The chronic sinusitis patient mentioned in the previous article, Lao Wang, has been suffering from nasal polyps, and the effect of medication has become less and less effective. This is because there is no special medicine for nasal polyps, it is difficult to cure with drugs. Surgery is the most effective way to treat chronic sinusitis and nasal polyps. But it is not the case that there is no need to take drugs, the direct surgery can be? The answer is no. Here we will talk about it.
1, the polyps are small, can first drug therapy: If the polyps are small, did not cause nasal congestion, headaches and other symptoms, you can use nasal spray hormone, 2 times a day, for about 4 weeks. If the polyp becomes smaller and the symptoms are relieved, nasal spray hormone can be gradually reduced and stopped according to medical advice; if the effect is not good after 4 weeks, then consider surgery.
2, polyps larger or positioned to block the sinuses, must be surgical treatment: when nasal polyps grow to block the nasal cavity, or are growing out of the nostrils, should be taken to surgery. In addition, some polyps are not large, but block the opening of the sinuses, sinus secretions can not be smoothly discharged, then also need surgery. At present, the surgery is mostly performed under the nasal endoscope, which is very traumatic.
3, pre-operative medication can improve the effectiveness of surgery: However, even if surgery, pre-operative medication is also required. Foreign treatment is recommended, first with 3 months of medication before surgery, domestic at present it is difficult to do 3 months of standardized treatment, but try to do 1~2 weeks of short-term medication. Preoperative application of antibiotics and steroid hormones have good effect on controlling infection and inflammatory edema and other reactions, which can reduce intraoperative and postoperative bleeding to different degrees, and the vision during surgery will be clearer, which facilitates doctors to operate instruments more precisely and remove lesions completely, thus reducing the recurrence rate.
The following is a list of drugs that need to be used before surgery: oral hormones: glucocorticoids are good for reducing the inflammatory response of the mucous membrane of the nasal cavity and sinuses before surgery and for reducing the volume of nasal polyps. For patients with more nasal polyps, heavier inflammatory response in the nasal cavity and no contraindications to glucocorticoids, oral prednisone 30 mg can be taken daily for 7-10 days.
Nasal spray hormone: glucocorticosteroids are used to spray the nasal cavity for 7-10 days, or longer.
Antibiotics: Inflammation of the sinuses causes varying degrees of vasodilation of the nasal mucosa, submucosal tissue, and periosteum, leading to increased intraoperative bleeding. Therefore, antibiotics are used preoperatively in patients with more severe sinus inflammation.
Mucus promoter: It helps to reduce the viscosity of sinus secretions, which is helpful for sinus recovery.