Evaluation of a Novel External Neuromodulation Device (iCLEAR™) for the Acute Relief of Rhinitis and Rhinosinusitis Symptoms
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Purpose: To evaluate the efficacy and safety of a novel portable sonic external neuro-stimulation device (iCLEAR) in alleviating symptoms of chronic rhinitis and rhinosinusitis.Keywords:
Neuromodulation
Chronic Rhinosinusitis
Abstract Puncture and lavage of the maxillary sinuses is a common procedure in ENT practice. Repeated irrigations are required in chronic sinusitis refractory to treatment. In our department we use a No. 14 gauge Braunula® for such cases. Over 100 patients have been treated over the past two years with no significant complications. This device is inexpensive, sterile, safe and easy to use and we recommend its use for patients with chronic maxillary sinusitis requiring repeated irrigations.
Therapeutic irrigation
Chronic Rhinosinusitis
Chronic sinusitis
Refractory (planetary science)
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Sinusitis, in general is a significant and increasing health problem resulting in a large financial burden in South Africa and to society in general. Increasing antibiotic resistance is a major problem with no new antibiotics on the immediate horizon and poor & inappropriate antibiotic usage amplifying this burden. Correct dosages of antibiotics are often not covered in formularies whereas inappropriate formulations of antibiotics and other inappropriate medications often are. The “Updated guideline for the management of upper respiratory tract infections in South Africa: 2008”, clearly defines the treatment of the various forms of sinusitis, with appropriate antibiotics, where required, and their dosages clearly laid out1. This guideline appears to be poorly applied in general. Inappropriate use of other non-antibiotic, especially over the counter treatments adds considerably to these issues especially costs2.
More important though is that accurate diagnosis is an absolute essential for treatment of the various forms of sinusitis.
Rhinitis and sinusitis usually coexist and are concurrent in most; the correct terminology is now rhinosinusitis.3
Guideline
Chronic Rhinosinusitis
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Chronic Rhinosinusitis
Confusion
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Chronic Rhinosinusitis
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Background: Long-term treatment with low to moderate dosages of the antimetabolite and antifolate medication methotrexate (MTX) has been shown to be effective, safe, and well-tolerated for a wide range of autoimmune diseases.As a result, methotrexate may be used to treat vitiligo and other autoimmune disorders.The hepatotoxic and hematologic side effects of the drug's topical formulations, which were developed for the treatment of localized lesions, were deemed to be clinically insignificant.Objective: This review article aimed to assess the possible role of topical methotrexate in the management of vitiligo.Methods: Methotrexate, and the vitiligo were all looked for in PubMed, Google scholar, and Science direct.References from relevant literature were also evaluated by the authors, but only the most recent or complete studies from January 2005 to May 2021 were included.Due to the lack of sources for translation, documents in languages other than English were ruled out.Papers that did not fall under the purview of major scientific investigations, such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations, were omitted.Conclusion: Topical methotrexate use could be an effective and safe treatment modality of vitiligo.
Vitiligo
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Rhinosinusitis is a common illness that represents a substantial economic burden. The vast majority of cases resolve spontaneously but a small proportion develops a secondary bacterial infection. Accurate diagnosis of rhinosinusitis depends upon clinical assessment. Isolation of the causative agents must be considered in cases failing initial treatment.This up-to-date review defines the anatomy, pathogenesis, phases of rhinosinusitis, the unique microbiology of each type of rhinosnusitis (acute and chronic, acute exacerbation, nosocomial, rhinosinusitis in immunocompromised host, and rhinosinusitis of ododental origin), clinical features, diagnosis, and treatment.The reader will gain understanding of the above issues and logic for choosing the appropriate treatment for each condition of rhinosinusitis.The proper choice of antibiotic therapy depends on the probable infecting pathogens, bacterial antibiotic resistance and antibiotics' pharmacologic profiles. In addition to antibiotics, adjuvant therapies and surgery are used in the management of bacterial sinusitis. Accurate diagnosis and careful consideration when choosing therapy for rhinosinusitis will optimize the chances of achieving an early recovery and avoiding complications.
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We discuss the care of patients failing the typical medical and surgical management for chronic rhinosinusitis who need further evaluation to rule out various mimics of sinus disease and other disorders that may require specific treatment plans. We also look at the many treatment options for the recalcitrant sinusitis patient recently published.Work-up of diseases such as gastroesophageal reflux, dental infection and immunodeficiency in the chronic rhinosinusitis patient are discussed. There have been multiple treatment options evaluated in the literature in the past year, including long-term macrolide therapy and various antibiotic, antifungal, and surfactant irrigations. Recommendations regarding these therapies are discussed.Patients with recalcitrant chronic rhinosinusitis offer a significant challenge to the otolaryngologist. This review provides a structured look at both diagnosing and treating the disease processes in these patients, with recently published literature presented.
Chronic Rhinosinusitis
Chronic sinusitis
Disease management
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Objective: To study the efficacy of the endoscopic surgical treatment of sinusitis.Methods: From January 1,2007 to December 31,2008,100 cases of patients with sinusitis and nasal polyps underwent endoscopic surgery and were followed up for 1 year,the therapeutic effect was observed and the results were analyzed.Results: Among 100 patients,75 patients(75.00%) were cured,20 patients(20.00%) were improved,5 patients(5.00%) were ineffective,no serious postoperative complication was observed.Conclusion: The endoscopic sinusitis surgery can achieve good results,has less complications and good clinical practice.
Nasal Polyps
Chronic sinusitis
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Sulfamethoxazole
Trimethoprim
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Objective:To investigate the clinical effect of operative treatment in patients with chronic rhinosinusitis with nasal polypsis.Meth ods:The clinical data of 154 patients with chronic rhinosinusitis with nasal polypsis in 2010 ～2012 were retrospectively analyzed.Results:The time of surgery,hospitalization and blood loss of observation group were significantly less than control group,and all the patients were followed-up for 9.6±3.5 months,58 cases of patients were cured(60.4%),32 cases effective(33.4%),6 cases ineffective(6.2%)in the observation group.The total effect rate,complications and recurrence of observation group were 93.8%,3.1% and 1.0% respectively,significantly better than that of control group(P0.05).Conclusion :The method of operative treatment in treating chronic rhinosinusitis with nasal polyp sis has a good effect and virtue of safe and less complication,deserve to clinical.
Chronic Rhinosinusitis
Nasal Polyps
Clinical efficacy
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