Air to breathe seems natural – until the nose is closed. Diagnosis: inflammation of the sinuses (sinusitis). If this is not just a simple infection, but rather polyps, an operation is sometimes an option.
When your nose is dripping, it’s annoying. Sometimes you almost miss the runny nose – when the mucus is stuck and the sinuses become inflamed. Every breath becomes torture, the sense of smell is gone and the face hurts. Sometimes there is also a headache and fever. In many cases, patience and medication help against sinusitis. But what if not? Does surgery make sense then?
Acute and chronic sinusitis
Doctors differentiate between acute and chronic sinus infections. Those affected have to struggle with chronic sinusitis for more than twelve weeks. According to Achim Beule, senior physician in the Department of Otorhinolaryngology at the University Hospital in Münster, around eleven percent of Germans are affected. The acute form is more common and lasts a maximum of twelve weeks. In 60 to 80 percent of those affected it heals within two weeks under drug therapy, after six weeks the ghost is over for almost everyone.
Drug therapy – that means, for example, decongestant nasal sprays, as Stefan Fink, board member of the German Pharmacists’ Association, says. But: These should not be used for more than seven days because they can lead to a habituation effect and damage the nasal mucosa in the long term.
Nasal sprays cause damage to the nasal mucosa when used in excess. (Source: Thinkstock by Getty-Images)
A simple home remedy is to drink enough. Two to three liters a day help to liquefy the mucus. The same applies to heat, for example in the form of a red light lamp. Fink also recommends that those affected inhale. The water shouldn’t boil, just 70 to 80 degrees. A nasal douche can also be helpful. The nasal cavity is rinsed out with a saline solution. Herbal products for ingestion such as distillates from eucalyptus, myrtle or thyme as well as extracts from gentian, primrose and verbena can also have expectorant and anti-inflammatory effects.
Measures for severe inflammation
If the disease persists or is particularly severe, patients are usually given a nasal spray containing cortisone. Antibiotics are used when bacteria colonize that have serious complications such as a Meningitis or cause blindness. However, it is a misconception that the early administration of antibiotics can prevent this, restricts Bump.
If none of these measures help, there may be an anatomical problem behind the permanent inflammation: a displaced nasal septum or benign growths in the nose – so-called polyps – sometimes prevent the mucus from flowing out. Then surgery is an option.
When is an operation necessary?
Before going under the knife, patients should consider getting the opinion of a second doctor, recommends Prof. Leif Erik Walther, an expert from the German Professional Association of Otorhinolaryngologists. “Such an operation is dangerous and should be carried out by an experienced ENT surgeon to avoid complications such as bleeding and injuries to the optic nerve or the base of the skull.”
The operation is not really necessary in every case. Also, polyps can sometimes be effectively treated with medication. Even if they have been removed, they may grow back. Whether that will happen is hard to predict, explains Walther.
In the case of an operation
If the doctor and patient decide to have an operation, the affected areas are first mapped using computed tomography. This allows the doctor to see exactly what is preventing the mucus from flowing out. In the meantime, the image is then often read into a PC to make navigation easier for the surgeon. “That should increase security,” says Walther.
During the procedure, the doctor removes the polyps or straighten the nasal septum. Such an operation takes between 30 minutes and four hours and is performed under general anesthesia. 5 out of 1,000 operated on suffer a serious complication, more than 80 percent have a benefit, explains Bauer.
After the operation
Most patients stay in hospital for four to five days after the operation. A nasal tamponade should prevent bleeding during this time. Afterwards, you are usually on sick leave for two to three weeks and continue to be looked after by your resident doctor during that time. For example, he removes the crust so that no scars form, sucks off the secretion and takes care of the medication.
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