Sinusitis is a non-specific inflammation of the mucous membrane of the sinuses, and is a common rhinological disease. The so-called sinuses are the air-containing cavities of the facial skull around the nasal cavity; there are four pairs: the frontal sinus, maxillary sinus, septal sinus, and pterygoid sinus. Because of its anatomical characteristics each sinus can develop alone, but also can form multiple sinusitis or full sinusitis, the highest incidence of the former group of sinuses, including the most maxillary sinusitis.
The disease is generally divided into acute and chronic 2 categories, the causes of many, such as overexertion, cold and moisture, malnutrition, vitamin deficiency, and poor living environment caused by the reduction of systemic resistance; allergic body, systemic diseases such as anemia, endocrine insufficiency (such as hypothyroidism, pituitary and gonadal function), acute infectious diseases such as influenza, measles, scarlet fever, diphtheria, etc. can induce the occurrence of the disease In addition, some diseases of the nasal cavity, such as nasal septal deviation, middle turbinate hypertrophy, nasal polyps, allergic rhinitis, nasal foreign bodies or nasal tumors and adjacent lesions, such as tonsillitis or adenoid hypertrophy, infection of the maxillary second bicuspid and the roots of the first and second molars, damage to the maxillary sinus wall during tooth extraction or caries residue falling into the maxillary sinus can also cause sinusitis. Nasal polyps are mostly seen in adults and are caused by long-term edema of the mucous membrane in the nose, with metaplasia and chronic inflammation as the main causes.
Sinusitis and nasal polyps are diseases that have become a serious impact on people’s health. With the wide application of antibiotics and nasal endoscopic surgery, most sinusitis and nasal polyps can be well treated.
The diagnosis and treatment of nasal polyps and nasal polyps mainly include: The main symptoms are: sinusitis mainly manifested as pus, nasal congestion, headache (often manifested as dull pain or heavy head, heavy during the day, light at night), phlegm, foreign body sensation or dry and painful throat, nasal congestion is mostly persistent, vasoconstrictor nasal drops have no significant effect, sneezing rarely, but if the nasal mucosa has metabolic inflammation, sneezing and clear snot can also occur. The sense of smell is diminished or missing. If a huge polyp obstructs the posterior nostril or even protrudes into the nasopharynx, it may cause tinnitus and deafness. The large size of polyps may cause changes in nasal appearance.
The nasal bridge is widened and flattened, and the nasal dorsum is raised on both sides. The polyps are round, smooth, soft, gray-white transparent cystic masses with their roots in the middle nasal passage or in the sinus cavity. Patients may have significant nasal congestion at night and open-mouth breathing, which can be followed by chronic pharyngitis over time.
In addition to nasal congestion and pus in the acute phase of sinusitis in children, there may be fever, dehydration, depression, irritability, shortness of breath, refusal to eat and even convulsions. In chronic cases, intermittent or frequent nasal congestion, mucus or mucopurulent nasal discharge is observed. Long-term nasal congestion and open-mouth breathing lead to jaw, chest, and mental retardation in children with the disease.
The diagnosis mainly relies on patient history, detailed nasal endoscopic examination of the nasal cavity or CT examination of the sinuses to understand the location and extent of the lesions.
Treatment of acute sinusitis generally includes furosemide nasal drops, antimicrobials and maxillary sinus puncture irrigation. Chronic sinusitis and nasal polyps mainly rely on surgical treatment, including surgery to remove the cause, such as septal correction for high septal deviation, partial turbinate excision for hypertrophy or polyp-like changes in the middle turbinate, nasal polyp removal and maxillary sinus radical surgery. The more popular surgical method is functional nasal endoscopic surgery.
In traditional nasal surgery, the patient is in a semi-sitting position and the surgeon operates under direct vision with a headlamp, so the field of vision is limited and the surgery is often not complete, and the patient bleeds a lot and suffers a lot.
Functional sinus endoscopic sinus surgery for sinusitis and nasal polyps has incomparable advantages. It is a functional surgery to restore the morphology and physiological function of the mucosa of the nasal cavity and sinuses.
And according to the severity of the lesion, it can achieve the purpose of curing sinusitis and nasal polyps by relying on the recovery of the nasal cavity and sinuses’ own physiological function. Together with the application of electric drill for nasal polyps, the surgery has the advantages of less trauma, less pain during and after surgery, thorough surgery and less recurrence after surgery, and can enable the surgery to be carried out to areas not easily reached before, which is the most ideal method to treat sinusitis and nasal polyps.
Before nasal endoscopy, especially in the presence of nasal polyps, the surgeon may order the patient to take some medications before surgery, which include antibiotics and hormones. The purpose is to improve the surgical condition of the sinusitis patient, and the patient should strictly follow the doctor’s orders and adhere to the medication. In addition, do not take blood aspirin analgesics (Bamil, Fenbendazole, Naproxen, etc.), vitamin E, garlic, ginkgo, ginseng, ergotamine, etc. for at least two weeks prior to surgery, as these drugs can thin the blood, thus making it easier to bleed during and after surgery.
In addition, the patient needs to change the medication regularly after the surgery, and the doctor will remove the nasal stuffing on the 1st and 2nd day after the surgery. In the 6 weeks after surgery, you need to come to the hospital at least 3-4 times for medication change, the specific time will be arranged by the doctor according to your recovery of the operation cavity, mainly to clear the nasal cavity of secretion scabs and newborn granules, to prevent the nasal cavity from adhesions causing nasal cavity non-ventilation and to protect the effect of surgery. 3-4 months later, the nasal cavity will generally recover completely, at this time, just pay attention to follow-up examinations and 1-2 times a year. It is still necessary to adhere to the use of nasal hormones after surgery, which can reduce the recurrence of sinusitis and nasal polyps.