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An experienced specialist told the media that conditions that cause the nasal mucosa to swell, increase discharge, make it difficult or impossible to breathe through the nose, cause various diseases and can be acute and chronic.
From chronic diseases, the doctor distinguishes chronic sinusitis. It is recognizable by a long and stuffy nose, difficulty in breathing through the nose, heavy secretions, a weakened sense of smell or its complete loss, pressure or even pain in the forehead, cheekbones, buttocks. Sinusitis is considered chronic when symptoms persist for more than 12 weeks.
According to the doctor, chronic sinusitis is not always the result of poorly treated acute sinusitis. It can be determined by the individual characteristics of the human body, the anatomical features of the nose, and concomitant diseases.
Initially, intranasal hormone therapy (corticosteroids, nasal sprays) is usually used to treat sinusitis, and additional antibiotics are given at high temperatures only with the addition of a bacterial infection. When conservative drug treatment is ineffective or its effect is short, surgical treatments are used.
CT scan of the sinuses is done when planning surgical treatment. In sinusitis, the nasal mucosa swells and narrows or closes the sinus openings completely, thus removing structures that interfere with normal sinus function, that is, the normal clearance of sinus secretions. . If polyps are found to be the cause of recurrent sinusitis, it is suggested that they be removed.
Sinusitas.
According to Vytautas Juntis, the gold standard is currently functional endoscopic sinus surgery.
In general anesthesia, derivatives are removed into the nasal passages with the help of special instruments and hard endoscopes, and the sinuses are opened for drainage through the dilated openings into the general nasal passage. In this way, an attempt is made to restore the physiological drainage of the sinuses. In the past, open sinus surgeries were performed, where the sinus was opened by making an incision on the outside, but due to the more difficult postoperative period and possible later complications, they have recently been abandoned.
Although, according to your doctor, the most serious complications of sinusitis can be avoided if you have a severe increase in headache, a temperature above 38 degrees, neurological symptoms such as vomiting, apathy, etc. blurred vision, wavering eyes. In this case, it can be suspected that the sinusitis was complicated.
The complications of sinusitis are divided into intracranial (brain) and intraorbital (in the eye) when urgent surgical care is required to save life or important functions such as vision. Complications can include not only the acute course of sinusitis, but also chronic exacerbations. In most cases, the patient undergoes an urgent CT scan of the head, including the sinuses, followed by surgery.
According to the specialist, patients often fear not so much the operation itself as the postoperative period. However, although everyone evaluates pain differently and different people have different sensitivity thresholds, most patients who have nasal swabs removed after surgery say they expected it to be much more dire.
“Patients are more concerned with removal of nasal swabs after surgery, but the recent use of small inflatable nasal swabs can significantly reduce the discomfort patients experience,” said the otolaryngologist.
The doctor says that patients often seek medical attention for loss of smell. In this problem, an otolaryngologist can carefully examine and accurately assess the structures of the nasal passages using rhinoscopy (nasal swab) or endoscopy (using a hard or soft endoscope) and reject or confirm the diagnosis of mechanical obstruction.
One of the most common findings is nasal polyps or other chronic diseases that lead to olfactory impairment or loss. Rare findings, especially when olfactory loss, bleeding, or shortness of breath occur on one side of the nose: benign or malignant tumors.
When a mechanical obstruction is not found, the range of possible causes of this pathology is reduced.
Loss of smell in patients with viral upper respiratory tract infection is not a new symptom, but a recent patient has recently been infected with the COVID-19 (SARS-Cov-2) virus.
According to Vytautas Juntis, of all the hypotheses raised, at present the virus most likely causes inflammation in the olfactory epithelium in the upper part of the nasal cavity. However, inflammation is likely not predominant in the sensory neuron body, but in the auxiliary cells and nourishing blood vessels. This alters the activity of neurons, but neurodegeneration (progressive loss of nerve cells) should not develop.
“The lack of solid scientific information hinders treatment options at this time, but several publications can be found supporting the potential benefits of intranasal hormones (prescription hormonal drugs that are sprayed into the nasal cavity) for olfactory return. Also, one should not forget about olfactory rehabilitation: at least twice a day after 30 seconds of olfactory training with different aromas, the condition of the sense of smell can be improved. Essential oils are perfect for this method, of course, if a person is not allergic to them. Recent scientific articles state that the sense of smell returns to many and only 10 percent in a month. Patients with the COVID-19 virus (SARS-Cov-2) may take longer to regain their sense of smell, ”said the otolaryngologist at the end of the interview.
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