Chapter 3: Nasal and Sinus Problems and Solutions

Peter Casano
12 May 202112:29
EducationalLearning
32 Likes 10 Comments

TLDRThis script delves into common nasal and sinus issues, such as the common cold and sinusitis, detailing their causes and treatments. It explains how rhinoviruses and bacteria can lead to sinus infections, often resolving without antibiotics. The script also covers surgical interventions like endoscopic sinus surgery and septoplasty for chronic issues, highlighting the importance of maintaining the nasal structure for proper airflow and the role of turbinates in humidity and airflow regulation.

Takeaways
  • 👃 The primary function of the nose is to serve as an air passage that needs to remain clean, humidify and warm the air, and handle undesirable particles.
  • 🤧 The common cold is a frequent issue, with the average adult getting 2 colds per year and children in day-care experiencing even more viral infections.
  • 🦠 Rhinoviruses and coronaviruses are both single-stranded RNA viruses that can lead to colds and are often transmitted through unwashed hands touching mucous membranes.
  • 🚫 Inflammation from viral infections can extend to sinus cavities, causing sinusitis, which is often mistaken for bacterial infections but usually resolves without antibiotics.
  • 💧 Chronic sinusitis can develop when sinus cavities become obstructed and fill with fluid, sometimes requiring surgical intervention to clear the obstruction.
  • 🔍 Endoscopic sinus surgery is a common procedure used to treat chronic sinus problems, involving the use of an endoscope and instruments to clear obstructions and improve drainage.
  • 👃🔧 Surgical techniques for sinuses include the use of a backbiter to remove parts of the uncinate process and a microdebrider to clear tissue, helping to restore normal sinus function.
  • 🌐 Nasal polyps are benign growths that can obstruct airflow and sinus drainage, and they often respond to steroid treatment to reduce inflammation.
  • 🔄 Deviated nasal septum is a common cause of airway obstruction and can be corrected through surgical procedures involving the removal or repositioning of bone and cartilage.
  • 🛠️ Turbinate reduction may be performed alongside septoplasty to address airway obstruction caused by the size or position of turbinates, using techniques like microdebriders and plasma wands.
  • 🩸 Nasal packing is used in some nasal surgeries to control bleeding, applying pressure to the bleeding site, and is usually removed within a few days.
Q & A

  • What is the primary function of the nose?

    -The primary function of the nose is to serve as an air passage. It is responsible for cleaning, humidifying, and warming the air, as well as handling undesirable particles such as dust, pollen, bacteria, and viruses.

  • How many colds does the average adult get per year?

    -The average adult gets 2 colds per year.

  • What type of virus is responsible for the common cold?

    -The common cold is caused by the rhinovirus, which is a single-stranded RNA virus.

  • How can touching a contaminated surface lead to catching a cold?

    -After touching a contaminated surface, if a person rubs their eye and touches the mucous membrane in the corner of the eye, the rhinovirus can travel with tears into the nasal cavity, causing the cold.

  • What is sinusitis and how does it differ from a common cold?

    -Sinusitis refers to inflammation of the sinus cavities. While a common cold is usually caused by a viral infection, sinusitis, when referred to by healthcare professionals, often implies a bacterial infection that may require antibiotics.

  • What is the term used to describe the liquid that can accumulate in the sinus cavities during an infection?

    -The liquid that can accumulate in the sinus cavities during an infection is often referred to as an 'air fluid level'.

  • What is the typical resolution time for acute bacterial sinusitis when the immune system is involved?

    -In most cases, the body's immune system successfully clears an acute bacterial sinusitis infection within a week or two.

  • What is chronic bacterial sinusitis and how does it develop?

    -Chronic bacterial sinusitis develops when inflammation and swelling block the drainage pathway of a sinus, preventing the infected mucous from escaping the sinus cavity.

  • What is the purpose of endoscopic sinus surgery?

    -Endoscopic sinus surgery is performed to clear obstructions in the sinus cavities, allowing the sinus to return to normal function and improve airflow and drainage.

  • What is a nasal polyp and how does it affect the nasal function?

    -A nasal polyp is a benign inflammatory growth that represents focal swelling of the mucous membrane. It can obstruct airflow, block sinus drainage, and interfere with the sense of smell.

  • What is a deviated nasal septum and how can it cause airway obstruction?

    -A deviated nasal septum is a misalignment of the cartilage and bone that divides the nasal passages. It can cause airway obstruction by altering the shape of the nasal passages and affecting airflow.

  • What surgical procedure is often performed alongside septoplasty to create a symmetric airway?

    -A turbinate reduction is often performed alongside septoplasty to create a symmetric airway by reducing the size of the turbinates and improving airflow.

  • What is the purpose of nasal packing in nasal surgery?

    -Nasal packing is used in nasal surgery to apply pressure to the site of bleeding, reduce the flow, and facilitate clotting, especially in cases of more persistent bleeding.

Outlines
00:00
🤧 Nasal Cavity and Sinus Problems

This paragraph discusses common issues affecting the nasal cavity and sinuses, such as the common cold, which is caused by viruses like rhinovirus and coronavirus. It explains how these viruses spread through unwashed hands and mucous membranes, leading to nasal congestion, inflammation, and sinusitis. The text also differentiates between viral and bacterial sinus infections, noting that bacterial infections often resolve without antibiotics but may require them if symptoms persist or are severe. It further describes chronic sinusitis and the potential need for surgical intervention, such as endoscopic sinus surgery, to clear obstructions and restore normal function.

05:03
👃 Surgical Solutions for Sinus and Nasal Issues

The second paragraph delves into surgical treatments for sinus problems, including the use of endoscopes and instruments like the backbiter and microdebrider to clear obstructions in the sinus cavities. It highlights the importance of pre-operative CT scans for understanding the patient's anatomy and condition. The text also covers the surgical management of chronic sinusitis, including the removal of bony partitions in the ethmoid sinuses and addressing the frontal sinus obstruction. Additionally, it touches on the use of balloon systems as a less invasive technique, although experienced surgeons often prefer tissue removal. The paragraph concludes with a discussion on the treatment of nasal polyps, which can be reduced with steroids and may require surgery in severe cases.

10:10
🩺 Nasal Septum and Turbinate Abnormalities

This paragraph focuses on the role of the nasal septum and turbinates in airflow and how their abnormalities can lead to airway obstruction. It describes various types of septal deviations and their impact on the nasal airway, as well as the surgical correction of these deviations through techniques such as septoplasty. The text also addresses the function of the turbinates in humidification and airflow regulation and the procedures for turbinate reduction when necessary. It discusses the importance of maintaining the nasal profile and the challenges in correcting misalignments at the nasal valve location. Lastly, the paragraph touches on the use of nasal packing in surgery to control bleeding and its removal in the post-operative period.

Mindmap
Keywords
💡Nasal Cavity
The nasal cavity is the internal air passage of the nose, responsible for filtering, humidifying, and warming the air we breathe. In the video's context, it is central to understanding how problems like colds and sinusitis affect respiration and air passage. The script mentions that the nasal cavity can become inflamed and swollen due to viral infections, leading to congestion.
💡Sinuses
Sinuses are air-filled cavities within the bones of the face surrounding the nasal cavity. They are integral to the discussion of sinusitis in the video. The script explains that viral infections can extend into the sinuses, causing inflammation and potentially leading to bacterial infections if the sinuses become obstructed and fill with fluid.
💡Common Cold
The common cold is a viral infection that primarily affects the upper respiratory system, including the nasal cavity. The video script states that it is one of the most prevalent problems, with adults getting an average of two colds per year. The cold is caused by viruses like the rhinovirus, which is introduced through unwashed hands touching the mucous membrane of the eye.
💡Rhinovirus
Rhinovirus is a type of virus that causes the common cold. It is a single-stranded RNA virus, as mentioned in the script. The video explains how the rhinovirus enters the nasal cavity through the eyes, leading to symptoms like swelling and increased secretions, which are key to understanding the development of a cold.
💡Sinusitis
Sinusitis refers to the inflammation of the sinuses, which can be caused by viral, bacterial, or fungal infections. The script distinguishes between viral and bacterial sinusitis, noting that while viral sinusitis is common, healthcare professionals often refer to bacterial sinusitis when using the term 'sinusitis,' which may require antibiotics.
💡Antibiotics
Antibiotics are medications used to treat bacterial infections. The video script discusses their use in treating bacterial sinus infections, emphasizing that most bacterial infections resolve without antibiotics, but they may be warranted in cases of severe symptoms or prolonged infection.
💡Chronic Sinusitis
Chronic sinusitis is a long-term inflammation of the sinuses that does not improve with standard treatments. The script describes how it can develop from persistent bacterial infections and may require surgical intervention if medications fail to resolve the infection.
💡Endoscopic Sinus Surgery
Endoscopic sinus surgery is a minimally invasive procedure used to treat chronic sinus problems. The video script describes the procedure, which involves using an endoscope to examine the site of obstruction and instruments to remove portions of the sinus wall to clear the drainage pathway.
💡Nasal Polyps
Nasal polyps are benign inflammatory growths that can form in the nasal cavity due to inflammation. The script explains that they can obstruct airflow, block sinus drainage, and interfere with the sense of smell. They are often treated with steroids, which can help shrink them.
💡Nasal Septum
The nasal septum is the cartilage and bone that divides the nasal cavity into two sides. Deviations in the shape of the nasal septum, as discussed in the script, can cause airway obstruction and may require surgical correction to improve breathing.
💡Turbinate Reduction
Turbinate reduction is a surgical procedure that reduces the size of the turbinates, which are structures within the nasal cavity that help humidify and warm the air. The script mentions that this procedure can be performed alongside septoplasty to create a symmetrical airway and improve nasal airflow.
💡Nasal Packing
Nasal packing is a technique used in nasal surgery to control bleeding. The script describes different types of packing materials, such as cellulose sponges, which expand when wetted to apply pressure to the bleeding site. It is an important aspect of post-operative care in nasal surgeries.
Highlights

The nasal cavity serves as an air passage that must remain clean, humidify and warm the air, and handle undesirable particles.

The common cold is the most common problem affecting the nasal cavity, with adults getting an average of 2 colds per year.

Rhinoviruses and coronaviruses are single-stranded RNA viruses that can cause colds and are often transmitted through unwashed hands.

Viral infections can lead to sinusitis, with the most common type being caused by rhinoviruses.

Bacterial sinus infections are often referred to as sinusitis in healthcare and usually require antibiotics.

Endoscopic sinus surgery is a common procedure used to treat chronic sinus problems by clearing obstructions in the sinus cavities.

A pre-operative CT scan is essential for understanding the anatomy and condition before sinus surgery.

The use of a backbiter and microdebrider in sinus surgery helps to clear the drainage pathway and reduce inflammation.

Chronic sinusitis can develop when the drainage pathway of a sinus is blocked, and infected mucous cannot escape.

Nasal polyps are benign inflammatory growths that can obstruct airflow, block sinus drainage, and interfere with the sense of smell.

Steroids are effective in shrinking nasal polyps and can provide relief for patients with chronic sinusitis.

Deviations in the nasal septum can cause airway obstruction and are often due to injuries or birth trauma.

Repairing a deviated septum involves removing or repositioning off-center portions of bone and straightening cartilage.

Turbinate reduction is often performed alongside septoplasty to create a symmetric airway and improve nasal airflow.

Nasal packing is used in nasal surgery to control bleeding by applying pressure to the site of bleeding.

Different types of packing materials are used in nasal surgery, with cellulose sponges being a common choice.

Packing is usually removed within one to four days post-surgery and is not as uncomfortable as patients may fear.

Transcripts

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Related Tags
Nasal CavitySinus ProblemsCommon ColdRhinovirusCoronavirusSinusitisAntibioticsSurgical TreatmentNasal PolypsSeptal DeviationTurbinate Reduction