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Abstract: Nasal polyps are benign masses originating from the nasal cavity, which can be broad-based or tipped, multiple or solitary, and are commonly found in men aged 30-60 years. 35-year-old male patient came to the clinic with nasal congestion for half a year, aggravated for half a month, and unsatisfactory results with the use of drugs. The nasal cavity was well ventilated after the operation.
Basic information】Male, 35 years old
Disease Type】Nasal polyp
Hospital】Northern War Zone General Hospital
Date of consultation】August 2021
Treatment plan】Surgical excision (nasal polyp removal under nasal endoscopy + maxillary sinus opening surgery to remove secretions + septum correction surgery to improve nasal septal deviation) + medication (cefuroxime sodium injection + saline)
Treatment period】3 days of inpatient treatment, 1 month of outpatient review
Treatment effect】The patient’s nasal congestion disappeared after surgery
I. Initial consultation
The patient had been treated as rhinitis for half a year, and had used many nasal spray hormones, such as budesonide nasal spray and trimethoprim nasal spray, and had taken many Chinese medicines, such as nasal abdomen and orifice granules, Cangerzi rhinitis drops, and orifice and orifice rhinitis tablets, etc. However, the nasal congestion would be relieved for a short time after using the medicine, and the nasal congestion would still appear again after stopping the medicine. In the last half month, the nasal congestion of the patient was significantly worse than before, and the purpose of this visit was to confirm the diagnosis and further treatment. In the outpatient clinic, the patient was given a complete nasal endoscopy and a coronal CT of the nose to clarify the specific situation inside the nasal cavity. The nasal endoscopy showed a new polyp-like organism with smooth and transparent surface in the right nasal cavity, and the coronal CT of the sinuses suggested the possibility of nasal polyp on the right side, maxillary sinusitis on the right side, left deviation of the nasal septum and hypertrophy of the right inferior turbinate. The current preliminary diagnosis is: nasal polyp, deviated nasal septum, maxillary sinusitis, and inferior turbinate hypertrophy.
Second, the treatment process
Because the polyps in the patient’s nasal cavity are extensive, it is difficult to cure them with medicine, so the patient is suggested to solve them through surgery. After communication, the patient expressed understanding and was admitted to the hospital. After admission, some relevant examinations were completed, and after excluding the absolute contraindication to surgery, surgery was arranged, such as complete removal of the patient’s right nasal polyp under nasal endoscopy, and opening of the right maxillary sinus to clean up the secretions inside the sinus. Due to the obvious left deviation of the nasal septum, the patient was also given corrective surgery of the nasal septum, and the patient was observed to have a clear nasal cavity and no residual polyps during the operation.
III. Treatment effect
The patient complained that the nasal cavity was well ventilated. On the third day after the operation, the patient simply cleaned the dry crust in the nasal cavity. The patient complained that the nose had regained its ventilation and was satisfied with the surgical result.
IV. Notes
We are glad that the patient’s symptoms have improved after treatment, but we still need to remind the patient of the following postoperative care measures.
1.The patient was instructed to reduce the stimulation of the nasal mucosa by avoiding smoking and drinking alcohol in life.
2.Telling the patient to insist on cleaning the nasal cavity to clear the nasal secretions and dry crusts.
3, need to regularly go to the hospital to review the nasal endoscope to prevent adhesions in the surgical area.
4, avoid forceful blowing of the nose to avoid postoperative rhinorrhea, nasal septum hematoma, etc..
5.In the daily diet, it is recommended that patients should maintain a light diet, while avoiding spicy and irritating foods.
V. Personal insight
Because the onset of nasal polyps is associated with a variety of factors, usually considered to be related to bronchial asthma, aspirin intolerance, and fungal sinusitis, cystic fibrosis, etc. Patients can manifest as nasal congestion, runny nose, and loss of smell, usually in the case of obvious nasal congestion, there may be a sense of cheek swelling and headache, and relatively easy to recur, so during the surgery, must try to thoroughly nasal cavity inside the Therefore, during the surgery, we must try to thoroughly clean the polyps inside the nasal cavity, and at the same time, we need patients to conduct regular review after the surgery, which can reduce the chance of polyps recurrence and avoid another surgery. Usually after treatment and proper care, the results can be as good as the patient’s.