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  • Sinus Headaches
    in the sinus comes from pressure on the membranes Often the most severe pain comes when a vacuum is formed For example flying at high altitude your nose may clog because of the dryness in the cabin and your failure to drink adequate fluids such as hot tea The nose closes and almost immediately the body starts to absorb the oxygen in the sinus which is now plugged On landing the sinus is now at a low pressure whereas the atmosphere outside is at a higher pressure 15 psi 100 kN square m the pain is like having a 5 pound weight 2 kg mass on your eyeball A similar thing can happen in scuba diving Treatment consists of opening the sinus passages so the air pressure can equalize Spray the nose with a nasal decongestant The doctor may give you cortisone by injection or pill to get the passages open Take papaya enzyme tablets every four hours dissolved in the mouth between the cheek and gums Taking a decongestant like Sudafed or Zephrex LA is good In my office we spray the nose well and put pledgets small wads of cotton with nose drops at the sinus openings Sometimes the patient breathes helium which easily goes into narrow openings If you have a clogged nose and vacuum in the sinuses this is a very painful conditins and we do give pain medicine as needed The nasal irrigator is recommended if there is phlegm or drainage that should be removed at home Pain from bacterial sinus infections is surprisingly rare even when the x rays show significant disease Drainage of the pus is done in the office especially local shrinking and suction and daily at home using the pulsatile nasal irrigation Antibiotics are also used plus decongestant and papaya as

    Original URL path: http://www.ent-consult.com/sinus_head.html (2016-02-01)
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  • Post-Nasal Drip
    is good but avoid moisturizing sprays with additives or preservaties such as benzalkonium which can actually be the root of your problems I like preparations which you make yourself so they re economical and which come with a refillable spray bottle This allows you to moisturize and clean your nose frequently right away when you are exposed to diesel bus fumes smoke or dust If the stuff is expensive or isn t in a bottle convenient for carrying with you you are less likely to use it right when you are dry or exposed to irritants Look for a nasal sinus moisturizer that contains no irritating additives including Benzalkonium and which comes in a convenient spray bottle for cleaning out your nose on the go A good sinus moisturizer can be used as often as desired and because it is free of irritating additives there is no sting so kids will use it Whatever helps to move the cilia helps post nasal drip Drink lots of hot tea Hot compresses over the nose above and below the eyes helps restore ciliary function Pulsatile Nasal Irrigation performed daily for 2 weeks is often sufficient because the pulsation encourages good ciliary movement

    Original URL path: http://www.ent-consult.com/pnd.html (2016-02-01)
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  • Sinusitis for Patients
    missing and so there is not enough mucus or cilia The mucus may be too thick like molasses and this keeps the cilia from moving The cilia may be too slow Diesel and other fumes impair the cilia movement In these conditions bacteria and viral invaders remain in the nose and multiply to enter the body and make you sick They multiply and give off an unpleasant odor In addition the accumulated mucus can block the sinus openings which allows bacteria to multiply inside the sinus cavity For example in Cystic Fibrosis or Aids the mucus is too thick and the cilia can t do an effective job Hence lots of sinus and chest problems It is estimated that 25 of asthmatics have sinus problems In the Drug Free Approach efforts are directed to restore cilia movement What Helps the Cilia First rule is adequate hydration Drink enough to make the urine light Drinking warm tea is effective because the chemical composition of tea stimulates cilia movement For example carry tea bags with you on long flights to overcome the dry cabin air Hot compresses to the nose and sinus areas helps blood flow which helps increase cilia movement Moisture to the nose in the form of liquids without harsh preservatives are desirable The closer the liquid is to the natural body the better For example saline with the body s electrolytes is reported to stimulate cilia best Irrigation can help by removing thick phlegm that contains bacteria and allergens Pulsatile irrigation has been reported in medical journals as being highly effective This is because the pulse rate matches the best rate of the cilia and helps encourage their movement Also pulsatile irrigation is more effective in removing thick mucus It is the choice for removing bacteria from surgical areas The pulsation movement has a massage affect in bringing circulation to the area and moving stale blood products out A significant advantage to the mechanical pulsatile irrigators is that you can set the pressure at quite low much lower than nose blowing so it can be gentle and accepted by kids as well as adults Pulsatile irrigation serves another purpose As a stream flows past a narrow opening like the sinus ones it creates a vacuum and pulls out the material and the solution replaces the sinus material This is called Bernoulli s Principle But with pulsation that suction displacement is enhanced by the pulsating action which acts like a pumping action so more fluid is displaced from the sinuses Antibiotics When the cilia or Mucociliary Clearance system fails antibiotics help by either killing the bacteria or interfering with their reproduction The problem comes after the bacteria are killed off If the cilia continue to non function or if the sinuses continue to be blocked eventually a new infection will begin Formally any sinus infection would respond to penicillin or sulfonamides Due to the abuse of antibiotics many bacteria are highly resistant to various antibiotics and doctors must study their

    Original URL path: http://www.ent-consult.com/sinusitis.html (2016-02-01)
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  • Sinus Disease
    that there are no preservatives such as benzalkonium and the mixture is buffered to avoid any burning sensation The refillable spray bottle it comes with can be used for spray drops or to irrigate or wash Without the burning this solution can be used regularly by kids When you feel a sinus infection coming on rest hot soup and tea hot compresses applied to the sinus area above the eyes for the frontal sinuses between the eyes for the ethmoid sinuses and below the eyes for the maxillary sinuses If this is not effective pulsatile nasa sinus irrigation can be used to restore nasal cilia remove nasal pus and thin the secretions With a proper pulsatile irrigatin device the irrigation pressure is adjusted to just the right value of 5 PSI the water stream is about an inch high The saline or better yet enhanced moisturizing solutinon goes in one side of the nose and out the other This is a natural way of healing the sinus condition Even children as young as 5 years find this a pleasant treatment Some people get symptoms after exposure to downtown smog or dust at work I advise them to use this irrigator much like washing the hands to remove dirt By irrigating in this manner the nose doesn t have to do the work I find it especially useful for Firefighters to use after the smoke of a fire Cilia are generally activated by increasing temperature up to 40 C so hot compresses over the sinus area are beneficial However above 40 C cilia are inactivated and hence the deleterious effects of hot steam nasal inhalation Long term dry steam inhalation sauna is suspected of being harmful For people with serious sinus disease pulsatile irigation has proven extremely useful For example patients with Cystic Fibrosis have very poor ciliary action and so develop serious sinus disease The pulsating saline irrigator can remove the pus and act like a normal cilia A good medication for nasal congestion is Sudafed Long Acting 120 milligrams every 12 hours The term mucocliliary clearance refers to the system of the cilia and the blanket of mucus This is a table of medicines and factors that increase clearance which is good and medicines that slow mucociliary clearance which is bad Mucociliary Clearance Increase Decrease Iodides Guiafenasen Fluids enough to lighten the urine Hot tea Hot chicken Soup Reducing bacterial load Terbutaline Inhaled coricosteroids Various enzymes e g Bromelin or Papain taken buccally proteolytic enzyme lozenges Pseudoephedrine Early stages of allergic rhinitis Breathing and cough excercises Flutter inhallation device Codeine Cocaine Antihistamines dehydration Inhallation of air or steam above 40 degrees centigrade Heavy load of iced drinks chilling drafts Sulphur dioxide ozone smog Inhalation of chromium dusts Cupric copper compounds Nickel dusts chimney dusts Formaldehyde Late stages of allergy Nasal polyps Skydrol a solvent used in airplane maintenance Severe infections such as pseudomonas bacteria H Influenze and many viral infections Pseudomonas infection Hyperbaric oxygen Reduction of airway diameter Environmental

    Original URL path: http://www.ent-consult.com/sinus_disease_pro.html (2016-02-01)
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  • Empty Nose Syndrome
    Turbinate Surgeries When the inferior turbinate is enlarged due to repeated infection this is called a hypertrophied nasal turbinate The enlargement may be allergic or due to an increase in circulation called vasomotor rhinitis There may be huge pools of blood in the turbinate There may be a physical swelling due to this enlargement that blocks breathing The middle turbinate is quite important as it supports the structures of drainage from most of the sinuses In persons with sinus problems in order to enlarge the opening to the maxillary sinus it may be necessary to remove part of this turbinate The surgery sometimes loosens the entire turbinate so that it can fall forward and block the drainage of the frontal sinus Thus removal of the middle turbinate may be clearly required in some cases The superior turbinate is different it is rarely enlarged enough to impair breathing The turbinates provide much of the good disease fighting stuff in the nasal cavity and sinuses mucus cilia and enzymes such as lysozyme If the inferior and middle turbinates are removed the source of warming and moistening the air is gone and then the dryness frequent infections crusting and local pain can result With the absence of the mucus cilia and enzymes frequent infections of the sinuses can occur This may lead to the need for further sinus surgery How do you prevent ENS Most sinus difficulties come from failure of the cilia and mucus the mucociliary system to do its job Severe infection toxic fumes certain drugs all can slow the cilia and this allows infection If steps are taken to insure good cilia function many sinus problems can be avoided If pulsatile irrigation is used when the cilia are slowed as is the case with chronic pus discharge this often helps Extreme dryness may impair the mucociliary system so nasal moisturizers are also useful Sometimes the nose is blocked no matter what has been tried allergy irrigation etc and X rays indicate serious sinus blockage If surgery is indicated speak to your doctor about procedures that spare the cilia These include Submucus resection of the turbinate Here only the bone is removed and the turbinate shrinks and goes to the side so it doesn t block airflow Radiofrequency treatment Here a probe which emits radio waves is used to congeal the tissue under the mucosa One such procedure is called a Somnoplasty Limited turbinate removal Most doctors have the necessary skill to remove small portions of the turbinate without doing harm Procedures that may result in Empty Nose Syndrome when done improperly include wide chemical or electric cautery laser cautery and of course surgical removal Once you have it how do you treat Empty Nose Syndrome Fortunately treatment is available for this condition For example Dr Steven Houser of Cleveland is developing a technique of implanting tissue that has helped these patients Instead of just narrowing the wide open area he directs airflow so that the pathology is reduced DR Terrance

    Original URL path: http://www.ent-consult.com/emptynose.html (2016-02-01)
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  • Allergies
    excellent antihistamines available over the counter I would start with Chlortrimeton This is available as a 4 milligram or 12mg long acting 12 hours tablet The problem is that everyone reacts differently to these pills Some people feel drowsy at a small dose There are other antihistamines that have less sedation for most people such as Seldane or Claritin On prescription there are several steroid nasal sprays such as Vancenase or Flonase If they work this is a preferred treatment because there aren t any systemic effects such as you might get with antihistamines In 1996 we feel that allergy can be reduced or avoided when there is a family history of allergy if the child is nursed All children should sleep in rooms with minimal dust It is important to follow the prescribed foods for infants For example if eggs are introduced at too early an age an allergy to this food may develop Often if a child hates a certain food he may do so because he is allergic to it Be very careful of nose drops such as Afrin and Neosynephrine All nose drops can be addicting the more you spray the more constriction of the nose then there is rebound and the nose is more congested Soon instead of every 12 hours you have to use the drops every 6 then every four hours Then the systemic effect of all that medicine takes over and the person becomes nervous jittery and sleep is difficult This is called Rhinitis Medicamentosum Once this happens the best treatment is a short course of Prednisone combined with an antibiotic from your doctor If you have allergies it is better to pay someone else to clean out grandma s attic because the symptoms brought on from the dust will be extreme

    Original URL path: http://www.ent-consult.com/allergies.html (2016-02-01)
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  • Journal Article: Pulsatile Irrigation Prevents Seasonal Allergy
    allergies to IgE a pollen present during the grass pollen season During this season the sample who performed pulsatile irrigation daily were checked for allergic response factors in the nose and in the blood and they were checked for inflammation in the nose The patients who irrigated show a significant reduction in the allergic factors of IgE in the nose and in the blood along with a reduction in inflammation The observations show that the pollen had been washed out of the nose actually preventing the allergic response People have washed out their nasal passages for centuries using salt water for health benefits Although everyone reacts violently to plain water in the nose properly prepared saline or water with a saltiness to match that of the nose causes no irritation A simple washing of your nose with saline does have some benefits verified by medical research but pulsatile irrigation is different It has been shown to actually improve the function of the body s own machinery for removing foreign materials the nasal cilia In pulsatile irrigation water is gently pumped into the nasal passages not in a smooth stream but in a pulsing one This action is believed to stimulate the sweeping or waving back and forth motion of the nasal cilia Tests show that the cilia work better after irrigation The pulsatile irrigation treatment requires only the use of a small device at home The treatment may entirely replace the use of drugs their side effects and avoids their great cost For comparison two months of Claritin costs around US 155 Patient response to the treatment was reported as positive The research was reported in the September issue of the Journal of Allergy and Clinical Immunology Drs Jose and Javier Subiza are widely recognized clinical allergy experts from Madrid

    Original URL path: http://www.ent-consult.com/news/allergysubiza.html (2016-02-01)
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  • Morning sneezing and hacking.
    time warm the body So especially if one is allergic the person sneezes and coughs This certainly warms the body but then a cascade starts that is hard to stop So to avoid morning sneezing have hot tea before you get out of bed This can be from a Thermos or a hot plate or a loving mate But it will reduce the morning symptoms It is better if the

    Original URL path: http://www.ent-consult.com/sneeze_hack.html (2016-02-01)
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