Nasal polyps

Nasal polyps are soft, sac-like growths on the lining of the nose or sinuses.

Causes

Nasal polyps can grow anywhere on lining of the nose or the sinuses. They often grow where the sinuses open into the nasal cavity. Small polyps may not cause any problems. Large polyps can block your sinuses or nasal airway.

Nasal polyps are not cancer. They seem to grow due to long-term swelling and irritation in the nose from allergies, asthma, or infection.

No one knows exactly why some people get nasal polyps. If you have any of the following conditions, you may be more likely to get nasal polyps:

  • Aspirin sensitivity
  • Asthma
  • Chronic sinus infections
  • Cystic fibrosis
  • Hay fever

Symptoms

If you have small polyps, you may not have any symptoms. If polyps block nasal passages, a sinus infection can develop.

Symptoms include:

  • Runny nose
  • Stuffed up nose
  • Sneezing
  • Feeling like your nose is blocked
  • Loss of smell
  • Loss of taste
  • Headache and pain if you also have a sinus infection

With polyps, you may feel like you always have a head cold.

Exams and Tests

Your doctor will look in your nose. Polyps look like a grayish grape-shaped growth in the nasal cavity.

Your doctor may do a CT scan of your sinuses. Polyps will appear as cloudy spots. Older polyps may have broken down some of the bone inside your sinuses.

Treatment

Medicines help relieve symptoms, but rarely get rid of nasal polyps.

  • Nasal steroid sprays shrink polyps. They help clear blocked nasal passages and runny nose. Symptoms return if treatment is stopped.
  • Corticosteroid pills or liquid may reduce swelling and other symptoms.
  • Allergy medicines can help prevent polyps from growing back.
  • Antibiotics can treat a sinus infection caused by bacteria. They can’t treat polyps or sinus infections caused by a virus.

If medicines don’t work, or you have very large polyps, you may need surgery to remove them.

  • Endoscopic sinus surgery is often used to treat polyps. With this procedure, your doctor uses a thin, lighted tube with instruments at the end. The tube is inserted into your nasal passages and the doctor removes the polyps.
  • Usually you can go home the same day.
  • Sometimes polyps come back, even after surgery.

Outlook (Prognosis)

  • Removing polyps with surgery usually makes it easier to breathe through your nose.
  • Over time, however, nasal polyps often return.
  • Loss of smell or taste does not always improve following treatment with medicine or surgery.

Possible Complications

  • Bleeding
  • Infection
  • Polyps coming back after treatment

When to Contact a Medical Professional

If you are suffering from this disease, then visit Dr Meena Nihalani ,  CLICK HERE to find her details .

Prevention

  • You can’t prevent nasal polyps. However, nasal sprays, antihistamines, and allergy shots may help prevent polyps that block your airway.
  • Treating sinus infections right away also may help.

References

Bachert C, Gevaert P, van Cauwenberge P. Nasal polyps and rhinosinusitis. In: Adkinson NF Jr., Bochner BS, Busse WW, Holgate ST, Lemaske RF Jr., eds.Middleton’s Allergy: Principles and Practice

Becker S. Surgical Management of Polyps in the Treatment of Nasal Airway Obstruction. Otolaryngologic Clinics of North America.

Mannin SC. Medical management of nasosinus infectious and inflammatory disease. In: Flint PW, Haughey BH, Lund LJ, et al, eds.Cummings Otolaryngology: Head & Neck Surgery

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Sinus Disease

3555541Introduction
Each year many suffer from sinus related diseases. What is more, indians spend h each year on health care costs contributable to sinusitis, making this disease an enormous public health issue. Sinus disease is a complex and wide ranging topic that go well beyond the scope of this website, but here we seek to educate our patients and referring physicians about some of the basic concepts surrounding this disease entity.

Sinus function and anatomy
The sinuses are hollow, bone and mucus lined spaces that lie just to the side of the nose and extend up to the bottom of our skull. There are several different sinuses in the human head and include two large paired maxillary (sometimes referred to as cheek sinuses), two frontal and sphenoid sinuses and multiple ethmoid sinuses. Although the function of the sinuses is subject to some controversy, most agree that the sinuses serve to warm, filter and humidify inspired air. In addition, these structures lessen the weight of the skull, act as a brace to absorb energy to protect the brain from trauma and play a role in creating certain resonances for human speech. The sinus mucosa has millions of tiny hairs called cilia that serve to push fluid and foreign material towards fixed openings called ostia. If this mucosa swells this can lead to build up of fluid and potential colonization with viruses, fungi, bacteria or chronic inflammation.

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Types of sinus disease
Sinus disease is not just one entity but many. Overall infectious or inflammatory sinus disease can be broken up into acute (quick onset) or chronic (over a long period of time). Acute sinusitis is the most common form of sinusitis and is typically treated with a combination of antibiotics and agents to decrease inflammation in the nose. This type of infection typically resolves quickly over the course of a week or two. Surgery is typically not performed in this setting unless the patient has a complication of sinusitis (which can include spread to the eye, meninges or brain itself), or occasionally for patients that get multiple infections due to a structural abnormality.

Chronic sinusitis is more of a structural and inflammatory problem where the patient suffers over most of the year with sinus symptoms. Typically for this problem patients are given an aggressive long-term course of antibiotics combined with a nasal steroid and/or an oral steroid combined with other medications. Failure of symptoms and CT findings to resolve with this treatment strategy are an indication for endoscopic sinus surgery.

There are several other types of sinus issues, many of which are related to fungus. Fungus likes warm and moist environments, and when host defenses are damaged or working improperly, the sinuses make a very attractive setting. Fungal sinus disease has varied presentations and can range from an isolated fungus ball that is of little consequence to invasive fungus that in immuno-suppressed patients can be life threatening. Depending on the type of fungus and the severity of the infection treatment can range from medicines which reduce swelling to allow the fungus to be removed by the body, to endoscopic sinus surgery.

An additional kind of sinus disease occurs in conjunction with polyps. These polyps are typically related to allergy and inflammation and can fill the nose and block the sinuses. They may occasionally be associated with asthma and aspirin sensitivity (known as Samter’s triad). These polyps are typically sensitive to oral steroids, but this usually serves to debulk rather than cure the disease. Typically these patients require periodic endoscopic sinus surgery to keep these polyps and the resultant sinusitis at bay.

Sinus tumors, although relatively uncommon do occur as well. These can range from benign and low grade malignant lesions that can be removed via a minimally invasive endoscopic approach to tumors that are extremely aggressive and require removal of most or all of the entire cheek bone (maxilla) and occasionally the base of the skull and eye as well. These tumors typically present with symptoms similar to those of sinusitis but fail to respond to treatment. They are usually diagnosed with nasal endoscopy as well as CT scanning and magnetic resonance imaging (MRI).

If you are suffering from this disease, then visit Dr Meena Nihalani ,  CLICK HERE to find her details .

 
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Sleep apnea

Sleep apnea

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Sleep apnea
Obstructive sleep apnea
by pauses in or instances of shallow or infrequent breathing during . Each pause in breathing, called an , can last for several seconds to several minutes, and may occur, by definition, at least 5 times in an hour. Similarly, each abnormally shallow breathing event is called a . Sleep apnea is classified as a , meaning abnormal behavior or psychological events occur during sleep. When breathing is paused, carbon dioxide builds up in the bloodstream. Chemoreceptors in the blood stream note the high carbon dioxide levels. The brain is signaled to wake the person sleeping and breathe in air. Breathing normally will restore oxygen levels and the person will fall asleep again. Sleep apnea is often diagnosed with an overnight sleep test called a , or “sleep study”.Classification and external resources

Sleep apnea (or sleep apnoea in British English) is a sleep disorder characterized by pauses in breathing or instances of shallow or infrequent breathing during sleep. Each pause in breathing, called an apnea, can last for several seconds to several minutes, and may occur, by definition, at least 5 times in an hour. Similarly, each abnormally shallow breathing event is called a hypopnea. Sleep apnea is classified as a dyssomnia, meaning abnormal behavior or psychological events occur during sleep.[When breathing is paused, carbon dioxide builds up in the bloodstream. Chemoreceptors in the blood stream note the high carbon dioxide levels. The brain is signaled to wake the person sleeping and breathe in air. Breathing normally will restore oxygen levels and the person will fall asleep again.[3] Sleep apnea is often diagnosed with an overnight sleep test called a polysomnogram, or “sleep study”.

There are three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea (i.e., a combination of central and obstructive) constituting 0.4%, 84%, and 15% of cases, respectively. In CSA, breathing is interrupted by a lack of respiratory effort; in OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common. According to the National Institutes of Health, 12 million Americans have OSA. There are more cases of sleep apnea still because people either do not report the condition or do not know they have sleep apnea.

Regardless of type, an individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening.Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years (or even decades) without identification, during which time the person may become conditioned to the daytime sleepiness and fatigue associated with sleep disturbance. Sleep apnea affects not only adults but some children as well.

ReferenceWikepedia 

If you are suffering from this disease, then visit Dr Meena Nihalani ,  CLICK HERE to find her details .