#Maxillary Sinus Cancer

[doctoramit]

In most cases, cancer is found in the lining of the mouth, lips, tongue, throat, or the esophagus. Buccal mucosa cancer is the cancer that develops in the mucous membrane that lines the inside of the cheek and the roof of the mouth. It is also called oral cavity cancer.

[crimsonpublisherscancerstudy]

Sphenoidal Chondrosarcoma-Review of Literature of a Rare Case_Crimson Publishers

Sphenoidal Chondrosarcoma-Review of Literature of a Rare Case by Rajaram Sharma in Novel Approaches in Cancer Study

Abstract

Background: Chondrosarcoma is an unsual tumour involving the skull base. This malignant tumour most commonly occurs in young adults, and it is found in countless anatomic locations, including long bones, flat bones, and craniofacial bones. It is necessary to distinguish myxoid chondrosarcoma from the chondroid variant of chordoma, as the treatment protocol and prognosis varies for both conditions.

Case report: A 30-year-old female came to our hospital with a complaint of right nasal obstruction for the past few months. The patient underwent a Computed Tomography(CT) scan of paranasal sinuses including base of skull was ordered. The CT scan revealed a well-defined lobulated hypodense soft tissue density mass lesion centered in the body of the sphenoid bone. The mass had internal ring and arc type of calcification. The mass was filling the sphenoid sinus, whole right sided ethmoidal sinuses, and eroding the skull base to reach into the extra-dural space. Mass was extending into medial part of right orbit causing compression of the medial rectus muscle and resulting in lateral side proptosis. Post obstructive sinusitis changes were observed in right frontal and maxillary sinuses. The patient underwent surgical management.

Conclusion: Sphenoidal chondrosarcoma is a rare entity; misdiagnosing it or missing the findings may have profound implications for the patient. CT provides an accurate and detailed depiction of the entity.

Read more about this article:

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[dramarnathandentalcare]

8 reasons why you have strange bumps on the roof of your mouth

The palate is the roof of our mouth that separates our oral and nasal chambers. Because the palate is made up of bone and muscles, it is prone to injuries, infections, and other problems. You may have pain and soreness on the roof of your mouth on occasion. It occurs as a result of illnesses such as allergies, infections, and others.

You may detect pimples on your mouth palate and feel them with your tongue or fingers. Right?

Hard cysts form the bumps on the roof of the mouth that resemble little blisters. It is a mild ailment that resolves on its own. Injuries primarily cause oral bumps, canker sores, cold sores, infections that can lead to cysts on the lips, and intra-oral regions such as the tongue, palate, and so on.

Aside from this, a variety of disorders have been associated to the development of bumps on the palate. This blog post has highlighted them.

What could create pimples on the roof of the mouth?

1) Papilloma Squamoma

Squamous Papilloma is characterized by excessive development of soft tissues within the oral cavity. It is a harmless disorder caused mostly by the human papillomavirus (HPV). It gradually develops pimples anyplace inside the mouth with no pain. A difficult palate is hardly an exception.

When it develops larger, it will resemble a cauliflower-shaped white or pinkish lesion and will cause discomfort when eating. Even though it is a benign condition, it has the potential to become cancerous in rare circumstances. In such cases, dentists recommend surgical excision of the cyst.

2) Palatinus Torus

Torus palatinus is a benign disorder that causes bone development in the center of the hard palate. This disorder causes spherical and smooth oral pimples. Some people are born with this ailment, while others develop it as a result of difficulties such as crowded teeth, jaw bone abnormalities, and so on.

Palatal tori lumps, like those caused by Squamous Papilloma, become bothersome when they grow larger. It will make chewing, swallowing, and wearing dentures difficult..

3) Nasopharyngeal Duct Cyst

The incisive papilla, which is the area behind the two front teeth, is where the nasopalatine duct cyst forms. As a result, it is also known as an incisive canal cyst, and it appears as swelling in the palatal regions.

Its precise cause is unknown. However, researchers believe that this abnormality is caused by embryogenic remains in the region where the maxillary sinus connects with the nasal cavity.

In most circumstances, it is also harmless, but there is a slight risk of discomfort.

4) Pearls by Epstein

Epstein Pearls are small, innocuous whitish-yellow cysts that form in the mouths of newborns. It shows as a 1 to 3 mm colored hump on the roof of the infant's mouth.

It is not unusual and usually fades away before the infant reaches the age of three months.

5) Mucoceles

Mucoceles are innocuous mucus-filled cysts caused by irritations in the salivary gland. It appears as transparent, round-shaped pimples that range in size from 2 to 10 millimeters. It is likely that it can move around inside the mouth but does not cause pain.

Oral mucous cysts can last anywhere from a few days to months and break on their own.

6) Orthodontia

Hyperdontia is a disorder characterized by the development of an abnormally large number of teeth anywhere in the mouth. These extra teeth are known as Supernumerary Teeth. Extra teeth on the palate behind the front teeth can occur in persons with Hyperdontia. It resembles pimples on the roofs of their mouths.

It is critical to get these additional teeth extracted by a dentist. Otherwise, they might contribute to tooth crowding and cause jaw pain.

7) Teeth that are not normal

Teeth are typically erupted in the dental arch.

Teeth rarely grow in locations other than the dental arch. Ectopic eruptions are the medical term for this illness. Dentists believe it is caused to iatrogenic activity, developmental disruptions, and tumor growth.

If it grows on the roof of your mouth, it will give your palate a bumpy appearance.

8) Throat Strep

Group A strep bacteria are frequently found in the nose and throat. They are gram-positive aerobic organisms that cause difficulties in the throat, skin, and other areas. When the bacterium infects your throat, you will experience pain and scratching.

Similarly, it causes lymphatic tissues at the back of your throat to grow. The roof of your mouth may have some lumps in such circumstances.

It is common and can be treated with antibiotics.

conclusion

In most circumstances, bumps on the roof of the mouth are innocuous. It is caused by a variety of reasons. It is almost never linked to significant, life-threatening disorders.

If the lumps persist for several weeks or are accompanied by discomforts such as extreme burning, changes in size, strong pain, foul breath, or others, see a dentist right away. It could be an indication of the advancement of any infectious illnesses within your oral cavity or body.

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[loveislattes]

Long Health Post Update

You know, I don't think I ever did a post here talking about what's been going on the past couple of months. So, let's do that.

Warning: This is a decently long post and it goes in-depth with medical and surgery talk.

On July 1st, I went to the ER after dealing with debilitating dizziness for about a week (not vertigo). I had seen my primary earlier and she said to go to the ER if it got worse so, when I almost passed out off my bed, I finally went. Found out I have a cyst in my right maxillary sinus causing all my migraines and sinus troubles (that we're keeping an eye on to make sure it doesn't grow) along with discovering I was in the early stages of walking pneumonia. I'm going to be seeing a neurologist in a few months to see if the dizziness was caused by a vestibular disorder as I keep having episodes.

I've also been working towards gastric bypass surgery for the last 5ish months and I'm finally having surgery this Wednesday, the 17th. I've been on liquids, no caffeine, and minimal-to-no sugar since the 10th. It's going like hell but I'm managing. A big reason for surgery is, of course, for weight loss health BUT the main reason is that they found I have a condition called Barrett's esophagus. This is caused by prolonged reflux in the esophagus (GERD) that causes the lining to become rough like the stomach lining and, if not prevented with this surgery, usually leads to esophageal cancer; which obviously has a short life expectancy.

So, it's been a busy and scary few months with all this on top of having my appendix out last November and my carpal tunnel surgery this January. Safe to say, I feel like I'm falling apart lol.

I'll definitely update my close friends and family first once I'm out of surgery and coherent, but I'll also try to make a post here in case anyone else wants to be aware of my status (AKA me NOT dying on the operating table, which I'm terrified of lol).

[lupine-publishers-sjo]

Lupine Publishers | Adenoid Cystic Carcinoma of the Sinonasal Tract: Two Cases Report

Lupine Publishers | Journal of Otolaryngology

Abstract

Adenoid cystic carcinomas (ACC) of the sinonasal tract is a malignant neoplasm, characterized by slow and insidious growth. Thus, patients usually present in advanced stages. Clinical presentation is unspecific. Treatment is based on surgery followed by radiotherapy. Since the tumor spreads through perineural and hematological routes, delayed metastasis and local recurrence may occur several years after remission. In the present manuscript, we report the case of two patients who present with an ACC of the maxillary sinus diagnosed in an advanced stage. Orbital and cerebral involvement was objectified in one patient. Treatment consists in surgery. Post-operative radiotherapy was performed in one patient. He had a complete remission. Loco-regional recurrence occurred in the second patient. ACC is a particular entity among sinonasal cancers. Further studies are needed to define multimodal treatment including surgery, radiotherapy, and chemotherapy

Keywords: Adenoid cystic carcinoma; sinonasal tract; surgery, radiotherapy

Introduction

Adenoid cystic carcinoma (ACC) of the sinonasal tract is a rare cancer that originates from salivary glands [1]. It is the most frequent malignancy in the maxillary sinus among non-squamous cell carcinomas [2]. Clinically, it presents as a slow growing and locally aggressive tumor with a tendency to local recurrence and late metastasis [3]. Through two cases report, we illustrate clinical, histological, and therapeutic characteristics of sinonasal ACC.

Case Presentation

  Case 1:

A 50-year-old female patient, with no medical history, presented with right nasal obstruction, epistaxis and nasal discharge that appeared one year ago. Physical examination found a mass of the right nasal cavity. The neck was free from lymph nodes. The neurological and ophthalmological examination were normal. CT scan showed a 5 cm mass, occupying the right maxillary sinus (Figure 1). Tumor extended to the ethmoid and the right nasal cavity. A biopsy of the lesion was performed. Histological examination (Figure 2) concluded to ACC with a cribriform type. No metastasis was found. Tumor was classified T3N0M0. Patient was operated on by Rouge-Denker technique. Post-operative radiotherapy was performed. Patient had regular clinical and radiological follow-up. No recurrence was noted during the 10 year-follow-up.

Figure 1:  Axial CT scan showed a tumor of the right maxillary sinus.

Figure 2: Histological examination showed a cribriform type of ACC.  

Figure 3:  A bleeding mass occupying the left nasal cavity.  

Case 2:

A 39-year-old male patient, presented with unilateral rhino logical symptoms (epistaxis, rhinorrhea, and nasal obstruction) evolving for 5 months. At the physical examination, we found a nasal deformity and a bleeding mass of the left nasal cavity (Figure 3) that extended to the nasopharynx. A left exophthalmia was noted. No cervical lymph nodes were found. The ocular motility and the fundus examination were normal. MRI was performed and showed a mass of the left maxillary sinus which was isointense on both T1 and T2-weighted sequences. Extension to the nasal cavity, nasopharynx and left orbit was objectified. Tumor was removed by paralateronasal approach. Post-operative radiotherapy was planned. Unfortunately, orbital, and cutaneous recurrence occurred. Thus, palliative radiotherapy was achieved.

Discussion and Conclusion

Sinonasal tract malignancies are rare tumors that account for 3% to 5% of all the upper aerodigestive tract cancers [4]. Among these malignancies, ACC is the most frequent salivary gland cancer. It represents 10% of all malignancies at this site [5,6] and about 10% to 25% of all ACCs of the head and neck [7]. It is a slow-growing and locally aggressive tumor with clinical, biological, and therapeutic characteristics. Mean age at diagnosis is 55 to 57-year-old [8]. ACC is thought to be hormonally dependent. A female predominance was noted in literature [9]. Tumor growth is insidious thus, patients are asymptomatic for a long period and may present with advanced-stage disease [3] . ACC is also characterized by a tendency for perineural spread along major and minor nerves which makes the treatment challenging [10]. Most frequent signs are nasal obstruction, epistaxis, nasal discharge, facial pain and dysosmia [6] likewise our patients. This unspecific presentation leads generally to a delayed diagnosis. When the tumor reaches large dimensions and invades surrounding bone and structures, severe signs appear such as headaches, seizures, ophthalmoplegia, diplopia and trigeminal neuralgia [6,8]. The occurrence of neurological and ophthalmological signs is correlated with poor prognosis [3]. The maxillary sinus is the most common site followed by the nasal cavity and the ethmoid sinus [8,11]. The frontal and sphenoid sinuses are correlated with a worse survival rates due to their proximity to the skull base [7]. Skull base involvement and intracranial extension are remarkably high. Cervical lymph node metastases are rarely reported. They accounted for 6% in the series of Rhee [11], 3.6% in the series of Unsal [7] and none of our patients. Lymph node involvement is correlated with poor prognosis as they represent a risk factor for distant metastasis and low survival rate [12]. Histologically, ACC is composed of three subtypes: tubular, cribriform, and solid [7]. The cribriform subtype is the most common one whereas the solid subtype has the worst prognosis [11]. Treatment of sinonasal ACC is based on surgery, followed by radiotherapy [13]. According to Lupinetti et al., overall, and disease-specific survival are improved when patients are treated with surgery and postoperative radiation compared with other treatment modalities [6]. The aim of surgery is to ensure complete tumor removal with negative margins. However, surgery of advanced stages tumor is challenging and can result in serious morbidity, especially when critical anatomic structures are involved such as the brain, the orbit, the cranial nerves, and the nasopharynx [10]. In our series, tumor extended to the nasopharynx and orbit in one patient. ACC is a radiosensitive tumor but not radio curable [13]. Postoperative radiotherapy aims to clear positive margins left after surgery [14]. Long-term survival does not seem to be improved when radiotherapy is associated, but 5-year diseasefree period is slightly prolonged [7]. In the study of Rhee, the 5-year local recurrence rate was 42% in T3 and T4 stages despite postoperative radiotherapy was performed in most of the patients [11]. Radiation therapy alone is indicated in T4 unresectable tumors [15]. Chemotherapy has not proven effectiveness in ACC treatment. Further clinical trials using combined therapeutic approaches are required [11]. ACC is characterized by local recurrence and distant metastasis that can occur several years after initial treatment and remission [11]. In the series of Miller, local failure rate was 50%. This high rate was explained by the high proportion of patients diagnosed in advanced stages [10]. In other studies, treatment failure rates range from 60% to 70% [15]. ACC of sinonasal tract has a poor prognosis. The most relevant prognosis factors are tumor site, skull base invasion, stage, histopathologic type, and treatment modalities. Treatment is based on surgery. Even though ACC is not radio curable, post-operative radiotherapy improves locoregional control. Early diagnosis, applying the appropriate therapeutic approach and long-term follow-up are the mean guarantees to improve prognosis.

Funding and Conflict of Interest

Authors declare that they have not receive any financial support. No conflict of interest.

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[meddco11]

Who is a Candidate for Thyroidectomy Surgery?

Thyroidectomy may be Total Thyroidectomy Packages in Mumbai recommended for any of the following

·         Hyperthyroidism ( hyperactive thyroid gland) after drug retirement

·         Hypothierism ( inactive thyroid gland) with enlarged gland

·         Thyroid cancer Inguinal Hernia Hernioplasty

·         Non-cancerous thyroid bumps that beget trouble breathing or swallowing

·         Swish Hospitals for Thyroidectomy Surgery in India

·         The swish hospitals for thyroidectomy surgery in India have advanced technology and top India thyroid surgeons offering high quality Total Thyroidectomy Charges in Mumbai  medical services and care at affordable prices. Meniscectomy in Mumbai

What is drug for thyroidectomy surgery?

·         Cost of thyroidectomy surgery India Retinal detachment surgery Packages in Kanpur Before any surgery, your croaker will give you a complete physical examination and estimate your general health and medical history.

·         You may need to have fresh tests analogous asx- shafts and laboratory tests. Your croaker will also review the implicit risks and Best Total Thyroidectomy Packages in Mumbai, benefits of surgery with you and ask you to subscribe a concurrence form.

·         It's important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

·         Total Thyroidectomy Packages in Mumbai It's important Inguinal Hernia Hernioplasty Packages in Angul that you tell your croaker if you are antipathetic to any specifics, what specifics you are taking, and if you have bleeding problems.

·         It's also important to tell your croaker if you are pregnant. Your croaker will also give you specific instructions on how to prepare for your surgery, including advice on food and drink, smoking, and taking or avoiding certain vitamins and specifics.

·         Haemorrhoidectomy Charges in Mumbai

 Types of haemorrhoidectomy endoscopic surgery in ENT center in mumbai

·         Sinusotomy is the most common endoscopic ENT operation, which is effective for habitual sinusitis, excrescencies, antrochoanal excrescencies, fungal and foreign bodies of the maxillary sinus. Meniscectomy Charges in Mumbai Retinal detachment surgery cost in Kanpur The sinus is performed through the natural opening of the maxillary sinus in the nasal depression first, it expands by a numerous millimeters, and also the sinus is examined with an endoscope. Total laparoscopic hysterectomy Meniscectomy Packages in Mumbai The pathological contents are removed from the sinus, and the mucous membrane remains complete.

·         Maxillary ethmoidotomy-this operation is more volumetric than maxillary sinus, because it affects the conterminous sinuses-the ethmoid maze cells.

·         Haimoroetmoidotomy FESS -Functional Endoscopic Sinus Surgery cost in Kanpur  is necessary for habitual purulent and polyposis sinusitis.

·         Polysinusotomy is an extensive endoscopic operation, in which several or all of the paranasal sinuses are operated simultaneously from two sides the maxillary sinuses, anterior and wedge- shaped, ethmoid maze. Endoscopic polysinusotomy is most constantly performed with polypous rhinosinusitis.

WHAT DISEASES ARE TREATED AT THE ENT CENTER ENDOSCOPICALLY?

As we have formerly mentioned, the FESS endoscopic fashion includes several different types of operations for different ENT conditions. Endoscopic nose surgery is used in the ENT Center clinic to treat not only sinusitis of any nature, but also excrescencies, excrescencies and other excrescences of the sinuses.

[juniperpublisherscasestudies]

Juniper Publishers- Open Access Journal of Case Studies

Post-Surgical Prosthetic Rehabilitation of a Patient after Partial Maxillectomy: A Case Report Report

Authored by Mohammed Abujalala

Abstract

This clinical case report describes a method for prosthetic rehabilitation of a patient with malignant cancer of the palate following partial maxillectomy. These findings suggest that an obturator significantly contributes to minimizing postoperative complications and improving the quality of life of maxillectomy patients. In prosthetic treatment, the satisfaction of the patient is related to great understanding and co-operation of the dentist with regard to gaining the necessary confidence of the dentist.

Keywords: Palatal obturator; Rehabilitation; Aesthetics; Delayed surgical obturator

Introduction

Maureen [1] clarified that treatment for head and neck cancers has evolved in the last few decades with multiple modality treatments, including radiation and chemotherapy, to improve regional and local disease control, preserve anatomic structures, reduce distant metastasis, and enhance quality of life and overall survival. He also viewed surgery as the first preferred choice for early cancers as well as cancers unresponsive to chemotherapy and radiation and in the salvage form. However, according to Kantas & Rogers [2] surgery can result in psychological, functional and cosmetic impairment and therefore severely impacting the quality of life for patients. On the other hand, Moser et al. [3] emphasized that rehabilitation goals are focused on the restorative, supportive, palliative and preventive aspects of treatment.

Keyf [4] indicated that advanced cancers or trauma destroy structures, which include hard and soft tissues of jaws, oral tissues, facial skeleton, cheeks, lips, eyes, nose and can negatively affect the maxillofacial region. Keyf [4] remarked that the main objectives of maxillofacial rehabilitation and prosthetics are to construct a prosthesis to cure the defect, improve the function, enhance esthetics, engage the patient in society, and in doing so improve the spirit of the cancer patient, thus contributing to his/her quality of life.

McGregor [5] suggested that there are three main types of maxillectomy: maxillectomy with loss of orbital support; maxillectomy with preservation of the orbital floor; and maxillectomy with orbital exenteration and ethmoidectomy. Rodrigues [6] highlighted that the selection of rehabilitation depends on the site, etiology, size, age, severity and the patient’s desires. Goiato et al. [7] illustrated that nearly 5% of all cancers affect mouth structures: the oropharynx, tongue, nasopharynx and larynx. After the removal of these lesions, problems relevant to speech, swallowing and chewing may emerge. Moreover, changes in psychosocial function, appearance, and vocational status may negatively affect the patients’ quality of life after surgical intervention.

Beumer & Marunick [8] clarified that the Surgical obturators may be classified as immediate and delayed surgical obturators. Daniel & Vinod [9] explained that the defect may appear as a small opening caused by communication of the oral cavity into the maxillary sinus, or it may involve portions of the soft and hard palate, the floor of the nasal cavity and the alveolar ridge. A maxillary obturator was the name given by Danial & Vinod [9] to the prosthesis constructed to repair the defect. Its placement rehabilitates oronasal separation to increase intraoral pressure and decrease nasal airflow rate.

According to Kanazawa et al. [10], obturators provide immediate enhancement in intelligibility and speech articulation, voice quality and swallowing that approximates pre-surgical function, enabling the patient to drink and eat immediately. Kanazawa [10] clarifies that obturator fabrication for edentulous patients is considered a major challenge due to lack of suction and support from the teeth. Therefore, Kornblith [11] said that the obturator prostheses must achieve certain functions such as protecting the wound or keeping the defective area clean, facilitating food, increasing trauma healing, promoting speech, and improving aesthetics, and helping the remodeling and rebuilding of the palatine contour.

Rodrigues & Saldanha [6] suggested many different materials used for the fabricating of the hollow obturator. The first material is silicone rubber, which is advantageous in certain clinical situations, although it is porous in nature and has poor durability, requiring replacement on a regular basis. The second material is visible light-polymerized resin, but the maximal strength and long-term durability of these obturators have not been assessed yet. The third material is heat-processed acrylic resin, which is one of the most durable, tissue-compatible materials presently for the fabrication of the prosthesis.

Case Report

A 66-year-old male patient, diagnosed with malignant cancer of the maxilla, had undergone a partial maxillectomy and was referred to the Department of Prosthodontics, Near East University, Faculty of Dentistry, North Cyprus (Figure 1).

On examination of the defect, it was noted that the partial maxillectomy was done and we found that the defect included hard and soft tissue of the maxilla, presence of anterior residual ridge (canine to canine) and tooth #12, #13. The patient had difficulty in speaking and could not eat or swallow properly. To minimize postoperative complications, the first prosthesis was placed. The second phase of treatment included an interim obturator. When the patient was examined four weeks later, the healing was satisfactory for the placement of the interim obturator. The interim obturator functional prosthesis facilitates proper healing. When the surgical site had completely healed (3-6 months postsurgically) a definite prosthesis was placed (Figure 2).

It was decided to use a heat-polymerizing acrylic resin prosthesis, the expectations of this prosthesis were explained to the patient and to prevent any trauma to the underlying tissue, undercuts at the surgical site were blocked with vaselinized gauze. An irreversible hydrocolloid was used to make an impression of the defect area. The impression was removed and poured into a Type III dental stone and the final cast was obtained, on which a custom tray was made using a self-curing auto-polymerizing resin.

All undercuts on the cast were blocked out with plaster and wax. The final denture base and occlusal wax rims were prepared to record maxillomandibular relations. The record was articulated, and teeth arrangement was performed (Figure 3). All the undesired undercuts were blocked, jaw relation was recorded, and tooth arrangement was completed.

The pressure areas were relieved, and the peripheral seal of the prosthesis was tested by making the patient drink and eat without any resultant leakage into the nose. The prosthesis was delivered to the patient and he was instructed on home care and prosthesis maintenance (Figure 4 & 5). The patient was instructed to gently remove any exudates with a wet cotton tip soaked with a 5% Betadine solution and to clean the intaglio surface of the prosthesis once a day. Post treatment photographs showed a marked improvement of the patient in the aesthetics sense due to replacement of the missing teeth and the solution of the maxillary defect issue.

Conclusion

This clinical report describes a method for prosthetic rehabilitation of a patient with malignant cancer of the palate following partial maxillectomy. Maxillectomy, the total or partial removal of the maxilla, creates a challenging defect for the maxillofacial prosthodontist when attempting to provide an effective obturator. These findings suggest an obturator significantly contributes to improving the quality of life of maxillectomy patients.

The literature says, that both types of obturators allow for the fabrication of a lightweight prosthesis that is readily tolerated by the patient, while effectively closing the defect. In prosthetic treatment, the satisfaction of the patient is related to the dentist’s psychological attitude in regard to gaining his confidence “but great understanding and cooperation on the patient’s part is needed’.

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[biomedres]

Journals on Cancer medicine- BJSTR Journal

The Relationship of the 2nd: 4th Digit Ratio to the Maxillary Sinus Volume in Men by Hasan Emre Koçak* in Biomedical Journal of Scientific & Technical Research (BJSTR) https://biomedres.us/fulltexts/BJSTR.MS.ID.001222.php#

Objective: Recently, the 2nd and 4th (2D:4D) digit ratio have been reported to be a non-invasive indicator of intrauterine androgen balance and androgen receptor sensitivity. The maxillary sinus (MS) is the triangular pyramid shaped air filled space found inside the maxilla. Like other paranasal sinuses, MS plays a prominent role in the formation of facial contour. The possible relationship between the MS volume and the 2D:4D ratio in men has been investigated.Materials and Method: 41 male patients aged between 21-39 years (mean 27±5.24), who had a paranasalsinus (PNS) computer tomography (CT) scan. The MS volume was calculated from the PNS CT scans using the Syngo software. The 2D:4D ratios were calculated by measuring in mm the distance between the end point of the 2nd and 4th digits on the palmar side of the right hand and the lowermost crease (the meta carpophalangeal crease) using a digital caliper. The relationship between these two numerical values was statistically analyzed.Results: As a result of the volume analyses, the total volume was found to be 31±8.6. Average 2D length was found as 72.8±10, 4D lengths as 75.1±10.8 and the average 2D:4D ratio as 1. There was a significant negative correlation between the 2D/4D ratio and the right, left and average MS volumes.

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[krispytalegiver]

7 keys to good health thanks to good breathing

A very common motto among people with asthma is "When you can't breathe, nothing else matters," alluding to the desperation of someone who cannot breathe the air that gives life. The air that gives life the whole story of breathing? This article takes common breathing tips and gives reasons for its effectiveness. It goes further and brings essential elements to the respiratory technique for better health. Breathing is perhaps one of the most integrated autonomous behaviors at the central level that goes beyond simply filling the lungs. García AJ wrote in 2011: "Breathing occurs through complex network interactions that involve neurons distributed throughout the nervous system. The respiratory rate-generating network is made up of micro-networks that work within larger networks to generate different rhythms and patterns that characterize breathing. ". The functioning of García's study can be best observed when a person is affected by strong emotions such as fear and anger. The main advice for breathing is to cancel autonomous control and consciously breathe in deeply through your nose and breathe out slowly through your mouth with pursed lips. Dr. Carla Naumburg, renowned doctor "Ready, ready, breathe" suggests that breathing exercises bring all their attention to daily life. When thinking about breathing, space is created to restore calm and reduce blood pressure and stress hormones, thus creating the possibility of controlling the situation. Professor Konstantin Buteyko (Russia 1923-2003) is credited with a technique characterized by slow, reduced breathing combined with spaced non-respiratory pauses that allow carbon dioxide to accumulate to the breaking point. Breathing is a relevant component of yoga practice. Breathing techniques in yoga usually accompany different postures or some form of meditation. Therefore, it is difficult to separate and attribute the result to breathing, postures or meditation. Pandit JJ, in 2003, tested 3 breathing techniques for optimal oxygen absorption, as follows: 1. Three (3) minutes of the tidal breath 2. Four (4) deep breaths taken in 30 seconds 3. Eight (8) deep breaths taken in 60 seconds The oxygen uptake was the same for items 1 and 3 and more effective than for item 2. His work illustrates that the breathing technique is important. Enter nitric oxide (NO), a colorless gas with a half-life of only a few seconds. Nitric oxide (NO) was named "molecule of the year" in 1994 by the journal Science. In 1998, the Karolinska Institute awarded the Nobel Prize to American pharmacologists Robert F. Furchgott, Ph.D., Ferid Murad, MD, Ph.D., and Louis J. Ignarro, Ph.D. for their discoveries of the role of nitric oxide (NO) as a signaling molecule in the cardiovascular system It does not relax the smooth muscle of the arteries by providing a larger area of ​​blood circulation, which lowers blood pressure and brings more nutrients where they are needed. The importance of NO in human bodily functions cannot be overstated. Although thousands of research articles have been written, global research continues. NO is involved in heart health, low blood pressure, a better quality of sleep and even erectile dysfunction. It does NOT occur in the paranasal sinuses, the largest of which is the maxillary sinus on either side of the nose. These are closed chambers, except a small soft tissue opening called Cosio which opens the olfactory airways. There is no right or wrong way to breathe: autonomous brain function ensures that you get enough oxygen in your system. However, there are ways to breathe to get the most NO out of your system. Here are 7 tips to help you transport this incredible gas into your bloodstream. 1. BREATHE QUICKLY WITH YOUR NOSE. Nasal hair and contracted nasal passages guarantee negative pressure in the airways. This partial vacuum causes the sinuses to deliver a small amount of NO-charged air into your inhaled breath. The more you breathe, the more breasts will be released. 2. LOCK A NOSTRIL AND BREATHE. Block one nostril and, in turn, the other nostril will increase the partial vacuum to cause the injection of NO-laden air into the inhaled breath. 3. LOCK US AND TRY TO BREATHE. Close both nostrils and try to inhale. This creates the greatest amount of vacuum in your respiratory system by allowing NO-laden air to be drawn from the sinuses. Of course, you can only do this for a short time before resuming normal breathing. 4. BREATHE SLOWLY THROUGH YOUR MOUTH. It does NOT need time to be absorbed into the bloodstream. Therefore, it is good to hold your breath as long as it suits you. Otherwise, exhale slowly to allow the lungs to absorb NO. 5. HUM OR SONG Lundberg et al showed in 2003 that the buzz increases expired NO by 700%. Another researcher found an even greater increase in expired NO when snoring. The problem is that it is difficult to inhale while humming. Therefore, the suggested sequence hums for 3 seconds and then inhales immediately. 6. PROVE SNORE To overcome the problem of snoring and inhaling simultaneously, it is suggested to pretend to snore, making the sound as if you are snoring. Snoring frequencies are in the range of the maxillary sinuses, natural frequencies of around 110 to 350 Hz. Allowing the maxillary sinuses to resonate will drive the NO-charged air to the volume of inhaled breathing. Since snoring is an inhalation maneuver, NO will reach the lungs in larger volumes. 7. VALSALVA MANEUVER During an airplane descent procedure, headaches are often avoided by using the Valsalva maneuver. This maneuver consists of closing the two nostrils while trying to exhale until the eardrums "explode". This has the effect of pressurizing the breasts which, after a new inhalation, release the pressure and inject air loaded with NO into the olfactory respiratory tract. frequently asked Questions A. NOT in the sinuses is a limited resource and can be used up. How to replace it? Eat many foods rich in nitrates, for example, beets, fenugreek, etc. and give your body time to convert nitrates to NO. B. Why breathe NO gas like they do for babies with pulmonary hypertension? The dose of NO in a medical environment is carefully controlled. Exposure of animals to NO has caused drowsiness, loss of consciousness and death. C. Why not sit in a high traffic area and breathe in the NO produced by cars? Motor vehicle exhaust does not contain NO. However, exhaust fumes are a toxic cocktail of other gases such as carbon monoxide. The risk of poisoning far outweighs any benefit you get. After about 5 years of purchasing women's clothing in China, India, Thailand, Bangladesh, and Indonesia, we have discovered the need to ensure that the supply is as follows: • No child labor • There are no azo dyes that cause cancer. • It does not treat harsh chemicals that harm the environment. • Fabrics from renewable sources. • Natural flame retardant fabric. We went a little further and asked ourselves the question: What can we add to our range of clothing that improves user well-being? We have found incredible answers. Look at this space. 7 keys to good health thanks to good breathing good health, Health from bestof https://ift.tt/2HIoUkb

[essaymin]

EssayMIN教你写好NLM Reference Style

NLM Reference Style引文提示

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示例:

Meneton P, Jeunemaitre X, de Wardener HE, MacGregor GA. Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular diseases. Physiol Rev. 2005 Apr;85(2):679-715.

Jun BC, Song SW, Park CS, Lee DH, Cho KJ, Cho JH. The analysis of maxillary sinus aeration according to aging process: volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngol Head Neck Surg. 2005 Mar;132(3):429-34.

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Eyre HJ, Lange DP, Morris LB. Informed decisions: the complete book of cancer diagnosis, treatment, and recovery. 2nd ed. Atlanta: American Cancer Society; c2002. 768 p.

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 示例:

Hooper JF. Psychiatry & the Law: Forensic Psychiatric Resources Page [Internet]. Tuscaloosa (AL): University of Alabama, Department of Psychiatry and Neurology; 1999 Jan 1 [updated 2006 Jul 8; cited 2007 Feb 23]. Available from: http://bama.ua.edu/~jhooper/.

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[lupine-publishers-sjo]

Lupine Publishers | Non-Hodgkin Lymphoma of Hard Palate

Lupine Publishers | Journal of Otolaryngology

Abstract

Oral cavity lesions are common complaints in clinical ENT settings. They are often misdiagnosed as a periodontal disease or granulomas. A 43-year-old male came to the our OPD with complaints of hard palate swelling on the right side for 1 year coupled with a swelling on the floor of the mouth for 2 years.

Keywords: Non-Hodgkin Lymphoma; Lymphoma; Hard Palate; Tumor; Maxilla

Introduction

Lymphomas are primarily tumours of lymph nodes. They are further classified as Hodgkin lymphoma and Non-Hodgkin lymphoma. Non-Hodgkin lymphoma is primarily present in Lymph nodes. Its extra nodal presentation includes sites like GI tract, Waldeyer’s ring, lung, liver, spleen, bone, skin. However, it is rare to find Non-Hodgkin lymphomas in oral cavity and are thus often misdiagnosed. Vigilant clinical examination, radiological investigations and histopathological reports help in identifying the disease at an early stage. We therefore emphasize on a voracious workup to hasten diagnosis and early treatment. We report a rare case of a 43-year-old male presenting with a hard palate swelling (Figure 1). The swelling was associated with pain during chewing. His contrast enhanced CT face/neck was suggestive of soft tissue mass involving right half of hard palate up to the midline with bony erosion of the floor of maxillary sinus. Excision of growth was done and sent for Histopathology. Histopathology report of this growth showed Follicular B cell lymphoma.

Figure 1: The Human Normal Eye Anatomy.

Case Report

A 43-year-old male presented with complaints of swelling over the right half of the hard palate for 2 years along with swelling over the floor of the mouth on the left side for 1 year. He gave history of tobacco chewing for 15 years along with significant weight loss. The patient presented to us 2 years back when the lesion initially presented, failing to follow up. Examination: On intraoral inspection a 6*4*4cm lesion on the right side of hard palate extending from upper right canine to the third molar, crossing the midline. The swelling was firm, with visible dilated veins, without scars, sinuses or pulsations. On palpation it was cystic to firm in consistency, smooth, without any local rise of temperature. On inspection an ovoid, solitary swelling on the left side of floor of the mouth, measuring 5.5*3*3 cm was noted which occluded the gingivolabial sulcus without signs of scars, sinuses, discharge from the swelling. The swelling was firm and non-tender. Indirect laryngoscopy examination was normal.

Investigations

A Face CT along with that of paranasal sinuses was ordered so as to estimate the extent of the swelling which was suggestive of a soft tissue lesion involving the right hard palate, upper alveolus and bony erosion of the floor of the maxillary sinus. The swelling also extended posteriorly up to the right superior retromolar trigone causing erosion of the right medial pterygoid plate. The scan also revealed multiple non necrotic cervical lymph nodes on bilateral level Ib, II and Va. Following this an excision biopsy was planned for further evaluation (Figure 2). The samples were sent for histopathological evaluation. Biopsy revealed Lymphoid tissue arranged in variable sizes separated by thin and thick fibro cartilagenous septae was seen suggestive of? Non-Hodgkin lymphoma. For definitive diagnosis and to measure the extent/ spread of the condition FNAC of the cervical lymph nodes and Bone marrow aspiration was performed.

Figure 2: The Human Normal Eye Anatomy.

The samples were also subjected to Immunohistochemistry for classification, subtyping and further management. FNAC of the cervical lymph node showed similar morphology as that of the palatal swelling. Bone marrow aspirate had a hypercellular marrow with 25% lymphocytes. IHC Markers used were CD20(clone L26), CD3(CLONE PS1), CD5(CLONE SP19), CD43(CLONE DF-P1), CD10(CLONE 56C6), Bcl2(CLONE 100/B5), Bcl6(CLONE-PG- B6P), Ki67 which reported as: IHC markers that turned out to be positive were - CD20(CLONE L26)- Positive; CD10- focal positive; Bcl2- positive; Bcl2- positive; Bcl6- positive; Ki67- 15-20% in neoplastic follicles. IHC markers that were negative are - CD3- negative; CD5- negative; CD43- negative; He was thus diagnosed as a case of Non- Hodgkin – Follicular lymphoma grade II. The patient was referred to the Department of Medicine Oncology for further management.

Discussion

Lymphomas are primary tumour of lymph nodes. They have been majorly divided as Hodgkin lymphomas and Non-Hodgkin lymphoma. Named after Dr Thomas Hodgkin who identified the cells for the first time. NHL is further classified as B cell or T cell lymphomas depending on the cells they affect. GI tract is the most common extra nodal site for NHL followed by Oral cavity. Within oral cavity, Waldeyer’s ring is the most common area to be affected, other including mandible, hard palate, nasopharynx, parotid gland, paranasal sinuses, thyroid gland and orbit [1]. Incidence of oral cancers is high due to addiction to tobacco. Presentation of NHL with primary site in oral cavity is rare. The mean age of presentation of NHL is 42 years of age. and its incidence increasing as the age advances. They are ranked fifth in terms of cancer incidence and mortality worldwide [2]. Majority Non-Hodgkin lymphomas are that of B cell origin type. Presentation of the lymphomas in the oral cavity are usually tooth ache, numbness, painless swelling [3] The differential diagnosis for such swelling can be that of an infective aetiology, hence all baseline investigations like a complete blood count is equally mandatory. The presenting symptoms for lymphomas are an unexplained, painless swelling of the lymph node, , gradually increasing in size either in the neck, axilla or the groin region. It can also be associated with B symptoms (symptoms whose, presence or absence has an impact on outcome of disease) such as fever, night sweats, abdominal pain, unexplained weight loss.

Majority of the NHL’s are B cell in origin. In our patient the immunohistochemistry was CD20 (Pan B cell marker) positive, CD3 negative(Pan T cell marker) suggestive of Follicular lymphoma. The aetiology of Non-Hodgkin lymphoma remains unknown. It shows a strong association with immunocompromised patients [4]. In our patient there was no evidence of any immunocompromised state, His serological status was Negative for HIV. Lifestyle factors like smoking, tobacco chewing have all direct adverse effects with Non- Hodgkin lymphomas. There is a twofold risk for NHL in cigarette smokers and three-fold in bidi smokers [3] Standard treatment modalities for NHL is chemotherapy. Generally, a combination of Chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone) and radiation is recommended [5].

Conclusion

Non-Hodgkin lymphomas of hard palate are a rare entity. Clinicians attending patients who come with growth in the oral cavity, or over the hard palate must rule out NHL as their differential diagnosis [6,7]. When detected in time, at early stages and treated either surgically or by chemotherapy, the prognosis of such patients is good [8].

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[juniperpublishersophthalmology]

Unusual Visual Presentation from Optic Neuropathy Secondary to Recurrent Oral Squamous Cell Carcinoma-Juniper Publishers

Abstract

A number of medical conditions may present to the emergency department involving a change or loss of vision. Many of these conditions are sudden in onset and may result in complete or partial loss of vision, such as stroke or multiple sclerosis. A 53 year old male with a past history of oral squamous cell carcinoma presented with a headache and changes in color hue in his right eye. CT imaging revealed recurrent oral squamous cell carcinoma involving the right sphenoid and ethmoid sinuses with extension into the right middle cranial fossa and orbit. It is important to note that a change in color vision may be from optic nerve dysfunction, which was found to be the case for this patient. The patient was diagnosed with optic neuropathy secondary to recurrent oral squamous cell carcinoma, which represents the first case report of such condition.

Keywords: Human Papillomavirus

Abbreviations: OSCC : Oral Squamous Cell Carcinoma

Introduction

Oral squamous cell carcinoma (OSCC) represents the most frequent malignancy of the oral mucosa [1,2]. Tobacco and alcohol are strong risk factors [2], and a number of studies have commented on the association between human papilloma virus and OSCC [3,4]. It represents a significant clinical challenge, requiring aggressive surgical resection with staging of the tumor. Chemotherapy and radiation therapy are required to achieve remission [5] and management requires evaluation by MRI and PET [6]. The most frequent spread of OSCC is to the cervical lymph nodes and lung, followed by metastasis to bone and liver [7]. Nasopharyngeal spread may occur in up to 28% of cases; however secondary ocular spread is rare [8]. We report a patient who presented to the emergency room with symptoms of color vision changes which was found to be secondary to metastatic spread of OSCC.

Materials and Methods

Biomicroscopy, color vision testing, visual field testing, dilated indirect ophthalmoloscopy, optical coherent tomography, fundus photography, and fluorescein angiography was performed. Subsequent CT and PET imaging was also obtained.

Case Report

A 53 year old male presented to the emergency room with headaches and decreased contrast sensitivity in his right eye. He was a nonsmoker, but would occasionally drink alcohol and use recreational drugs. Family history was unremarkable for malignancy. Medical history included controlled hypertension and OSCC involving the tongue, with spread into the cervical lymph node. After undergoing surgical resection, he underwent chemotherapy and radiation therapy to the head, neck, and lungs. Two years later he was noted to have a recurrence of OSCC, which involved his left maxillary and ethmoid sinuses with extension into the left orbit. He underwent left orbital exenteration, left external sphenoidectomy, left ethmoidectomy including resection of tumor at cribriform plate, and left medial maxillectomy. The patient concurrently received an additional three month course of chemotherapy and radiation therapy.

The patient was referred for ophthalmologic consultation. Due to the patient’s unusual presentation, there was concern for recurrence of OSCC in the right orbit. The patient was sent for MRI imaging of the brain and orbit. Due to surgical clips from the previous orbital exenteration, a CT scan was performed instead. He was referred to oncology for further evaluation, and received a PET scan and another CT scan. The patient elected for hospice care rather than further surgical or medical treatment.

Results

Ophthalmic examination disclosed a best corrected visual acuity of 20/25-2 in the right eye, and an intraocular pressure of 10 mmHg. There were no abnormalities of the right eyelids, conjunctiva, cornea, lens, pupillary response, or extraocular eye motility. There was no proptosis or pain or resistance on retropulsion. There were no abnormalities of color vision by Ishihara plate testing. Humphrey 24-2 visual field testing revealed an enlarged blind spot and small peripheral abnormalities (Figure 1). After dilation, the optic nerve showed mild hyperemia and mild retinal venous congestion (Figure 2A). No abnormalities of the macula, peripheral retina, or vitreous were noted. A fluorescein angiogram was performed and disclosed mild late staining of the optic nerve, with no other abnormalities (Figure 2B). Evaluation of the optic nerve by optical coherent tomography demonstrated mild optic nerve elevation, consistent with optic neuropathy (Figure 3).

The CT scan disclosed sphenoid and posterior ethmoid sinus disease (Figure 4). PET scan imaging demonstrated progression of malignancy at the level of the right skull base with extension into the right cavernous sinus and extension to the posterior nasopharynx and adenoid region. Extensive new skeletal metastatic disease was also noted. Within a month, he presented with proptosis and an orbital apex syndrome. Extensive tumor invasion into the right orbit was noted by an additional CT (Figure 5). The patient succumbed to his illness within three weeks of this examination.

Discussion

Visual complaints can be a common presentation to the emergency department. This patient presented with a headache and changes in color hue, and was diagnosed with optic neuropathy secondary to recurrent OSCC. Given the ophthalmologic findings, CT and PET studies, it is likely the optic neuropathy was secondary to tumor spread in the cavernous sinus giving rise to the venous dilation and direct tumor involvement of the optic foramen from the sphenoid sinus. We suspect the patient’s headache was secondary to meningeal involvement. Macrophage polarization and regional spread to the cervical lymph nodes, both of which this patient demonstrated, have been indicators of a poor prognosis [9]. Fewer than 10 cases involving ocular spread have been reported, which also carries a poor prognosis [7]. None of the reported cases have presented as an optic neuropathy. In 2007, Feng et al. [10] reported the first case of acute visual loss in a head and neck cancer patient with ocular metastasis and sphenoid pyocele, however he points out that the visual loss occurred from compression of the optic nerve and the sphenoid pyocele.

This case serves to illustrate the unusual nature of visual complaints that may present to the emergency department and helps to illustrate the effectiveness of the multispecialty team approach in assessing complex patients.

Acknowledgments

The authors thank Dr. Vijay Suhag (Department of Oncology, Sutter Roseville Medical Center), Dr. Christopher Markus (Emergency Department, Sutter Roseville Medical Center), Dr. Randall Ow (Department of Otolaryngology, Sutter Roseville Medical Center), and Dr. Michael Kaplan (Department of Otolaryngology, Head and Neck Surgery, Stanford University Medical Center).

For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com

For more articles in JOJ Ophthalmology please click on: https://juniperpublishers.com/jojo/index.php

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[arunbeniwal-blog]

Causes of Oral Cancer | What is Oral Cancer | Oral Cancer Stages

Causes of Oral Cancer

Two separate lines of research are currently joining to unwind the unpredictable arrangement of occasions that prompt cancer. One region has unmistakably identified site-particular changes of oncogenes, for example, EGFR and tumor silencer qualities, for example, p53. The other depends on epidemiological evidence that has connected introduction to exogenous operators to the development of particular types of cancer. For instance, epidemiological examinations have firmly embroiled substance cancer-causing agents, for example, those in tobacco, with lung and laryngeal cancer. Presentation to bright light has been emphatically connected with carcinoma of the lower lip. Also, evidence is developing for the job of particular infections in cancers, for example, those arising in hematopoietic and lymphoid tissues, those of the uterine cervix and carcinoma of the oropharynx.3

Substance cancer-causing agents

Creature considers have demonstrated that the use of certain synthetic cancer-causing agents, for example, DMBA, to the oral mucosa will prompt the arrangement of squamous cell carcinoma. Nonetheless, the connection between substance cancer-causing agents that hypothetically may be experienced in day by day life, for example, those ingested in drinking water and Causes of Oral Cancer is not known.

Tobacco

Cigarette smoking is settled as a critical risk factor in Causes of Oral Cancer. Tobacco smoke contains a substantial number of compound cancer-causing agents including fragrant hydrocarbons, for example, benzopyrene and nitrosamines. These cancer-causing agents have been appeared to prompt particular hereditary changes of the p53 and H-ras qualities.

Liquor

All types of liquor have been embroiled in the development of Causes of Oral Cancer. Significantly, the impacts of tobacco and liquor are added substance with liquor acting synergistically to advance the cancer-causing impacts of tobacco items. The mechanism by which liquor adds to Causes of Oral Cancer is not surely knew but rather it likely acts specifically on the epithelial cells of the oral mucosa by expanding porousness and through its dehydrating impacts. Moreover, there may likewise be an aberrant impact through modified liver metabolism.4 Interestingly, there is some test evidence that liquor may act to change the p53 quality specifically.

Daylight

Actinic radiation has for quite some time been related with cancer of the lower lip. Bright light is an intense DNA harming operator actuating DNA cross-connecting, single strand and twofold strand DNA breaks and nucleotide substitution.

What is Oral Cancer

What is Oral Cancer Oral cancer begins in the cells of the mouth. A cancerous (dangerous) tumor is a gathering of cancer cells that can develop into and destroy adjacent tissue. It can likewise spread (metastasize) to different parts of the body. The most widely recognized place oral cancer spreads to is the lymph nodes in the neck. What is Oral Cancer may likewise be called oral hole cancer or mouth cancer.

Cells in the mouth at times change and never again develop or act regularly. These progressions may prompt non-cancerous (considerate) tumors, for example, warts and fibromas.

Changes to cells of the mouth can likewise cause precancerous conditions. This implies the strange cells are not yet cancer, but rather quite possibly they may move toward becoming cancer on the off chance that they aren't dealt with. The most well-known precancerous states of the mouth are leukoplakia and erythroplakia.

Oral Cancer Stages

Organizing describes or arranges a cancer dependent on how much cancer there is in the body and where it is when originally analyzed. This is often called the degree of cancer. Data from tests is utilized to discover the measure of the tumor, which parts of the organ have cancer, regardless of whether the cancer has spread from where it previously began and where the cancer has spread. Your social insurance group utilizes the phase to design treatment and gauge the result (your prognosis).

The most well-known arranging framework for oral cancer is the TNM framework. For oral cancer there are 5 Oral Cancer Stages – organize 0 pursued by stages 1 to 4. Often the Oral Cancer Stages 1 to 4 are composed as the Roman numerals I, II, III and IV. For the most part, the higher the stage number, the more the cancer has spread. Converse with your specialist on the off chance that you have inquiries regarding organizing.

We arrange oral cancer utilizing the American Joint Committee on Cancer's TNM framework, a generally acknowledged technique dependent on three key segments:

Tumor (T), which describes the extent of the first tumor

Node (N), which demonstrates whether the cancer is available in the lymph nodes

Metastasis (M), which alludes to whether cancer has spread to different parts of the body

A number (0-4) or the letter X is doled out to each factor. A higher number demonstrates expanding seriousness. For example, a T1 score demonstrates a littler tumor than a T2 score. The letter X implies the data couldn't be evaluated.

When the T, N, and M scores have been allocated, a general stage is determined.

T classifications for oral hole cancer

These estimations allude to the essential oral cancer tumor.

TX: Primary tumor can't be evaluated; data not known.

TO: No evidence of an essential tumor has been found.

Tis: Carcinoma in situ has been analyzed, which means the disease is as yet restricted, or contained inside the best layers of cells coating the oral hole. Cancer cells have not invaded the deeper layers of oral tissue.

T1: Tumor is 2 cm crosswise over or littler.

T2: Tumor is bigger than 2 cm over, yet littler than 4 cm.

T3: Tumor is bigger than 4 cm over.

T4 is divided into two subgroups:

T4a: The tumor is developing into adjacent structures. At this stage, the oral cancer is known as a moderately propelled nearby disease. The territories to which cells have spread differ as per the sort of oral cancer:

For oral cavity cancers, the tumor is developing into adjacent structures, for example, the bones of the jaw or face, deep muscle of the tongue, skin of the face, or maxillary sinus.

For lip cancers, the tumor is developing into adjacent bone, the substandard alveolar nerve (the nerve to the jawbone), the floor of the mouth, or the skin of the button or nose.

Oral Cancer Treatment

The kind of Oral Cancer Treatment your specialist will prescribe depends on where the tumor is and how far the cancer has spread. Here are normal approaches to treat diverse stages of oral hole and oropharyngeal cancer. In any case, every circumstance is extraordinary. Your specialist may have explanations behind proposing a treatment alternative not specified here.

Most specialists concur that treatment in a clinical preliminary ought to be considered for any kind or phase of cancer in the head and neck zones. This way individuals can get the best Oral Cancer Treatment accessible now and may likewise get the new treatments that are believed to be far better.

Jaypee Hospital

The Jaypee Hospital was conceptualized by a worshipped Founder Chairman, Shri Jai Prakash Gaur with the vision of advancing world-class medicinal services among the majority by furnishing quality and reasonable therapeutic consideration with duty.

Jaypee Hospital at Noida is the lead hospital of the Jaypee Group, which proclaims the gathering's respectable expectation to enter the medicinal services space. This hospital has been arranged and designed as a 1200 bedded tertiary consideration multi-claim to fame office and has commissioned 525 beds in the primary stage.

The Jaypee Hospital is built over a sprawling twenty-five-section of land grounds in Sector 128, Noida which is effortlessly available from Delhi, Noida and the Yamuna Expressway.

Dr. Sudarsan De

Dr. Sudarsan De is a General Physician and Radiation Oncologist in Sector 128, Noida and has an ordeal of 28 years in these fields. Dr. Sudarsan De hones at Jaypee Hospital in Sector 128, Noida. He finished MBBS from Calcutta University in 1979 and MD - Radiotherapy from All India Institute of Medical Sciences, New Delhi in 1984.Dr. Sudarsan De has over 30 years of cancer care involvement in Chemo and Radiation treatment of various parts of the body. He's filled in as HOD and Chief Radiation Oncologist at different private hospitals in Delhi. Dr. Sudarsan De is an alum from NRSMCH, Kolkata and did his post graduation (MD) in Radiotherapy from AIIMS, Delhi. He has been broadly prepared in modern methods of Radiation Therapy in different rumored cancer focuses both in India and abroad (in Italy, UK, Belgium, Netherlands, Sweden, Germany, China, Singapore, Denmark and Switzerland.)

For more information, Call Us :  +91-8929020600

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[mhmulticarehomeopathy]

6 Best Homeopathic Medicines for Allergy,HAY FEVER Treatment.

There are major 3 category of allergy-1.Respiratory tract and throat allergy – the respiratory tract and throat allergies are- Allergic rhinitis - Allergic rhinitis is an allergic inflammation of the nasal airways. It occurs when an allergen, such as pollen, dust or animal dander is inhaled by an individual with a sensitized immune system. It causes sneezing, itchy and watery eyes, swelling and inflammation of the nasal passages, and an increase in mucus production. Many of the same factors that trigger allergic rhinitis can also trigger an allergic bronchial asthma attack.Rhinosinusitis – rhino sinusitis is the inflammation of inner layer of nasal passage and  inner lining of sinus cavity result from allergic cause or viral cause. the common cause for developing of rhino sinusitis is allergy i.e. allergic rhinitis. the most common symptoms of rhinosinusitis are blocking of nose, heaviness and severe pain on sinus areas like at the side on root of nose, both side of nose just under the eyes, and on maxilla portion of face. there sometimes more nasal secretion of thin to thick discharges.Allergic Bronchial Asthma - It is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath. It is triggered by various allergens or irritants. In allergic asthma, when the airways come in contact with an allergen, the immune system reacts and releases chemicals. These chemicals cause the muscles around the airways to tighten. Inflammation, swelling, and a buildup of mucus in the airways causes further narrowing.Allergic tonsillitis and adenoids- Tonsils are the two round lumps in the back of the throat. Tonsils can be seen clearly in the back of the throat, while the adenoids are located high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible. Those are the lymph glands like other lymph gland. The inflammation of tonsils and adenoids are called tonsillitis and adenoids. the common symptoms occurs in tonsillitis are sore throat, can not swallow any thing because of throat pain, sometimes redness of tonsils, cough , fever etc. The adenoids symptoms are snoring, sleeping disorder, weakness feeling etc.Nasal polyp - Nasal polyps are non cancerous grape shaped growths found around the nasal mucus membrane especially at the place where the sinus opens to the nasal passage. They result from chronic inflammation due to allergy, asthma, recurring infection or certain immune disorder. The common symptoms are blocked stuffy nose, post nasal drip, runny nose, loss of smell, pain in maxillary portion, etc.2. Skin allergy – the skin allergy can be of –urticaria or hives - Urticaria or hives  is a skin reaction of appearance of  various sizes smooth, slightly elevated pinkish patches of wheals like attended with severe itching result from allergic reaction. Those are subsided automatically after a few minutes to hour  without leaving any scar. Most cases of urticaria are self-limited and of short duration. Chronic urticaria is defined as urticaria with recurrent episodes lasting longer than 6 weeks.Atopic dermatitis  or Eczema – Atopic dermatitis or eczema is one type of inflammation of skin characterize with itchy, redness , rough and cracked skin patches result from allergic cause. they may be wet and oozing of sticky watery fluid from that affected part. 3. G.I. Tract allergyGastro enteritis – There is abdominal pain, nausea and loose bowel movement generally occur in child and babies.Type of Allergy :-

[gotoocollectorheart-blog]

What Is Sinusitis?

Overview Sinusitis, a term used to describe infection or inflammation of the sinuses, affected nearly 30 million Americans in 2011, according to the United States Centers for Disease Control and Prevention (CDC). Sometimes called "sinus attacks," sinusitis may be acute (lasting for four weeks or less); subacute (lasting for four to eight weeks); chronic (lasting for more than eight weeks—or for months or years); or recurrent (attacks return several times within one year). Many people use the terms "sinus infection" and "cold" interchangeably. Most cases ofacute sinusitis do follow the common cold, but a cold doesn't cause the symptoms of sinusitis. Rather, it often sets the stage for sinusitis to develop. Fungal infections, chronic inflammation of the nasal passages caused by allergies, asthma or other conditions, structural problems and a weakened immune system can also cause sinusitis. Your sinuses are four pairs of hollow spaces in your face that surround your nose. Thefrontal sinuses are over your eyes; the maxillary sinuses are inside your cheekbones; the ethmoids are between your eyes, behind the bridge of your nose; and the sphenoids are behind your eyes. Each sinus opens into the nose and is joined with the nasal passages by a continuous mucus membrane lining. This allows mucus and air to travel freely. You feel pain in your sinuses when that free travel is blocked. Each sinus produces its own pain when infected. For example, if your maxillary sinuses are infected, your jaw and teeth might hurt and your cheeks might be tender. Your nose might hurt or be stuffy or you could lose your sense of smell if your ethmoid sinuses are inflamed. Pain in your forehead or headache might indicate a problem with your frontal sinuses. Your sphenoid sinuses, which are the least frequently affected sinuses, can cause earaches, neck pain and a headache in the top of your head. Diagnosis Typically, a cold lasts no more than seven to 14 days and goes away without treatment. However, when symptoms persist or don't respond to over-the-counter decongestants, this suggests that a bacterial infection has developed. Acute bacterial sinusitis can clear up on its own after several weeks. Antibiotic treatment is often used to decrease the duration and severity of sinusitis-associated symptoms. As with all medical conditions, proper diagnosis is important before starting treatment. To diagnose sinusitis, a health care professional will typically take a medical history, examine the inside of your nose and examine your sinuses by gently pressing on them to see if they are painful or swollen. During the history, the health care professional will give special attention to previous episodes of sinus infections, asthma, allergies or other upper respiratory tract conditions. He or she may order a computerized tomography (CT) scan, a type of X-ray, of the sinuses. Hallmark symptoms of sinusitis include: pain in the cheeks, forehead or around the eyes (often, these areas are painful to the touch), upper jaw, teeth, neck, ears or deep pain at the top of your head headache in the morning puffy, swollen eyelids and tissue around the eyes nasal stuffiness and congestion to the point that you can't breathe greenish mucus post-nasal drip cough (which may get worse at night) runny nose sore throat slight fever weakness fatigue loss of sense of smell Fever of greater than 103 degrees Fahrenheit, pain or swelling, red cheeks, redness around your eyes, severe headaches, confusion or a stiff neck are symptoms that need immediate attention by a health care professional. Chronic sinusitis is a common problem for people with allergies or asthma. Chronic sinusitis is usually characterized by sinus inflammation that persists for eight weeks or more. Chronic sinusitis can be caused by a variety of different things including: a blockage of the sinus openings due to allergic disorders of the nose or structural blockage, like a deviated nasal septum problems with the movement of mucus a weakened immune system asthma allergies Allergies and infections contribute to chronic sinusitis by keeping the sinus membranes inflamed. Because of the swelling and inflammation, the sinus membranes thicken and exacerbate the obstruction and infection. The symptoms of sinusitis may also be triggered by exposure to strong-smelling chemicals, cigarette smoke, pollution, dust, mold or even strong perfume in susceptible individuals. Structural disorders of the respiratory tract may also cause chronic sinusitis. For example, narrow drainage passages in your nose, a deviated septum or nasal polyps (growths that block the sinus passages) can all contribute to the condition. During an examination, a health care professional should carefully assess any anatomical abnormalities that could be causing chronic sinusitis. Nasal polyps are typically noncancerous, but they can cause obstruction. Nasal steroids will often reduce the size of the polyps, but when obstruction persists, they may need to be removed. A variety of cancerous growths, although rare, are possible and require immediate treatment. They can cause nasal obstruction or bloody nasal discharge. Treatment Often, acute sinusitis clears up after several weeks without treatment. You might be able to "wait it out" and find relief from your symptoms using over-the-counter (OTC) medications. There are many from which to choose, depending on your symptoms. OTC medications available for sinusitis symptoms are designed to unblock nasal passages and reduce congestion, as well as relieve sinus pain and pressure. These medications include: nonmedicated nasal sprays, such as saline solution medicated nasal sprays that contain a decongestant decongestant oral medications decongestant-combination products, which contain a pain reliever and a decongestant antihistamine medications Prescription-only medications include: Nasal corticosteroids are prescription medications that include fluticasone propionate (Flonase), beclomethasone (Beconase AQ), triamcinolone acetonide (Nasacort AQ), budesonide (Rhinocort) and mometasone (Nasonex). These medications reduce secretions and swelling in the nose and may have a beneficial effect on preventing and treating sinusitis. OTC saline nasal sprays are often the first-line treatment and prevention used to decrease congestion and wash away bacteria. They are not habit-forming. You can buy them in drugstores or make your own using 1/2 teaspoon salt and 8 ounces of warm tap water. Use twice a day, using an ear bulb syringe to irrigate each nostril with half the solution. OTC nasal decongestant sprays relieve swollen nasal membranes almost immediately after they are used. They are effective in helping to keep nasal passages clear in the early stages of a cold. However, they shouldn't be used for more than five days because they could cause chronic irritation or dependency. Oral decongestants, such as pseudoephedrine (Sudafed), relieve nasal swelling pressure and congestion, but they don't treat the cause of the inflammation. Some oral decongestants are packaged in combination with other pain relievers. Side effects of decongestants include high blood pressure, nervousness, sleeplessness and dizziness. Check the label for potential side effects and discuss any special conditions you may have, such as thyroid disorder or diabetes, with your health care professional before taking a decongestant. Antihistamines dry you up and relieve the itchiness and drainage common to sinusitis, but not the sinus congestion. OTC antihistamines may cause drowsiness or grogginess. Antihistamine-decongestant combinations relieve multiple symptoms of congestion and drainage and reduce the side effects of both. Nonmedical approaches may prove helpful in alleviating sinusitis symptoms in the short term. These include the use of steam inhalants, such as taking a steam shower, increasing the amount of fluids you drink, using humidifiers during winter and using saline nasal sprays. OTC medications will often relieve your symptoms and may cure a sinus infection, if you've developed one. If symptoms persist for more than seven days despite OTC decongestant medications, you may have developed a bacterial sinus infection. In this case, antibiotics are often prescribed to reduce the severity of symptoms, decrease the duration of symptoms and prevent serious complications. Antibiotics prescribed by a health care professional are not necessary to cure a sinus infection but do provide some benefit over decongestant therapy alone. Sinus infections are typically treated with the following antibiotics: amoxicillin (Amoxil, Augmentin, others) trimethoprim-sulfamethoxazole (Bactrim, Septra, others) doxycycline (Doryx, Monodox, others) erythromycin (ERYC, EryPed, others) fluoroquinolones (Levaquin, Avelox, others) cephalosporins (Ceclor, Ceftin, others) A 10-day course of treatment is typically recommended for cases of acute sinusitis, but treatment durations may vary. Often, antibiotic treatment for chronic sinusitis or an infection that is resistant to treatment will last three weeks or longer. If your sinusitis is severe, chronic or recurrent, your health care professional might prescribe oral steroids, such as prednisone, to help reduce inflammation. Steroids do have significant side effects, however, so they are only used when other medications have proven ineffective. About 20 percent of patients with chronic sinusitis develop nasal polyps, which are growths that block the sinus passages. Surgery may be recommended to remove polyps. Short-term use of an oral steroid may reduce the size of polyps, and these steroid treatment "bursts" can also be used after sinus surgery to reduce the need for a repeat surgical procedure. Nasal steroid sprays are the most effective treatment for chronic suppression of polyps' size and regrowth. Nasal polyps often regrow even after surgery. Discuss your options with a health care professional if you are diagnosed with this condition. Surgery If all other therapies fail, surgery may be recommended. Failure of previous treatments suggests a difficult case of sinusitis, and surgery, too, may fail. Surgery is usually reserved for patients whose symptoms do not go away after three months of treatment or in people who have more than two or three episodes of acute sinusitis each year. And most cases of fungal sinus infections require surgery. The goal of surgery, which is usually performed by an otolaryngologist, or ear, nose and throat (ENT) specialist, is to help the sinuses drain more efficiently, therefore preventing blockages. Specific surgical procedures may involve enlarging the natural openings of the sinuses, removing nasal polyps or correcting any structural problems that may be blocking the sinuses. Most people experience a better quality of life following surgery for sinusitis, but problems sometimes recur. Prevention Because the most common cause of sinusitis is allergic or nonallergic rhinitis, the first step in prevention should be seeing a health care professional and defining your allergic triggers so you can avoid those factors. In most cases, good medical management controls the frequency and severity of sinusitis. After that, the trick to preventing a cold from turning into sinusitis is to keep your sinuses as clear as possible. Here are a few ways to do this. Use an oral decongestant for a limited time or a nasal spray decongestant for no more than five days. Use nasal saline to flush impacted secretions and rinse the sinus passages. Block one nostril while blowing through the other when blowing your nose. Drink a lot of water. Avoid caffeine and alcohol. Avoid air travel. Do not smoke cigarettes. If you have allergies: Avoid contact with things that may trigger allergy attacks, such as pet dander, dust, pollen, mold and pillows, as well as irritants such as perfume and cigarette smoke, which could inflame your sinuses. Seek allergy advice to reduce allergen exposure. Consider proper medical treatment, including allergy immunotherapy, to reduce the likelihood of recurring sinusitis. Facts to Know Sinusitis affected nearly 30 million Americans in 2011, according to the U.S. Centers for Disease Control and Prevention. Your sinuses are four pairs of hollow spaces in your face that surround your nose. The frontal sinuses are over your eyes; the maxillary sinuses are inside your cheekbones; the ethmoids are between your eyes, behind the bridge of your nose; and the sphenoids are behind your eyes. Each sinus is joined to the nasal passages by small openings with a continuous mucous membrane lining through which mucus and air travel freely. You feel pain and congestion in your sinuses when that free travel is blocked or impeded by swollen membranes. Although each sinus produces its own distinct pain when infected, most people with inflamed sinuses report having pain in several locations and symptoms that don't point to one particular sinus cavity. Acute bacterial sinusitis is a short-term condition that begins suddenly, usually about a week into a cold. If cold symptoms last more than one to two weeks, the cold may have turned into a bacterial sinus infection. If you have frequent episodes of acute sinusitis or if your symptoms never completely go away, you might have chronic sinusitis, which is characterized by sinus inflammation that persists for months or years. Symptoms of chronic sinusitis may not be much different than those of acute sinusitis. Symptoms of chronic sinusitis typically last longer and don't involve a fever. Sinusitis can be exacerbated by strong-smelling chemicals, cigarette smoke, pollution, dust, mold or even strong perfume. And allergies and infections contribute to chronic sinusitis by keeping the sinus membranes inflamed. Another possible cause of chronic sinusitis may be structural. If you have narrow drainage passages in your nose, a deviated septum or nasal polyps, medications will only temporarily alleviate your symptoms. Often, acute sinusitis clears up on its own after several weeks. You might be able to "wait it out" and find relief from your symptoms using over-the-counter medications and not use antibiotics. Key Q&A How can I tell the difference between a cold and sinusitis?A cold that doesn't go away in a week or two may have developed into sinusitis. If you have sinusitis, you will have unusually thick nasal or postnasal drainage that is yellowish-green; a cough (which might get worse at night); pain in your cheeks, forehead and around your eyes; a headache; and maybe a fever. How do I know if I have chronic sinusitis or acute sinusitis?After taking a medical history and conducting a physical examination, a health care professional should be able to diagnose whether you have acute or chronic sinusitis. You might have nasal polyps or a deviated septum, which are causing the sinusitis. But generally speaking, if you have frequent episodes of acute sinusitis or if your symptoms never completely go away, you probably have chronic sinusitis. If you have symptoms and sinus inflammation that persists for seven to 14 days or more, you should see a health care professional. What causes chronic sinusitis?Chronic sinusitis can be caused by a variety of things, including a blockage of the sinus openings, problems with the movement of mucus or a weakness in the immune system. It can become a vicious circle. An allergy or an infection (a cold, for example) can inflame your sinuses. Because of the inflammation, the sinus membranes get thicker, causing more of a blockage. Eventually, your sinuses may be blocked completely.Noxious chemicals, cigarette smoke, pollution, dust, mold and even strong perfume can exacerbate sinus symptoms. Another possible cause of chronic sinusitis may be structural. If you have narrow drainage passages in your nose, a deviated septum or nasal polyps, medications will only temporarily alleviate your symptoms. Is surgery the best option?Surgery is used only if all other therapies fail and is almost always an elective procedure. Most cases of fungal sinus infections require surgery. The goal of surgery, which is usually performed by an otolaryngologist, or ear, nose and throat (ENT) specialist, is to help the sinuses drain more efficiently, therefore preventing blockages. Most people experience a better quality of life following surgery for sinusitis, but problems sometimes recur. Read the full article

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Sinusitis

Overview

Sinusitis, a term used to describe infection or inflammation of the sinuses, affected nearly 30 million Americans in 2011, according to the United States Centers for Disease Control and Prevention (CDC). Sometimes called “sinus attacks,” sinusitis may be acute (lasting for four weeks or less); subacute (lasting for four to eight weeks); chronic (lasting for more than eight weeks—or for months or years); or recurrent (attacks return several times within one year). Many people use the terms “sinus infection” and “cold” interchangeably. Most cases ofacute sinusitis do follow the common cold, but a cold doesn’t cause the symptoms of sinusitis. Rather, it often sets the stage for sinusitis to develop. Fungal infections, chronic inflammation of the nasal passages caused by allergies, asthma or other conditions, structural problems and a weakened immune system can also cause sinusitis. Your sinuses are four pairs of hollow spaces in your face that surround your nose. Thefrontal sinuses are over your eyes; the maxillary sinuses are inside your cheekbones; the ethmoids are between your eyes, behind the bridge of your nose; and the sphenoids are behind your eyes. Each sinus opens into the nose and is joined with the nasal passages by a continuous mucus membrane lining. This allows mucus and air to travel freely. You feel pain in your sinuses when that free travel is blocked. Each sinus produces its own pain when infected. For example, if your maxillary sinuses are infected, your jaw and teeth might hurt and your cheeks might be tender. Your nose might hurt or be stuffy or you could lose your sense of smell if your ethmoid sinuses are inflamed. Pain in your forehead or headache might indicate a problem with your frontal sinuses. Your sphenoid sinuses, which are the least frequently affected sinuses, can cause earaches, neck pain and a headache in the top of your head.

Diagnosis

Typically, a cold lasts no more than seven to 14 days and goes away without treatment. However, when symptoms persist or don’t respond to over-the-counter decongestants, this suggests that a bacterial infection has developed. Acute bacterial sinusitis can clear up on its own after several weeks. Antibiotic treatment is often used to decrease the duration and severity of sinusitis-associated symptoms. As with all medical conditions, proper diagnosis is important before starting treatment. To diagnose sinusitis, a health care professional will typically take a medical history, examine the inside of your nose and examine your sinuses by gently pressing on them to see if they are painful or swollen. During the history, the health care professional will give special attention to previous episodes of sinus infections, asthma, allergies or other upper respiratory tract conditions. He or she may order a computerized tomography (CT) scan, a type of X-ray, of the sinuses. Hallmark symptoms of sinusitis include: pain in the cheeks, forehead or around the eyes (often, these areas are painful to the touch), upper jaw, teeth, neck, ears or deep pain at the top of your head headache in the morning puffy, swollen eyelids and tissue around the eyes nasal stuffiness and congestion to the point that you can’t breathe greenish mucus post-nasal drip cough (which may get worse at night) runny nose sore throat slight fever weakness fatigue loss of sense of smell Fever of greater than 103 degrees Fahrenheit, pain or swelling, red cheeks, redness around your eyes, severe headaches, confusion or a stiff neck are symptoms that need immediate attention by a health care professional. Chronic sinusitis is a common problem for people with allergies or asthma. Chronic sinusitis is usually characterized by sinus inflammation that persists for eight weeks or more. Chronic sinusitis can be caused by a variety of different things including: a blockage of the sinus openings due to allergic disorders of the nose or structural blockage, like a deviated nasal septum problems with the movement of mucus a weakened immune system asthma allergies Allergies and infections contribute to chronic sinusitis by keeping the sinus membranes inflamed. Because of the swelling and inflammation, the sinus membranes thicken and exacerbate the obstruction and infection. The symptoms of sinusitis may also be triggered by exposure to strong-smelling chemicals, cigarette smoke, pollution, dust, mold or even strong perfume in susceptible individuals. Structural disorders of the respiratory tract may also cause chronic sinusitis. For example, narrow drainage passages in your nose, a deviated septum or nasal polyps (growths that block the sinus passages) can all contribute to the condition. During an examination, a health care professional should carefully assess any anatomical abnormalities that could be causing chronic sinusitis. Nasal polyps are typically noncancerous, but they can cause obstruction. Nasal steroids will often reduce the size of the polyps, but when obstruction persists, they may need to be removed. A variety of cancerous growths, although rare, are possible and require immediate treatment. They can cause nasal obstruction or bloody nasal discharge.

Treatment

Often, acute sinusitis clears up after several weeks without treatment. You might be able to “wait it out” and find relief from your symptoms using over-the-counter (OTC) medications. There are many from which to choose, depending on your symptoms. OTC medications available for sinusitis symptoms are designed to unblock nasal passages and reduce congestion, as well as relieve sinus pain and pressure. These medications include: nonmedicated nasal sprays, such as saline solution medicated nasal sprays that contain a decongestant decongestant oral medications decongestant-combination products, which contain a pain reliever and a decongestant antihistamine medications Prescription-only medications include: Nasal corticosteroids are prescription medications that include fluticasone propionate (Flonase), beclomethasone (Beconase AQ), triamcinolone acetonide (Nasacort AQ), budesonide (Rhinocort) and mometasone (Nasonex). These medications reduce secretions and swelling in the nose and may have a beneficial effect on preventing and treating sinusitis. OTC saline nasal sprays are often the first-line treatment and prevention used to decrease congestion and wash away bacteria. They are not habit-forming. You can buy them in drugstores or make your own using 1/2 teaspoon salt and 8 ounces of warm tap water. Use twice a day, using an ear bulb syringe to irrigate each nostril with half the solution. OTC nasal decongestant sprays relieve swollen nasal membranes almost immediately after they are used. They are effective in helping to keep nasal passages clear in the early stages of a cold. However, they shouldn’t be used for more than five days because they could cause chronic irritation or dependency. Oral decongestants, such as pseudoephedrine (Sudafed), relieve nasal swelling pressure and congestion, but they don’t treat the cause of the inflammation. Some oral decongestants are packaged in combination with other pain relievers. Side effects of decongestants include high blood pressure, nervousness, sleeplessness and dizziness. Check the label for potential side effects and discuss any special conditions you may have, such as thyroid disorder or diabetes, with your health care professional before taking a decongestant. Antihistamines dry you up and relieve the itchiness and drainage common to sinusitis, but not the sinus congestion. OTC antihistamines may cause drowsiness or grogginess. Antihistamine-decongestant combinations relieve multiple symptoms of congestion and drainage and reduce the side effects of both. Nonmedical approaches may prove helpful in alleviating sinusitis symptoms in the short term. These include the use of steam inhalants, such as taking a steam shower, increasing the amount of fluids you drink, using humidifiers during winter and using saline nasal sprays. OTC medications will often relieve your symptoms and may cure a sinus infection, if you’ve developed one. If symptoms persist for more than seven days despite OTC decongestant medications, you may have developed a bacterial sinus infection. In this case, antibiotics are often prescribed to reduce the severity of symptoms, decrease the duration of symptoms and prevent serious complications. Antibiotics prescribed by a health care professional are not necessary to cure a sinus infection but do provide some benefit over decongestant therapy alone. Sinus infections are typically treated with the following antibiotics: amoxicillin (Amoxil, Augmentin, others) trimethoprim-sulfamethoxazole (Bactrim, Septra, others) doxycycline (Doryx, Monodox, others) erythromycin (ERYC, EryPed, others) fluoroquinolones (Levaquin, Avelox, others) cephalosporins (Ceclor, Ceftin, others) A 10-day course of treatment is typically recommended for cases of acute sinusitis, but treatment durations may vary. Often, antibiotic treatment for chronic sinusitis or an infection that is resistant to treatment will last three weeks or longer. If your sinusitis is severe, chronic or recurrent, your health care professional might prescribe oral steroids, such as prednisone, to help reduce inflammation. Steroids do have significant side effects, however, so they are only used when other medications have proven ineffective. About 20 percent of patients with chronic sinusitis develop nasal polyps, which are growths that block the sinus passages. Surgery may be recommended to remove polyps. Short-term use of an oral steroid may reduce the size of polyps, and these steroid treatment “bursts” can also be used after sinus surgery to reduce the need for a repeat surgical procedure. Nasal steroid sprays are the most effective treatment for chronic suppression of polyps’ size and regrowth. Nasal polyps often regrow even after surgery. Discuss your options with a health care professional if you are diagnosed with this condition. Surgery If all other therapies fail, surgery may be recommended. Failure of previous treatments suggests a difficult case of sinusitis, and surgery, too, may fail. Surgery is usually reserved for patients whose symptoms do not go away after three months of treatment or in people who have more than two or three episodes of acute sinusitis each year. And most cases of fungal sinus infections require surgery. The goal of surgery, which is usually performed by an otolaryngologist, or ear, nose and throat (ENT) specialist, is to help the sinuses drain more efficiently, therefore preventing blockages. Specific surgical procedures may involve enlarging the natural openings of the sinuses, removing nasal polyps or correcting any structural problems that may be blocking the sinuses. Most people experience a better quality of life following surgery for sinusitis, but problems sometimes recur.

Prevention

Because the most common cause of sinusitis is allergic or nonallergic rhinitis, the first step in prevention should be seeing a health care professional and defining your allergic triggers so you can avoid those factors. In most cases, good medical management controls the frequency and severity of sinusitis. After that, the trick to preventing a cold from turning into sinusitis is to keep your sinuses as clear as possible. Here are a few ways to do this. Use an oral decongestant for a limited time or a nasal spray decongestant for no more than five days. Use nasal saline to flush impacted secretions and rinse the sinus passages. Block one nostril while blowing through the other when blowing your nose. Drink a lot of water. Avoid caffeine and alcohol. Avoid air travel. Do not smoke cigarettes. If you have allergies: Avoid contact with things that may trigger allergy attacks, such as pet dander, dust, pollen, mold and pillows, as well as irritants such as perfume and cigarette smoke, which could inflame your sinuses. Seek allergy advice to reduce allergen exposure. Consider proper medical treatment, including allergy immunotherapy, to reduce the likelihood of recurring sinusitis.

Facts to Know

Sinusitis affected nearly 30 million Americans in 2011, according to the U.S. Centers for Disease Control and Prevention. Your sinuses are four pairs of hollow spaces in your face that surround your nose. The frontal sinuses are over your eyes; the maxillary sinuses are inside your cheekbones; the ethmoids are between your eyes, behind the bridge of your nose; and the sphenoids are behind your eyes. Each sinus is joined to the nasal passages by small openings with a continuous mucous membrane lining through which mucus and air travel freely. You feel pain and congestion in your sinuses when that free travel is blocked or impeded by swollen membranes. Although each sinus produces its own distinct pain when infected, most people with inflamed sinuses report having pain in several locations and symptoms that don’t point to one particular sinus cavity. Acute bacterial sinusitis is a short-term condition that begins suddenly, usually about a week into a cold. If cold symptoms last more than one to two weeks, the cold may have turned into a bacterial sinus infection. If you have frequent episodes of acute sinusitis or if your symptoms never completely go away, you might have chronic sinusitis, which is characterized by sinus inflammation that persists for months or years. Symptoms of chronic sinusitis may not be much different than those of acute sinusitis. Symptoms of chronic sinusitis typically last longer and don’t involve a fever. Sinusitis can be exacerbated by strong-smelling chemicals, cigarette smoke, pollution, dust, mold or even strong perfume. And allergies and infections contribute to chronic sinusitis by keeping the sinus membranes inflamed. Another possible cause of chronic sinusitis may be structural. If you have narrow drainage passages in your nose, a deviated septum or nasal polyps, medications will only temporarily alleviate your symptoms. Often, acute sinusitis clears up on its own after several weeks. You might be able to “wait it out” and find relief from your symptoms using over-the-counter medications and not use antibiotics.

Key Q&A

How can I tell the difference between a cold and sinusitis?A cold that doesn’t go away in a week or two may have developed into sinusitis. If you have sinusitis, you will have unusually thick nasal or postnasal drainage that is yellowish-green; a cough (which might get worse at night); pain in your cheeks, forehead and around your eyes; a headache; and maybe a fever. How do I know if I have chronic sinusitis or acute sinusitis?After taking a medical history and conducting a physical examination, a health care professional should be able to diagnose whether you have acute or chronic sinusitis. You might have nasal polyps or a deviated septum, which are causing the sinusitis. But generally speaking, if you have frequent episodes of acute sinusitis or if your symptoms never completely go away, you probably have chronic sinusitis. If you have symptoms and sinus inflammation that persists for seven to 14 days or more, you should see a health care professional. What causes chronic sinusitis?Chronic sinusitis can be caused by a variety of things, including a blockage of the sinus openings, problems with the movement of mucus or a weakness in the immune system. It can become a vicious circle. An allergy or an infection (a cold, for example) can inflame your sinuses. Because of the inflammation, the sinus membranes get thicker, causing more of a blockage. Eventually, your sinuses may be blocked completely. Noxious chemicals, cigarette smoke, pollution, dust, mold and even strong perfume can exacerbate sinus symptoms. Another possible cause of chronic sinusitis may be structural. If you have narrow drainage passages in your nose, a deviated septum or nasal polyps, medications will only temporarily alleviate your symptoms. Is surgery the best option?Surgery is used only if all other therapies fail and is almost always an elective procedure. Most cases of fungal sinus infections require surgery. The goal of surgery, which is usually performed by an otolaryngologist, or ear, nose and throat (ENT) specialist, is to help the sinuses drain more efficiently, therefore preventing blockages. Most people experience a better quality of life following surgery for sinusitis, but problems sometimes recur.

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