrences of the symptoms? That's why most of the consultants will tell you nasal polyposis is just to clear the nostrils from the polyps, create a wide surface area for the medications to reach.
Regarding the removal of adenoids, there are various techniques today. Apart from the conventional curate technique, we have nasal endoscopic technique where it is visualized under the vision and shaver system and coblation is used to remove adenoids and the division. So it is no longer applying procedure so the success rate of removal of adenoids is much higher and better. Septoplasty we have already discussed. Sinus surgery for bacterial infections and infective causes is how well we open up the affected sinuses. You create a larger area of drainage and a good antibiotic serves the purposes. Regarding the tumor and other masses, it depends on the etiology and pathology of the tumor, how bad or good the disease is for the recurrence kind of thing. Thank you and you can go through the post and other things on the lybrate website.
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Me Dr. Sangeeta Raodeo hun, practicing gynecologist. Me practice krti hun Central Hospital and Fortis Hospital me. Me ek high-risk pregnancy specialist hun and infertility me bhi kafi ruchi rkhti hun. Aaj me baat krungi bad-obstetric history ya recurrent pregnancy loss se pidit mahilaon ke bare me. Ye vo mahilayein hoti hai jinme pregnacy rehne me koi problem nhi hoti lekin 1-1.5 months pregnancy hone ke baad, bacha apne aap gir jata hai, abortion ho jata hai.
Kbhi kbhi aisa bhi hota hai ki sonographic krne pe pta chalta hai ki bache ki dhadkan hi nhi hai. Kbhi kbhi aisa bhi hota hai ki pregnancy 7-8 months tak chalti hai lekin bache ki growth and vajan ache nhi badh pata. Blood pressure ho jata hai or premature delivery krni pdti hai. Agar 1-1.5 months me aisa ek bar ho to hum generally usko normal smjhte hain lekin ye baar baar ho to iska investigation important hai. Kayi ladies me blood me factor ki kami ya fir molecular or placenta level pe blood clot banne lgta hai. Jiske karan bache ko nutrition nhi mil pata hai.
Agar hum iska investigation kren to iska treatment 100% possible hai. Ye ek parkar ki high-risk pregnancy hai jise hum carefully monitor krte hue chalen to iska ilaj ho skta hai. Ye treatment jyada expensive bhi nhi hai. Investigation ke li normal expenses hote hain. Lekin uske baad daily injections lene pdte hain. Maa banna ek bhut hi sukhad and gauravshali anubhav hai. Lekin maa banne ke baad use khona, kisi bhi stri ke lia bhut bada mansik dhakka ho skta hai. Islia agar apke parivaar ye jaan pehchan me kisi ko bhi y problem hai to aap mujhe contact kar skte hain. Iska treatment ache tarike se ho skta hai. Mujhse consult krne ke lia aap mujhse Lybrate ke through contact kar skte hain.
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