should I go for sinus Surgery? Role of steroids in sinusitis
Вставка
- Опубліковано 17 жов 2024
- decision-making in sinus Surgery could be a tough call. Functional Endoscopic Sinus Surgery is now a well-established procedure giving benefits to many. Should I go for sinus Surgery remains the most frequently asked question. will the disease be cured forever after sinus surgery or not?
One of my patients, who just visited me for her 2nd follow with a recently done CT scan
Her sinuses on the CT scan especially on one side are fully filled with disease, so I told
her to undergo sinus surgery.
I suggested surgery because I thought she has significant deviated nasal septum and
turbinates are also swollen and sinus openings are also blocked.
So, It is better to open the sinuses openings first with the surgery then we will ask her
to do Nasal douching, take nasal spray and other medicines, then she will make a fast recovery.
But she was shell-shocked after hearing this and tears started pouring out.
after some time, she regained her composure and then started firing questions.
Then, I kept explaining her in detail, and then it strikes me to make a video for all
my viewers who are in a similar situation. Should I go for immediate surgery or not.
Is that doctor speaking right or should I take a second opinion?
You should take a second opinion.
But, what I believe, I am telling you.
There would be many of you, who would like
to finish a job or an exam or a project before
undergoing surgery at your convenient time.
In that case, you can go for the second option,
which is waiting for one month, in which we
prescribe some particular medicines, including
steroids, antibiotics, anti-allergic nose
sprays, and drops
coupled with nasal douching and nasal endoscopies
in which we suctioned out collected secretions
in sinuses.
and sometimes, we even remove a large obstructing
polyp to facilitate drainage.
A weekly follow-up is scheduled.
In my experience, there are few cases ( roughly
one-third) , Nearly 30-40% of cases do not
require any surgery.
We define such treatment just before surgery
as MAXIMAL MEDICAL THERAPY (MMT)
MMT lasts for 4-6 weeks.
If you are not prepared for sinus surgery,
then you should definitely discuss your ENT
doc about MMT.
Tell your ENT doctor that you are not mentally
prepared for surgery and you would like to
have medicines for few weeks before surgery.
There is one more issue in MMT that you don't
wish to take steroids.
You are neither willing for surgery nor for
steroids.
Steroids are a special class of medicines
that may have serious side effects.
like obesity, hypertension or increased appetite,
vision issues,
If you read about the side effects of steroids,
then you would not feel like taking steroids.
steroids are like double edge swords, which
magically cure your sinus disease but at the
same time give you side effects.
But if you are a young person and even at
old age, in carefully chosen selected few,
in low dosage, monitoring the side effects
of the medicine, under supervision of your
doctor, these can work like magic.
So, in good faith, we prescribe steroids and
many of my patients got cured with steroids
only.
you first understand that sinus problems like
sneezing, running nose, and polyp formation
are mostly allergic cases.
Allergy is basically a medical problem.
Surgically, why do we operate then?
Operation is a mechanical job.
Where a path has deviated, we straighten it.
Where any sinus room is blocked, we open it.
So ultimately, medicines will continue even
after surgery.
The same patient then asked the doctor, even if I undergo surgery as you suggested, whether
now or after a month, will this disease will not recur ever? Then told her that Polyp recurrence is a rule rather than an exception.
Polyps do recur after surgery sometimes in
a minor way and sometimes in an aggressive way.
Very counted patients are there who never have a recurrence during their lifetime.
Mostly it depends also on your follow-up with your doctor and regularity with medicines.
It may happen to repeat the steroid course once or twice a year.
and how you control episodes of cough and cold in the future which decides whether polyps recur again or not.
we have to see polyp recurrence with help of nasal endoscopes in follow-up.
A small polyp, we are able to remove in OPD
itself.
So far, we have discussed that if your doctor
has asked for sinus surgery, then don't panic,
speak to your doctor, talk logically, that
doctor, I m not prepared mentally, Give me
medicines for a while now.
I will take time to get prepared for surgery.
I have read that few cases get cured with medicines too including steroids and
if we can go ahead with steroids, then do try this option as well.
and if you feel this operation is urgent, then do let me know that as well.
#sinussurgery
#sinusitistreatment
#sinüs
#steroids
#steroidsinsinusitis
#functionalEndoscopicSinusSurgery
#Sinusitis
#ChronicRhinosinusitis
Good information in very simple words to understand the disease of sinusitis and its management 👍
thanks। 🙏
Sir mera nasal polyps ka oparation ka 1 sal ho gaya lekin avi sir mere nak ka andar bahut pain hota hai or khujali vi hota hai balgam bahut jada ata hai kaya karu sir plz bataye
Sir ji mujhe bhi polyps hai very huge polyps both side abhi ct scan karaya hai. Antroconal polyps bhi hai galeme.
Mai mouth se saas leta hu dono naak band hai.
Investigation: CECT PNS AXIAL/ CORONAL
Highlights of report:
Observation:
* Mild DNS towards right side with spur formation
* Mild hypertrophied bilateral inferior turbinates.
* Collection with mucosal thickening in bilateral maxillary, ethmoid, sphenoid and frontal sinuses with blocked bilateral OM units and bilateral fronto-ethmoid recess- s/o pansinusitis.
Ye tino bold point hai report ke
*Bilateral lamina papyracea intact.
*Cribriform plate appears intact.
Visualized bones appear normal. No evidence of sclerosis or erosion.
Impression:-
* Mild DNS towards right side with spur formation
* Mild hypertrophied bilateral inferior turbinates.
* Collection with mucosal thickening in bilateral maxillary, ethmoid, sphenoid and frontal sinuses with blocked bilateral OM units and bilateral fronto-ethmoid recess- s/o pansinusitis.
Sir ji thoda hindi me explain kar de to badi kripa hogi
Kya operation hoga
Any tips mai kaise prepare rahu ane wale samay ke liye matlab ki operation ke liye
Report ko thoda brief me explain kar de kya likha hai isme dhayawad.
Sir aap ka clinik kaha hai sir
Bhut jld apse milte hain sir
Ji jarur
Sir sardi ki allergies koi achi tablet batao ga App Mujhe sardi sa Mujhe kan bhi baheya ha
Aap tab levocetrizine 5 MG once daily at bedtime le sakte hai.
Dr shaba pranam mai septoturbiono plasty surgery karaya hoo do mahina hogaya magaeathika nahi huwa hai nak me dard hai
ओह। aap apne surgeon se baat kare.
Sir mera septumplasti surgery hua 3 din pahle abhi mein ghar par hu lekin cough kyu aa raha hein or cough mein blood bhi aa raha hein 😔
Aisa ho sakta hai. Aap apne surgeon ke sampark me rahiye.
The throat is usually sore after general anaesthesia. After Septoplasty, you have to breathe through your mouth because of the nasal pack. Clots from the Surgery may also trickle into the throat. This will settle soon.
@@ChannelENT sir aaj 6 va din hein stool paas bhi nahi hua Dr kahte he ki khana soft khate ho is liye thode time aaisa hoga
to us k liye kya karu mana doctor sa bhai pucha par k App ko sardi sa kan baheta ha
Toh sardi ka ilaaj bhi apke ENT doctor hi karenge.
Esha hota ha sir
True
App Mujhe koi sachi table bata
What is your problem?
Doctor na Mujhe tablet di par koi fark nahi pad rah ha
🤔
Ma bahot par esha hu sir
Phone par aise treatment dena mushkil hai. Me yaha par just general baatein kar sakta hu.
please go and have a check-up with your ENT doctor. कृपया आप अपने ENT डॉक्टर को चेक कराए।
Agar aap mujh se ilaj chahte hai toh aakar mile
Mene kan ka opreson bhi kar va ya ha
Oh..
Phir bhai sardi sa baheta ha
Sardi ke liye aap Levocetrizine 5 mg once daily le सकते है.