Treatment of Acute Sinusitis

Symptomatic therapy

Normal saline lavage is used to remove secretions and promote nasal mucosal healing. Oral and topical decongestants can reduce mucosa congestion and improve drainage. Mucolytic is used to thin mucus secretions, reduce mucus stasis, and promote clearing. Antihistamine can decrease mucus production and diminish nasal discharge. Intranasal corticosteroid is also used to reduce inflammation and improve associated symptoms.

Antibiotic

Antibiotics are a common prescription for acute rhinosinusitis. However, only 0.2%-2% of viral upper respiratory tract infections are complicated by bacterial rhinosinusitis and around 40% of acute bacterial infections resolve spontaneously. That means 85%-98% of patients with acute rhinosinusitis are needlessly prescribed an antibiotic

Early treatment of rhinosinusitis should be focused on control inflammation to allow sinus drainage and prevent bacterial infection. Antibiotic should be reserved for persistent moderate to severe disease and complications.

Treatment of Chronic Sinusitis

A careful history taking and past medical records review are important. A thorough physical examination including fiberoptic nasoendosocpy is necessary to delineate the patient's anatomy. CT scan of paranasal sinus will help document the extent of disease and clarify any other anatomic abnormalities.

An optimal medical treatment consists of antibiotic, nasal saline irrigation, intranasal steroid spray should be given. The patient should then be re-evaluated and restaged in 1 month. If the patent is not responsive to the treatment, surgical intervention should be considered.

Reference information:www.ent-hk.com ent-hk.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.

Treatment for obstructive sleep apnea

Life style adjustment is important. Obstructive sleep apnea patients are usually over-weight. Weight reduction, by diet and regular exercises, is utmost important. Improve sleep hygiene with regular sleep, avoid alcohol and sleeping pills will improve the sleep quality. 

Positive airway pressure machines (CPAP) are the gold standard of the management of the sleep apnea. By applying positive pressure ventilation, the airway is splinted. Airway vibration and collapse are prevented and sleep quality improved. The compliance is the major problem. Lots of people refuse the idea of using CPAP and many find wearing a mask to sleep intolerable. It needs time for patients to get use to the CPAP machine and most of them will find it useful.

Surgery is reserved for those who cannot tolerate CPAP machine. Different kinds of surgery, aim at different level of obstruction, are available. The aim of the surgery is to enlarge and stiffen the airway. Success rate varies from 40% to 80%, depending on the individual. Sometime multilevel surgery is required for optimal results. Minimal invasive techniques such as radiofrequency ablations can be used to relieve obstruction at different level.

Dental appliances are another option for the treatment of sleep apnea. It is usually tailor made by dentists and wearing them during bedtime, may control the snoring and sleep apnea.

Reference information: ent-hk.com www.ent-hk.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.

Radiofrequency of inferior turbinate

It is a minimal invasive procedure for Nasal obstruction caused by inferior turbinate hypertrophy. A special designed applicator is used to apply the radiofrequency to the submucosal tissue of the inferior turbinate. With a controlled increase in temperature, volume reduction is achieved through the scaring and later resorption of the submucosal tissue. The whole procedure is performed under local anaesthesia in outpatient basis. No hospital stay is required. The pain or discomfort will be minimal and easily controlled by analgesic.

Inferior turbinectomy

Nasal obstruction can be caused by the mucosa hypertrophy of the inferior turbinate. Under general anaesthesia, the inferior turbinate will be removed. A dramatic relieve of Nasal obstruction will be expected.

Septoplasty

Nasal obstruction can be caused by a deviated nasal septum. By removing the deformed bone or cartilage and repositioning of the septum, the septum can be straightened. Symmetric patent nasal air flow can then be restored. The operation is performed under general anaesthesia.

Reference information: ent-hk.com www.ent-hk.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.

Rhinosinusitis

Rhinosinusitis is defined as inflammation of the nose and the paranasal sinuses. The symptoms include nasal blockage, loss of smell, nasal discharge, postnasal drip and facial pain. It is defined as acute sinusitis if complete resolution of symptoms is achieved within 12 weeks. If the symptoms persist more than 12 weeks, it is defined as chronic sinusitis.

Examination for sinusitis must include nasoendoscopy. This procedure is performed by ENT specialists under local anaesthesia. The abnormalities include mucopurulent nasal discharge, the mucosal edema with total obliteration of the sinus outlet and nasal polyps will be detected. Besides, the anatomy of the nasal cavity and sinus outlet can also be seen.

CT scan of the paranasal sinuses is useful for assessment of sinusitis. It can detect mucosal changes within ostiomeatal complex and/or sinuses and also opacity of the sinuses and delineate the anatomy of the sinuses.

Reference information: ent-hk.comwww.ent-hk.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.

Allergic Rhinitis Treatment

Allergens Avoidance

House dust mites feed on human skin danders. Warm and humid condition facilitates their growth. Bed mattress, pillows, carpet, upholstered furniture and fluffy toys should be cleaned regularly.

Animal danders are present in high amounts in domestic dust, upholstered furnishings and mattress. Avoid keeping pets if possible.

Pollens that cause most common allergies are grasses, weeds and trees. Wearing mask for outdoor activity during the pollen seasons is recommended.

Medication

The most common prescribed medication is antihistamine. Both sedating and non-sedating antihistamine are available.

The other type of medication is Vasoconstrictor which can be administered as oral or local via nasal spray. Vasoconstrictor is useful for relieving nasal obstruction. Oral Vasoconstrictor may cause systemic side effects while local Vasoconstrictor should not be used continuously for more than a week.

Steroid nasal spray is useful for all nasal symptoms including nasal obstruction. It is more effective than the oral medication. 

Reference information: www.ent-hk.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.

Allergic rhinitis

Allergic rhinitis is a global health problem affecting 10% to 20% of the population. It represents an immunoglobulin E (IgE)-mediated inflammation of the nasal mucosa.

The symptoms of Allergic rhinitis include sneezing, nasal discharge, postnasal dribbling, nasal obstruction and nasal itchiness. It affects social life, sleep, work and school. Serious Allergic rhinitis may lead to sinusitis, asthma, etc.

Allergic rhinitis can be seasonal or perennial. Outdoor allergens (e.g. pollen) appear to constitute a greater risk for seasonal rhinitis than indoor allergens and indoor allergens (e.g. house dust mite) a greater risk for perennial rhinitis.

Reference information: www.ent-hk.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.

良好睡前「儀式」有助解決失眠

參考資料:  http://www.metrohk.com.hk/  www.ent-hk.com

一代流行曲天王米高積遜突然離世，引起陣陣惋惜。據報導，他生前患有經常性失眠，出現依賴安眠藥問題。若果我們同樣出現失眠情況，究竟應如何處理？

 

失眠對我們都市人來說並不陌生。治療失眠除了避免飲用過量咖啡、濃茶或服用藥物外，睡前一小時應避免上網、看電視或其他視聽娛樂，避免過度官能刺激。更應避免在睡牀上看電視和看書。

一些睡前「儀式」亦可助入睡，那就是定時的作息時間、穿舒適的睡衣，睡前聽一會輕鬆的音樂等等，這有利營造安靜的入睡環境。

若失眠情況持續，便應主動求醫，避免在坊間購買安眠藥。服用安眠藥時，應依照醫生處方的分量，以避免濫用或依賴。新一代的安眠藥能有效幫助失眠症患者入睡，藥力維持約4至6小時；故服用後翌日，不會有昏昏欲睡的感覺，而影響早上的精神狀態和日常生活。

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。