MANAGEMENT FOR CHRONICRHINOSINUSITIS - GRH BASED

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MANAGEMENT FOR CHRONICRHINOSINUSITIS - GRH BASED

Post by Admin on Sun Mar 07 2010, 00:45

DIAGNOSTIC CRITERIA
siinus tenderness
pus in the middle meatus
postnasal drip


MEDICAL MANAGEMENT


amox / cotri / erythro /cipro total 3 courses each course for 7 - 10 days
along with PARA . cetrizine / CPM ( if allergy co exists)
& vit c

IF symptoms persists do DNE

DIAGNOSTIC NASAL ENDISCOPY

indications - for evaluation of nasal symptoms for recurrent headache , heaviness of head and facial pain, nasal obstruction , epistaxis , smell disturbances ,nasal mass tubotymapanic CSOM

After doing DNE plan for proper management

+ve findings

plan for FESS / septal correction
if planning for FESS do CT PNS

no +ve findings
continue medical treatment

AMBIGUOUS

order for CT PNS

INDICATIONS FOR SEPTAL SURGERY
septal deviation causing nasal obstruction after medical treatment .

FESS - not preferred under 15 yrs

POST OP

pack removal on 1st post op day
nasal decongestion with xylocaine & oxymetazoline nasl drops , antibiotics , antihistaminics & analgesic

if post op period uneventful discharged with advice to continue medicines prescribed for 7 - 10 days

saline douching ( taught to the patient ) .
periodic review weekly once for 2 wks , fortnightly once 1 month , monthlyonce for 3 months ,quaterly once for 1 yr during every contact do DNE to be done & results reviewed and problems tackled.

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Admin
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