Effective Treatments and Exercises for Sinusitis Relief - Otolaryngology

Dr. Ye Dawei reply Otolaryngology

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Mr.
Yeh Da-Wei's ENT Clinic Medical Education
Date: 2000/02/20
Leading Vertigo Specialist in the Zhuliu Area, Pioneer in Internet Medicine in Taiwan
Website: http://www.csie.nctu.edu.tw/~yehdawei
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"Nasal Disease Package Cure" That Makes One's Nose Sour
In the outpatient clinic of an ENT specialist, symptoms such as cough, headache, dizziness, and nasal congestion are quite common.
However, due to their complex causes, treatment can be challenging, leading patients to flock to exaggerated advertisements promising "cure" and "complete treatment." In the past two years, I have treated numerous patients who underwent the so-called "five-minute nasal disease cure," resulting in complications such as nasal mucosal adhesions, nasal vestibulitis, nasal obstruction, and nasal septal perforations—issues that are truly overwhelming and disheartening.
The causes of nasal congestion generally include "infection," "nasal structural abnormalities," "allergic rhinitis," and "vasomotor rhinitis," each with its own pathogenic mechanisms and treatment approaches.
Of course, each condition has its limits in terms of treatment efficacy, which has allowed these alternative practitioners to gain traction with their unconventional therapies.
Below, I will briefly introduce each condition based on this classification.
Infection:
The most common cause of nasal congestion is the common cold.
Once the cold resolves, the nasal congestion typically improves.
However, bacterial infections leading to sinusitis are more severe, presenting symptoms such as nasal congestion, post-nasal drip, headache, difficulty concentrating, and chronic nighttime cough.
In children, this can significantly affect sleep quality and academic performance.
If conservative treatments such as medication and nasal irrigation prove ineffective, surgery may be recommended.
The traditional Luc's procedure, which involved incising the lip to remove the entire sinus mucosa, has now been completely replaced by endoscopic sinus surgery.
This technique allows for selective removal of obstructive mucosal tissue under good visualization, restoring normal sinus function.
Nasal Structural Abnormalities:
Nasal septal deviation and chronic hypertrophic rhinitis are common issues.
"Nasal septal deviation" can occur naturally at birth or result from trauma causing cartilage distortion.
The degree of deviation does not always correlate with nasal congestion, and the decision to surgically correct it may depend on the patient's subjective experience.
"Chronic hypertrophic rhinitis" refers to the hypertrophy of normal turbinate tissue, which can lead to nasal congestion.
The turbinates, also known as nasal conchae, are normal physiological structures located on the lateral wall of the nasal cavity, and patients can often see them when examining their own nasal cavities.
Sometimes, patients are misinformed that these are nasal polyps and subjected to inappropriate cauterization procedures.
Allergic Rhinitis:
Currently, there is no definitive cure for allergic rhinitis in medicine.
It is a disease caused by a specific predisposition, leading to edema of the nasal mucosa and resulting in nasal congestion.
Treatment can be tailored based on the severity of symptoms, utilizing oral medications, nasal sprays, immunotherapy, or surgery to alleviate nasal congestion.
Vasomotor Rhinitis:
Various factors can contribute to vasomotor rhinitis, including work stress, hormonal changes during pregnancy, certain antihypertensive medications, and even irritants such as perfumes, temperature and humidity changes, or cooking fumes.
These factors can cause dilation and congestion of the blood vessels within the nasal mucosa, leading to symptoms of nasal congestion.
Treatment options for chronic hypertrophic rhinitis, allergic rhinitis, or vasomotor rhinitis include conservative oral medications, nasal sprays, traditional inferior turbinate resection, and advanced laser surgery.
There are also newer techniques involving the use of thermal needles placed submucosally in the turbinates, where radiofrequency generates low heat to cause protein coagulation in the submucosal tissue, leading to fibrosis and reduction of the hypertrophied turbinate tissue.
Nasal congestion is not classified as a disease, but it is a highly bothersome symptom.
In addition to causing difficulty in breathing, it can easily lead to dizziness, headaches, difficulty concentrating, snoring, insomnia, or sleep apnea.
Consulting a professional ENT specialist to identify the true cause of nasal congestion and selecting an appropriate treatment approach is the right path forward.
I sincerely hope to no longer see so-called "cure-all nasal disease packages" in the clinic.

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Reply Date: 2005/08/12