Nasal Voice Changes: When to Seek ENT Help - Otolaryngology

Dr. Ye Dawei reply Otolaryngology

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Dear Sir/Madam:
1.
Please visit the outpatient clinic for examination.
2.
Excessive nasal voice may not necessarily resolve.
Understanding Sinusitis
What are the sinuses and their functions: The sinuses are located within the skull and nasal cavity.
There are four pairs of sinuses: the maxillary sinuses on either side of the nose, the ethmoid sinuses above, the frontal sinuses in the upper front, and the sphenoid sinuses in the upper back (as illustrated).
The sinuses are lined with a thin membrane that contains tiny cilia.
These cilia move to help drain secretions from the sinuses through their drainage openings into the nasal cavity.
Since the nasal cavity is constantly exposed to the external environment, when the sinuses become infected with bacteria, the secretions increase, and the mucosa swells, leading to nasal congestion.
At this point, the drainage openings of the sinuses can become blocked, preventing the expulsion of invading bacteria and secretions, resulting in sinusitis.
Causes and Persistent Symptoms: Sinusitis often results from an incomplete recovery from a cold, leading to recurrent infections.
It can be classified into acute and chronic forms.
Patients with acute sinusitis typically experience nasal congestion, purulent nasal discharge, and tenderness around the nasal bridge, forehead, and under the eyebrows, along with possible fever, headache, fatigue, and swelling around the eyes.
Chronic sinusitis usually arises from inadequately treated acute sinusitis or is associated with conditions such as allergic rhinitis, nasal polyps, deviated septum, or hypertrophic rhinitis, which obstruct nasal and sinus drainage.
Consequently, infected sinuses can become a site for continuous bacterial proliferation, leading to chronic sinusitis.
Its main symptoms include nasal congestion, purulent nasal discharge, post-nasal drip, cough, a feeling of heaviness or dizziness upon waking, difficulty concentrating, and memory impairment.
Treatment: Adolescents are particularly susceptible to sinusitis due to incomplete physical development, and nasal discomfort is often overlooked by parents, delaying treatment.
Therefore, it is crucial to consult an otolaryngologist promptly when experiencing the aforementioned symptoms for appropriate treatment.
For the treatment of acute sinusitis, the general approach involves medication and local treatment, with sinus puncture and irrigation performed if necessary to facilitate nasal and sinus drainage, typically resulting in complete recovery within three weeks.

For chronic sinusitis, surgical intervention is often required for definitive treatment, usually recommended after the age of 14.
Patients with allergic rhinitis, nasal polyps, or deviated septum must also be addressed to ensure optimal surgical outcomes.
Endoscopic sinus surgery, combined with ethmoid nerve anesthesia, has shown good results, with advantages including minimal bleeding, reduced pain, and clear surgical visibility, allowing the surgeon to thoroughly remove pathological tissue while avoiding unnecessary damage.

Surgical treatment for chronic sinusitis is akin to reconstructing a new sinus, requiring proper care.
The new and healthy tissue within the sinuses will take about three months to fully develop post-surgery.
Therefore, regular local treatment and medication may be necessary until the new tissue is completely formed, followed by six months of recovery to consider the treatment complete, ultimately alleviating the distress caused by sinusitis.
Sincerely,
Dr.
Da-Wei Yeh, Head of the Department of Otolaryngology, Hsinchu Hospital

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Reply Date: 2009/02/22