Does sinusitis affect more than just nasal congestion? Fear of high blood pressure and heart attack without treatment! Medical warning: Group 1 has the highest risk of recurrence
healthorn expert Q&A
Q: My nose is constantly flowing? Is it a sign of allergies or formaldehyde poisoning?
A: If you have frequent coughing, sneezing, itching or allergies at home, you should pay attention to whether it is a poisoning symptom caused by “excessive formaldehyde”. If you live in an environment with excessive formaldehyde for a long time, it may seriously cause infertility, leukemia, and sinus cancer. , liver cancer, etc. The wood used in decoration or the new furniture purchased (mattresses, sofas, curtains) will release a large amount of “carcinogen formaldehyde”. Even if non-toxic building materials are used, there is still a risk that the accumulated formaldehyde in the whole room will exceed the standard.
If you want to solve the problem of formaldehyde poisoning, it is recommended to seek formaldehyde removal companies for formaldehyde treatment. However, allergic children should pay special attention to whether the manufacturer uses “formaldehyde” to remove formaldehyde. After all, chitin is one of the common allergens. If you are not careful, It may induce chitin allergy. Especially for infants and young children, those who are allergic to seafood, and those with cystitis, because chitin is taken from the shells of crustaceans such as shrimps and crabs, and may cause various allergic reactions after contact, such as asthma and allergic rhinitis. , skin problems, etc., so you should try to avoid choosing formaldehyde removal companies that use “chitin” as coatings.
Does sinusitis affect more than just nasal congestion? Doctor: I may suffer damage to my ears and hearing as well!
If you have chronic sinusitis, it may not only cause nasal congestion and smell problems, but combined with “nasal polyps” may also affect the ears, causing otitis media or tinnitus, etc.?
Dr. Li Jingze, the attending physician of the Department of Otolaryngology at Chi Mei Hospital, said that common symptoms of sinusitis combined with nasal polyps include nasal congestion, weakened or lost sense of smell, increased nasal mucus and mucus secretions, pain or blockage in the cheeks and forehead, and backflow of nasal secretions to the In the oropharynx and hypopharynx, there are symptoms such as throat discomfort, foreign body sensation, cough, and hoarseness. In severe cases, it may be combined with ear symptoms such as otitis media and middle ear fluid, resulting in ear fullness or tinnitus.
Sinusitis makes sleep worse and increases cardiovascular risk! If your nasal congestion has not improved for several weeks, do the “three major checks” as soon as possible
Nasal congestion and discomfort lead to poor sleep quality, which can easily lead to fatigue and burnout in patients and increase the risk of cardiovascular diseases such as high blood pressure and heart disease. Dr. Li Jingze pointed out that the following are the main diagnostic tools for sinusitis combined with nasal polyps:
Sinus endoscopy: It can directly enter the nasal cavity to evaluate the degree of inflammation and swelling of the nasal mucosa, the presence of nasal polyps, nasal discharge, nasopharyngeal adenoid hypertrophy, nasal passage obstruction and other problems.
Sinus computed tomography: It can determine the degree of inflammation of each sinus and confirm the location, depth, and surrounding organs of the lesion. It is also the gold standard for diagnosing sinusitis.
Cow Ear Smell Test: The “Cow Ear Smell Test” specially designed for Taiwanese people is also included in health insurance benefits. Different from the Penn State Olfactory Test from abroad, the Cow Ear Olfactory Test incorporates many smells that are familiar to local Taiwanese people and can accurately understand the olfactory health of Taiwanese people.
Why do sinusitis recur? Medical answer: related to “type 2 inflammatory response”
Sinusitis combined with repeated attacks of nasal polyps, may it be related to “type 2 inflammatory response”? Dr. Li Jingze explained that chronic sinusitis is caused by a variety of factors. The main reason is that the sinuses are invaded by pathogenic microorganisms, allergens and air pollution, which lead to inflammation of the nasal mucosa and trigger a series of immune reactions, affecting the normal clearance function of the mucosa.
In addition, inflammation may also cause the sinus exits to become blocked, preventing sinus mucus from being discharged, thereby exacerbating the inflammation. Sinus polyps and inflammation will interact with each other. When the nasal mucosa is in a state of inflammation for a long time, fibrin will accumulate, excessive swelling of the tissue, and damage to the mucosal epithelium, which may lead to the formation of polyps.
In recent years, research on recurrent chronic sinusitis combined with nasal polyps has found that “type 2 inflammatory reaction” is related to this type of disease, and is also one of the main causes of asthma, atopic dermatitis, and chronic spontaneous urticaria. . To confirm whether you have type 2 inflammatory reaction constitution, you can draw blood to confirm whether the eosinophil count (Serum eosinophil count) or immunoglobulin E (IgE) concentration is higher than normal.
Sinusitis keeps coming back after surgery? “1 treatment” intervention is expected to improve patients’ troubles
Dr. Li Jingze said that after patients are diagnosed with chronic sinusitis, they will first receive medical treatment, such as steroid nasal sprays, nasal irrigation, etc.; if they encounter more stubborn chronic sinusitis, oral steroids will be used as a treatment method. When there is an acute bacterial infection, it is treated with antibiotics. If medical treatment is ineffective and the sinusitis invades the tissues surrounding the sinuses, such as the skull base and orbit, or causes tissue abscesses, surgical treatment is recommended.
Currently, “functional endoscopic minimally invasive sinus surgery” is the mainstream surgery for sinusitis, and most of the sinusitis lesions can be safely and efficiently removed. However, patients with type 2 inflammatory response constitution have a higher chance of recurrence than other patients, even after high-quality sinus surgery. With the development of precision medicine, the medical community has discovered that “biological agents” can effectively reduce the risk of recurrence of chronic sinusitis combined with nasal polyps.
In the second type of inflammatory reaction, cytokines (Cytokine) are an important factor in the inflammatory reaction. The 2020 European Sinusitis and Nasal Polyps Treatment Guidelines (EPOS2020) mentioned that biological agents can antagonize cytokines (IL-4 and IL -13), blocks the inflammatory pathway of nasal polyp formation. Now, the Taiwan Rhinology Society has also formulated a consensus on biologic treatment guidelines, giving otolaryngologists a standard basis for the use of biologic therapy.
Who is suitable for biologic treatment? Sinusitis patients may consider “3 out of 5 conditions”
Dr. Li Jingze pointed out that the Taiwan Rhinology Association recommends that patients must be adults with bilateral chronic sinusitis and nasal polyps, have undergone at least one complete and high-quality surgical treatment (or are not suitable for surgery due to surgical contraindications), and have bilateral internal sinusitis. If the nasal polyp score is above 4 points, it can be evaluated. For patients who meet more than three of the following five conditions, it is recommended to consider biological agent intervention.
Type II inflammatory reaction constitution: the patient has more than 250 eosinophils per milliliter in the blood, or more than 10 eosinophils per high-magnification field of view in the tissue, or more than 100 units of immunoglobulin E in the blood per milliliter.
Those who have previously received oral steroid treatment (more than 5 days) more than twice a year.
A score of 40 or above on the Rhinitis and Sinusitis Assessment Scale (SNOT-22).
The sense of smell is assessed as hyposmia or worse.
Have comorbidities such as asthma that requires routine use of inhaled steroids, or severe respiratory diseases aggravated by aspirin or non-steroidal analgesics (NSAIDs).
Biological agents are a great boon for patients with refractory sinusitis and nasal polyps, allowing them to
Get rid of the nightmare of constant steroid use and repeated hospitalizations for surgeries. International journals point out that biological agents can rapidly
And to continuously improve the sense of smell of such patients, the treatment strategy for sinusitis is a step towards precision medicine.
Stride.
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