![]() Sinusitis is one of the chronic disorders, affecting more than 31 million people in the US every year. Americans spend a hefty amount on countless medications, battling the symptoms of Sinusitis. Unlike previous times, sinus surgery has become less risky with the advancements in medical procedures. Modern day sinus operations involve nasal endoscope, without any incisions on face and cheek. Nasal endoscopic surgery is more effective and less painful with speedy recovery times. Surgical recommendations depend on a range of factors such as age, sensitivity to treatment and complexity of the manifestations. Preparatory measures before Endoscopic Sinus Surgery Preoperative Clearances: Before surgery, doctors prescribe some medicines that help reduce the inflammation of sinuses. Even post-surgery, some medications may be prescribed. Smoking: Smoke has a significant impact on the sinuses and can severely affect the outcomes during or after your surgery. If you are a smoker, doctors usually advise to quit smoking 2-3 months before the surgery. Avoiding Over-the-counter Medications: You may have to refrain from taking over-the-counter vitamin supplements and medicines such as aspirin to avoid the risk of nasal bleeding during and after the surgical procedure. Why is Sinus Surgery the Last Resort? Preliminary treatment includes nasal decongestant sprays, antihistamines, and nasal saline washes. The methods are short-term, and recovery is slow with a high probability of recurrence. Such medications may be helpful in treating the cases of little or intermittent discomfort. In the case of acute respiratory issues, individuals need immediate surgical attention. Cases of critical rhinosinusitis don’t show any significant medical improvement through medicines. Going for an endoscopic sinus surgery prevents further worsening of the patient’s condition. Opting for sinus surgery is the sole discretion of the practitioner depending on the severity of the problem. Recovery after Sinus Surgery Postoperative discomfort and nasal congestion subside in a week or two. Sinus treatment may involve a series of operations depending on post-surgery results. The recovery period will largely depend on the complexity of the surgical procedure. Most patients show drastic improvements in symptoms such as nasal drip, headache, and facial pain. Your doctor may suggest nasal rinsing and sprays as precautionary measures after the sinus operation. The Way Forward The thought of a sinus operation is fairly intimidating for people in the US. People are not aware of the less painful methods involving local anesthesia that provide long-term relief. Efforts to heal with medications isn’t a bad option, but it isn’t possible in extreme cases. The need of surgery shouldn’t be undermined considering the possible complications.
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![]() Individuals mostly associate a runny nose with virus, sinus, cold or allergic reaction. It could, however, be an indication of something more serious called CSF Rhinorrhea. Cerebrospinal fluid leaks occur as a result of high intracranial pressure that lead to bony defects and spontaneous leaks. CSF Rhinorrhea is the drainage of fluid surrounding the brain into the nose. The brain fluid is important as it provides a cushion to the brain, maintains pressure within the eye and cleanses the central nervous system. While some patients have CSF rhinorrhea for years without any consequences, others may develop bacterial meningitis within a few days of onset of rhinorrhea. Any change in the level of consciousness of the individual, neck stiffness or fever and chills is an indication of bacterial meningitis and it can be fatal. The patient requires immediate medical attention in such a scenario. Diagnosing CSF Rhinorrhea A physician performs a careful examination of the patient and looks for the history of CSF leak. Prior surgery, trauma, watery or mucus-like nasal drainage and duration of rhinorrhea are a few things the physician looks at to determine CSF rhinorrhea. Physical examination includes a survey of the neck, head and endoscopy of the nasal cavity and surrounding areas. Tests for CSF Rhinorrhea Pledget Test A nuclear medicine pledget test confirms a CSF leak. The physician makes lumbar puncture and places a radioactive-tagged isotope into the CSF. If the cotton pledget placed inside the nose is positive for isotope, it confirms the leak and its side. CT Cisternogram The test helps to confirm the site of the leak. The physician makes lumbar puncture to inject a contrast material into the subarachnoid, the place where CSF circulates. The procedure is followed by a CT scan and presence of contrast material in nasal cavity shows the area of the leak. Beta-2 Transferrin The enzyme Beta-2 Transferrin is found in CSF and not in tears, blood or mucus. If the clear nasal fluid of the patient is positive for the enzyme, it confirms the CSF leak. Must Read: Cerebral Spinal Fluid – The Problem and Treatment Treatment of CSF Rhinorrhea While leaking stops on its own in some cases, it is better to consult a physician at the earliest to minimize the chances of getting meningitis. The surgery for CSF rhinorrhea is performed through nasal cavity in most of the cases to repair the hole. It is an external procedure that uses craniotomy and has a high success rate. Summary Individuals often confuse a runny nose with cold or minor allergies. It may be a sign of CSF rhinorrhea that could lead to meningitis. The post talks about symptoms, diagnosis and treatment of CSF rhinorrhea. Further Read: Frequently Asked Questions About CSF Leak |
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November 2016
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