Why is chronic sinusitis complicated by nasal polyps not cured by surgery alone? Worried about complications from cardiovascular and other 4 diseases?
Germs clog the sinuses like “moss”! Beware of chronic sinusitis combined with nasal polyps
Frequent nasal congestion, runny nose and “abnormal sense of smell” should not only pay attention to whether the upper respiratory tract symptoms are caused by the new coronavirus, but also pay attention to “chronic sinusitis” combined with nasal polyps. In addition to affecting respiratory health, if not treated properly for a long time, it may also increase the risk of otitis media and sleep disorders. Apnea risk.
Dr. Wang Tangquan, director of the Department of Otolaryngology and Audiology Center of China Medical University Hsinchu Hospital, said that sinusitis is divided into acute sinusitis and chronic sinusitis. There are four pairs of sinuses in the human body, and their structure is complex like ditches. When an upper respiratory tract infection occurs, the bacteria continue to cause edema and inflammation along the nasal mucosa, leading to obstruction of the sinus outlet. Bacteria may breed inside the sinuses and spread like “moss”, causing chronic sinusitis. inflamed.
Dr. Wang Tangquan pointed out that acute sinusitis generally has the opportunity to gradually recover after reaching a stable state through the regulation of the autoimmune mechanism. However, once sinusitis lasts for more than three months, the chance of spontaneous improvement decreases, symptoms may recur, seriously affecting the quality of life, and interventional treatment may be required.
Chronic sinusitis affects more than just breathing! Are you afraid that various diseases will occur and your hearing will be seriously affected?
Does sinusitis not only affect breathing? In recent years, some big data studies have shown that chronic sinusitis may be associated with sleep disorders, sleep apnea, depression and anxiety, cardiovascular disease or stroke, chronic otitis media, and hearing loss.
Dr. Wang Tangquan pointed out that when chronic sinusitis is severe, it will cause the proliferation of mucous membranes in the nasal cavity and sinuses, leading to nasal polyps and prone to nasal congestion, nasal discharge, abnormal smell or loss of sense of smell. There may even be symptoms such as facial swelling and pain, headache, and swelling and pain in the eye sockets, which not only affects work and life, but also affects hearing.
Dr. Wang Tangquan explained that the Eustachian tube in the middle ear cavity is connected to the back of the nasopharynx. When the nasal cavity and sinuses are chronically inflamed, bacteria may expand along the Eustachian tube and into the middle ear cavity, which may cause hearing loss in severe cases. Since the muscles next to the Eustachian tube are responsible for balancing the middle ear cavity, when the Eustachian tube is dysfunctional and encounters pressure changes, it may also cause severe ear pain in a short period of time.
For example, Dr. Wang Tangquan once had a patient who was a professional sound recordist. Chronic sinusitis combined with nasal polyps affected the function of the Eustachian tube and the pressure regulation of the middle ear. Not only was he complicated with otitis media, but it also led to loss of smell and hearing. After treatment with biological agents, The symptoms improved and hearing returned to normal.
Can chronic sinusitis be cured by repeated surgeries? Biological agents reduce recurrence by 70%
If chronic sinusitis combined with nasal polyps is not treated properly, is it likely to recur? Dr. Wang Tangquan said that if the symptoms of chronic sinusitis last for more than 3 months, active interventional treatment is recommended, usually starting with drug treatment. If the sinus improvement is still not satisfactory after a period of treatment, or the symptoms worsen, surgery should be considered. Treatment, such as functional minimally invasive endoscopic sinus surgery, or advanced 3D endoscopic navigation surgery.
However, some patients with chronic sinusitis may not be completely improved even if they undergo surgery. Dr. Wang Tangquan pointed out that this type of patients with chronic sinusitis and nasal polyps may have an inflammatory constitution with type 2 immune response that is closely related to the immune system. Compared with patients with the general type, they have a higher risk of recurrence of nasal polyps. Sometimes they need to be matched with Treat with steroid nasal sprays or oral medications.
Dr. Wang Tangquan said that simply surgical removal of nasal polyps may not be the best option for these patients. It is usually combined with imaging examinations and blood tests to evaluate whether interventional biologic treatment is suitable. It can not only precisely regulate inflammatory substances, inhibit chronic sinusitis caused by type II inflammation, reduce the size of nasal polyps, improve symptoms such as nasal obstruction and loss of smell, but also reduce the chance of recurrence and subsequent need for repeated surgeries by 70%.
Pay attention to nasal immune inflammation! If recovery does not improve after 1-2 weeks of rest, seek medical attention.
Studies in European and American countries show that the prevalence of chronic sinusitis combined with nasal polyps is about 12.5%, which means that one in 10 adults has chronic sinusitis combined with nasal polyps. Dr. Wang Tangquan reminds that if you have symptoms of nasal discomfort that do not improve after 1-2 weeks of rest, or if treatment is not satisfactory, you should see an otolaryngologist for evaluation as soon as possible to confirm whether there is an immune inflammation problem in the nasal cavity.
Dr. Wang Tangquan emphasized that there is not only one way to treat ear, nose and throat diseases, but also the immune and inflammation status of the patient. With the continuous advancement of medicine, diseases that were poorly treated in the past have the opportunity to be treated with the advent of new treatments such as biological agents. For better improvement, patients should communicate with their doctors in detail to discuss the treatment method that is most suitable for them.
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