Endoscopic Sinus Surgery

The surgery is done under general anaesthesia. The sinus opening will be widened with all the obstruction removed. The sinuses will be cleansed with the mucopus drained.

The normal mucus clearance mechanism will be restored. The operation is performed inside the nose under endoscopic control with no external surgical scar.

In certain situation, it will combine with other nasal surgeries (such as septoplasty or polypectomy) to improve the access of the surgical field and the ventilation of the sinuses.

Postoperatively, the nose will be packed with dressing for hemostasis. The dressing will be removed in 1 to 2 days. Nasal saline irrigation should be started after the removal of nasal packing.

The complications include bleeding and infection which is not common. Rare complications include brain and eye injury.

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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 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.

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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.

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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.

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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.