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How long will a bacterial sinus infection last,how to get rid of a red cold sore,how to remove white residue from baby tongue kiss - 2016 Feature

Upper respiratory tract infections range from common, benign processes, such as nasopharyngitis, to uncommon, potentially lethal processes, such as epiglottitis.
Upper respiratory tract infections typically occur after insults to host defenses—such as allergic rhinitis, chemical irritation, trauma, and, especially, viral respiratory tract infections— that impair ciliary function and produce increased volumes of thin secretions and mucosal edema that block the narrow channels draining the sinuses and middle ear. Although infections of the paranasal sinuses are common, they are greatly overdiagnosed by patient and physician.
Nosocomial sinusitis occurs as a complication of nasotra-cheal intubation or, less often, the use of nasoenteric feeding tubes.4 Unexplained fever may be the presenting symptom, and computed tomography scanning is often required for diagnosis if the patient cannot localize the pain. Frontal sinusitis produces pain and tenderness over the lower forehead and purulent drainage from the middle meatus of the nasal turbinates. Acute sinusitis The diagnosis of acute sinusitis can usually be established on clinical grounds. Because of technical difficulties in obtaining valid cultures, the bacteriology of sinusitis has been incompletely defined. Functional Endoscopic Sinus Surgery (FESS) is one of the most challenging operations for the Otolaryngologist (ear, nose and throat surgeon) to perform.
The earliest age at which endoscopic sinus surgery should be performed is usually late teens. General anesthesia is preferred for endoscopic sinus surgery; it is very important that patients are asleep during this procedure as patients will not be able to tolerate twilight or IV Sedation anesthesia. The Seattle Sinus Surgery Center has many patients traveling from throughout the Pacific Northwest, Eastern Washington and from around the country. Additional time will be spent with out office manager and patient care coordinator to discuss scheduling, preauthorization of medical insurance and with our nurse for the pre operative appointment. When patients have sinus surgery, there are certain medical and laboratory tests that may need to be ordered prior to any outpatient surgery. The recovery period from endoscopic sinus surgery lasts approximately two weeks after the surgery. Medications: It is important to avoid certain medications prior to any surgery, especially the endoscopic sinus surgery. Smoking: It is important to stop smoking two weeks prior to the surgery since it can delay healing in the sinuses. Patients should avoid drinking or eating anything by mouth from midnight the night before the sinus surgery prior to undergoing sinus surgery – a mandate of anesthesia physicians. Patients should come to the surgery center in very comfortable clothing such as sweats and a front closure top. Patients will also meet with the anesthesiologist from Swedish Medical Center during the preoperative visit on the morning of the surgery. Patients recovering from their endoscopic sinus surgery typically take at least two weeks for the swelling to come down on the inside of the nose.


There are a few complications that can occur with endoscopic sinus surgery; there is a one in a thousands chance of having a severe nosebleed and if this should occur, Afrin is applied to the nose.
Mechanical defenses tend to prevent penetration by organisms from the nasopharynx and oral cavity into more vulnerable areas.
Barotrauma, which results from a rapid change in atmospheric pressure, can intensify upper respiratory tract problems, particularly in patients with rhinitis, otitis, or sinusitis. The proximity of upper airway structures to the central nervous system and the presence of abundant vascular channels connecting the two account for some of the most severe complications. Acute sinusitis is characterized by nasal congestion, purulent nasal discharge, fetid breath, facial pain that typically increases when the patient stoops forward, and, often, fever and other systemic symptoms.
Nose blowing propels nasal fluid into the sinuses, potentially introducing viscid fluid and bacteria that can lead to sinusitis.3 Nasal polyps, deviation of the nasal septum, or hypertrophied adenoids may predispose to purulent sinusitis by obstructing sinus drainage.
Frontal sinusitis and maxillary sinusitis are most common in adults; ethmoiditis is most common in children. They are uncommon pathogens in acute infections but are common pathogens in chronic sinusitis and otitis, as well as in abscesses, soft tissue infections, and periodontal infections; aerobic pathogens participate synergistically in most of these processes.
Such fungi as As-pergillus, Mucor, and Rhizopus species produce invasive sinusitis in patients with leukemia or poorly controlled diabetes10,11 and, occasionally, in normal hosts.10 In immunocompromised patients, sinusitis may also be caused by Candida, Alternaria, Pseudomonas, Nocardia, Legionella, atypical mycobacteria, and certain parasites.
Portuese is Board Certified in Otolaryngology, head and neck surgery (ear, nose and throat surgery) and his expertise in the sinus area is extensive with over 25 years of experience – performing thousands of functional endoscopic sinus surgeries. Portuese and if the patient decides to proceed with endoscopic sinus surgery there will also be a preop appointment with one of our nurses, schedule with three weeks of the surgery date. Portuese will review with the patient the surgical plan of what is going to be performed that day, prior to the induction of anesthesia. Portuese at The Seattle Sinus Surgery Center is a very rewarding experience for both the surgeon and the patient. These regions are normally teeming with a variety of microbial flora, and many potential pathogens can temporarily colonize these epithelial surfaces without causing true infection [see Table 1].
In addition, the numerous fascial planes of the head and neck provide potential spaces where infection can become sequestered. In most patients, acute sinusitis responds well to medical therapy; in a few persons, however, chronic sinusitis may result. Cigarette smoke and overuse of topical decongestants impair ciliary action and alter the mucous blanket, predisposing to sinusitis. Sinus punctures reveal that the most common pathogens in acute sinusitis are Haemophilus influenzae, pneumococci, streptococci, and Moraxella catarrhalisF Staphylococcus aureus has been isolated in nasal cultures from some patients with acute sinusitis, but the organisms are probably contaminants rather than the true causative agents. In addition, local immunologic defenses attempt to deal with organisms that have breached the mechanical barriers; such defenses include abundant lymphoid tissue, secretory IgA antibodies in respiratory secretions, and a rich vasculature that can rapidly deliver phagocytic leukocytes.
Furthermore, because the upper airway is narrow, infection in the neck may compromise the patency of the airway itself.


Chronic sinusitis is characterized by purulent discharge, usually without fever, that persists for weeks or months. Contributing factors may include rapid changes in altitude, trauma, in-tranasal foreign bodies or tumors, cocaine abuse, and such systemic processes as cystic fibrosis and Kartagener syndrome (situs inversus, bronchiectasis, and sinusitis). As a result, the microbiology laboratory faces the challenge of isolating potential pathogens from the normal mouth flora, and the clinician faces the challenge of distinguishing between the carrier state and active infection. Finally, immunosup-pression renders persons vulnerable to unusual pathogens and unusual complications.
Factors that predispose to chronic sinusitis include inadequately treated bacterial infections, long-term impairment of mucociliary clearance, obstruction of sinus drainage, and allergies and asthma. Patients with eth-moidal sinusitis complain of retro-orbital pain and may have pain, tenderness, and even erythema over the upper lateral aspect of the nose. Radiologic studies are essential in the diagnosis of severe, refractory, nosocomial, or complicated cases of sinusitis but are not necessary in routine cases. Portuese will presecribe a moderate strength pain reliever such as Vicodin, during the first two to three weeks in the postoperative phase. A respiratory epithelium, composed of ciliated columnar cells, goblet cells, and mucous and serous glands, lines the paranasal sinuses, the middle ear, and the airway below the epiglottis. The anterior ethmoidal cells drain through the middle meatus, whereas the posterior cells drain through the superior meatus.
Portuese’s surgery center is called The Seattle Sinus Surgery Center and is a Medicare Certified Ambulatory Surgery Center located at 1101 Madison Street, Suite 1280. Portuese has performed this procedure on professional chefs and winemakers which has literally changed their careers because they had no idea they had lost their sense of smell.
Isolated sphenoid sinusitis, which occurs in only 3% of patients with sinusitis, is often misdiagnosed. Because these areas are inaccessible for routine culture, it is often necessary to diagnose and treat infections on the basis of clinical findings and statistical probabilities [see Table 1] rather than on the basis of bacteriologic data derived from an individual patient. This disorder has traditionally been considered to cause pain at the occiput or vertex; in fact, frontotemporal, retro-orbital, or facial pain is more common.
Medications, including some prescription drugs, vitamins and herbal supplements all contain elements that thin the blood and interfere with anesthesia. All tissues blocking sinus drainage are conservatively removed through the functional endoscopic sinus surgery techniques.



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23.11.2014, author: admin


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