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2 July 2023

Influenza or the common cold, what is the difference?

christine Uncategorized, ENT > NOSE, Pediatric ENT, Sinusitis, ENT > PEDIATRIC ENT, Ear Nose Throat (ENT)

Influenza is an acute disease of the respiratory system that occurs every year from autumn and the peak period for influenza in the northern hemisphere extending from November to March. It is caused by viruses and can affect people of all ages.

The symptoms of the flu usually begin suddenly and include:

Fever (usually high)
Pain in the joints and muscles, but also around the eyes
Generalized weakness
Pale skin and red, moist eyes
Headache
Dry cough
Sore throat and watery discharge from the nose (runny nose) or nasal congestion (bloating)
Vomiting or diarrhea, especially in children
What is the incubation period of the flu in adults?

The incubation period is the time between exposure to the virus and the onset of symptoms of the disease. The incubation period for the flu is from two to four days.

Is it Influenza or the common cold?

Influenza or Common Cold?

The common cold is a mild infection often caused by a virus, different from those of the flu.

Separating the symptoms of the common cold from those of the flu can sometimes be difficult, but, in general, people with a common cold, runny or stuffy nose are more common symptoms.

While people with the flu:

have sudden onset of symptoms
they appear very sick
feel very weak
have a higher fever
have body aches
fatigue
dry cough

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19 May 2023

Immunotherapy for Allergies of Respiratory Tract

christine Allergic Rhinitis, Allergy, ENT > NOSE Post a Comment

Immunotherapy treatment is based on a century-old concept that the immune system can be desensitized to specific allergens that trigger allergy symptoms. These symptoms may be caused by allergic respiratory conditions such as allergic rhinitis and asthma.

Immunotherapy can potentially lead to lasting remission of allergy symptoms, and it may play a preventive role in terms of development of asthma, nasal polyps and new allergies.

The Immunotherapy Process

Immunotherapy for allergic rhinitis

Sublingual immunotherapy has emerged as an effective and safer alternative to the subcutaneous route for both seasonal and perennial disease. Sublingual immunotherapy has also been shown to have long-term benefits has the big advantage of self-administration in the patient’s home.

What is the treatment duration?

Most patients will require 3-5 years of treatment to ensure good long term remission of allergies

How do I know treatment is effective?

The first results are visible after completing the first year of treatment. The best measure of successful treatment is the reduction in symptoms and the need for nasal sprays and antihistamines.

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17 May 2023

The Nose

christine ENT > NOSE Post a Comment

The nose is a complex organ with multiple functions:

The nose forms the beginning of the respiratory tract,
It receives olfactory stimuli,
The Nose
It contributes to the formation of voice and speech, and
It participates in the induction of various physiological reflexes.

5 May 2023

Snoring and Sleep Apnea

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What is snoring?

Snoring and Sleep Apnea

Snoring is the hoarse or harsh sound that occurs when breathing is obstructed in some way while sleeping. Sometimes snoring may indicate a serious health condition. In addition, snoring can be a nuisance to your partner. Snoring is due to incomplete obstruction of the upper airway.

Many habitual snorers have complete episodes of upper airway obstruction where the airway is completely blocked for a period of time, usually 10 seconds or longer. This silence is usually followed by snorts and gasps as the individual fights to take a breath. When an individual snores so loudly that it disturbs others, obstructive sleep apnea is almost certain to be present.

Unlike simple snoring, obstructive sleep apnea (OSA) is a potentially life-threatening condition that requires medical attention.

Causes of snoring and sleep apnea:

The following conditions can affect the airway and cause snoring:

Mouth anatomy. Having a low, thick soft palate or enlarged tonsils or tissues in the back of the throat (adenoids) can narrow the airway. Likewise, if the triangular piece of tissue hanging from the soft palate (uvula) is elongated, airflow can be obstructed and vibration increased.
Neck circumference. People with a thicker neck may have a narrower airway.
Being overweight. Extra weight can build up in the throat and contribute to narrowing of the airway.
Being male. Men are twice as likely to have sleep apnea. However, women increase their risk if they’re overweight, and their risk also appears to rise after menopause.
Being older. Sleep apnea occurs significantly more often in adults older than 60.
Alcohol consumption. Snoring can also be brought on by consuming too much alcohol before bedtime. Alcohol relaxes throat muscles and decreases the natural defenses against airway obstruction.
Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking may increase the amount of inflammation and fluid retention in the upper airway. This risk likely drops after you quit smoking.
Nasal problems. Chronic nasal congestion or a crooked partition between the nostrils (deviated nasal septum) may contribute to snoring.
Allergies.

Sleep apnea is considered a serious medical condition.

Complications may include:

High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. If you have obstructive sleep apnea, your risk of high blood pressure (hypertension) is greater than if you don’t. The more severe your sleep apnea, the greater the risk of high blood pressure. However, obstructive sleep apnea increases the risk of stroke, regardless of whether or not you have high blood pressure..
Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and irritability. You may have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. You may also feel irritable, moody or depressed. Children and adolescents with sleep apnea may do poorly in school or have behavior problems.
Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea may be more likely to experience complications following major surgery because they’re prone to breathing problems, especially when sedated and lying on their backs.
Heart problems due to Sleep apnoea
Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring.
Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It’s not uncommon for a partner to go to another room, or even on another floor of the house, to be able to sleep. Many bed partners of people who snore are sleep-deprived as well.

Results of prolonged sleep apnoea

People with sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, a need to urinate frequently at night (nocturia), and a decreased interest in sex.

Children with untreated sleep apnea may be hyperactive and may be diagnosed with attention-deficit/hyperactivity disorder (ADHD).

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5 May 2023

Nose- bleeds/ Epistaxis

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60% of the general population has had at least one episode of a bleeding nose. Nose-bleeds can occur at any age but are most common in children aged 2 to 10 years and adults aged 50 to 80 years.

Nose-bleeds can be dramatic and frightening. Luckily, most nose-bleeds are not serious and can be handled fairly easily. They are divided into two types, depending on whether the bleeding is coming from the anterior (front of the nose) or posterior (back) of the nose.

Anterior nosebleeds make up more than 90% of all nosebleeds. The bleeding usually comes from a blood vessel at the very front part of the nose. Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a doctor.

Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually comes from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

Causes of Nose-Bleeds

Allergic rhinitis
An object stuck in the nose
Barotrauma
Blowing the nose very hard
Chemical irritants
Direct injury to nose, including a broken nose
Hereditary hemorrhagic telangiectasia
Nose picking
Overuse of decongestant nasal sprays
Repeated sneezing
Surgery on the face or nose
Taking large doses of aspirin or blood-thinning medicine
Upper respiratory infection
Very cold or very dry air

Repeated nosebleeds may be a symptom of another disease such as high blood pressure, allergies, a bleeding disorder, or a tumor of the nose or sinuses

Treatment

Home treatment for Nosebleeds
A small amount of bleeding from a nosebleed requires little intervention.

To stop a nosebleed:

Remain calm.
Sit up straight.
Lean your head forward. Tilting your head back will only cause you to swallow the blood.
Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier.
Spit out any blood in your mouth. Swallowing it may make you vomit.

After the bleeding has stopped

Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours.
Ice packs may help.
Exposure to dry air, such as in a heated home in the winter, can contribute to the problem.
Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.
If the bleeding does not stop then medical intervention is required by an ENT surgeon, as nasal packing or cauterization may be required in order to stop the

Management of Nose-Bleeds

bleeding.

Seek medical care immediately if:

The bleeding lasts for more than 20 minutes
The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose

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15 March 2023

Acupuncture for Allergic rhinitis

christine Allergic Rhinitis, Allergy, ACUPUNCTURE > UPPER AND LOWER RESPIRATORY INFECTIONS, ENT > NOSE Post a Comment

Spring has arrived bringing along renewal and the need to get out and enjoy nature. Spring for some people though, who suffer from allergic rhinitis, is a very difficult season, as it puts them in a constant challenge with the circulating allergens that cause them irritating symptoms.

Allergic rhinitis, also called hay fever, is an allergic reaction that causes sneezing, congestion, itchy nose and sore throat. Pollen, pet dander, mold and insects are the allergens responsible for these symptoms.

When do people get allergic rhinitis?

These symptoms can occur at any time of the year. Seasonal allergies occur in the spring, summer and early fall when trees and weeds bloom and pollen counts are higher. Perennial allergies can happen year-round. They result from irritants that are always around, such as pet dander, cockroaches and dust mites.

How is Hay Fever Treated?

Acupuncture for Allergic Rhinitis

The goal of treatment is to achieve maximum symptomatic relief with as few side effects as possible. The most practical and effective treatment is based on avoiding allergens and alleviating symptoms with drugs, such as corticosteroids, decongestants, antihistamines etc.

Acupuncture: allergic rhinitis can be treated with acupuncture as it can relieve symptoms, starting from the first session. This holistic therapy can also increase the intervals between flare-ups.

If there is a seasonal distribution of the disease, it is advisable to repeat the treatment protocol before the onset of symptoms, but with fewer acupuncture sessions.

This ancient method strengthens the body’s immune system as a whole, thus helping it to react better to allergenic stimuli.

References

Small, P., Keith, P.K. & Kim, H. Allergic rhinitis. Allergy Asthma Clin Immunol 14 (Suppl 2), 51 (2018).
McDonald JL, Smith PK, Smith CA, Changli Xue C, Golianu B, Cripps AW; Mucosal Immunology Research Group. Effect of acupuncture on house dust mite specific IgE, substance P, and symptoms in persistent allergic rhinitis. Ann Allergy Asthma Immunol. 2016 Jun;116(6):497-505.
Chen YD, Jin XQ, Yu MH, Fang Y, Huang LQ. Acupuncture for moderate to severe allergic rhinitis: A non-randomized controlled trial. Chin J Integr Med. 2016 Jul;22(7):518-24.
Wen CY, Liu YF, Zhou L, Zhang HX, Tu SH.
A Systematic and Narrative Review of Acupuncture Point Application Therapies in the Treatment of Allergic Rhinitis and Asthma during Dog Days. Evid Based Complement Alternat Med. 2015;2015:846851.

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10 February 2023

Nasal spray, the corticosteroids are not the problem.

christine Allergic Rhinitis, ENT > NOSE, Pediatric ENT, ENT > PEDIATRIC ENT

A runny nose and a blocked nose are the most common symptoms of a common cold, which afflict many of us, especially in the winter months. An easy solution, albeit a temporary one, is the use of a decongestant nasal spray. In fact, a medical prescription is not even required in order to purchase one in Greece and in most countries of the world.

What we need to know about these sprays, in order to get the best result but also to avoid unpleasant side effects and problems:

The use of decongestant spray should not be more than 7 days!
Decongestant sprays work by causing the blood vessels in the nose to constrict causing the inside lining to shrink, thus, breathing becomes easier.
Simultaneously, the glands that produce the mucus also contract, therefore, secretion also decreases.
Blocked Nose.Nasal Spray

However, prolonged use of nasal spray can have unpleasant effects, the main of which are:

Addiction: A larger and larger dose is required, for the same effect, while without a spray, the nose is always blocked.
Rebound effect: When, finally, the use is stopped, the nose is more clogged than before.
Medicinal rhinitis: Prolonged or chronic use, due to the disturbance of blood supply, causes serious damage to sensitive mucosal cells.

Are cortisocosteroid nasal sprays dangerous?

Nasal sprays that contain only corticosteroids do not cause immediate decongestion, so there is no point in using them for colds or other acute inflammations of the nose. These sprays are indicated in chronic rhinitis or sinusitis and nasal polyps, where they relieve or, often, control chronic inflammation.

The continuous use of sprays containing only cortisocosteroids is allowed, and for very long periods of time, always with the guidance of a specialist doctor. The reason is that the medicine they contain is absorbed into the circulation in zero or negligible amounts, hence, our nose gets cortisone but not us! Thus, the serious side effects of chronic cortisone use, such as hypertension, diabetes, osteoporosis, etc., are not caused.

At the same time, cortisone, when used topically in the nose, does not cause addiction and medicinal rhinitis, as with decongestants.

In conclusion, we should emphasize that it is not nasal sprays containing cortisone that are dangerous for prolonged use, but those containing decongestants!

How should nasal spray be used?

Decongestant sprays are typically used 3 or 4 times a day, for 3 to 5 days.
Cortisone sprays are used in therapeutic regimens longer than one month, usually 3-6 months (always according to the doctor’s instructions).
Before the first use, it is recommended to spray into the air, so that the dosing vial is filled and the correct dose is administered from the first spray.
Before using all sprays, it is good to blow our nose so that it is clear of secretions when it comes into contact with the medicine.
Spraying is more effective if we close the nostril we are not spraying with our finger.

Finally, it is good to avoid inhaling strongly, at the same time as spraying. This causes a large amount of the medicine is drawn towards the pharynx and does not reach the nasal mucosa.

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2 December 2022

Nasal Irrigation

christine ENT > NOSE, Pediatric ENT, ENT > PEDIATRIC ENT, ENT > THE EAR

Got a stuffy nose from allergies or a cold? Nasal irrigation may help. Pouring a saltwater (saline) solution into one nostril will help alleviate the symptoms. As it flows through your nasal cavity into the other nostril, it washes out mucus and allergens. Irrigation can benefit people who have sinus problems, nasal allergies, colds, and even flu symptoms. It can help both adults and kids.

Guidelines to avoid the saline solution during nasal irrigation from seeping into the middle ear and causing ear blockage:

Tilt your head so that one nostril is pointed down toward the sink. Don’t tilt your head back.
Breathe through your mouth, not your nose and say the “K” sound throughout the lavage. This helps the soft palate to protect the opening of the eustachian tube (in the nose), so that the solution does not seep into the middle ear.
You shouldn’t use it, though, if you have an ear infection or a nostril that’s plugged and hard to breathe through.

References

Succar EF, Turner JH, Chandra RK. Nasal saline irrigation: a clinical update. Int Forum Allergy Rhinol. 2019 May;9(S1):S4-S8.
Gallant JN, Basem JI, Turner JH, Shannon CN, Virgin FW. Nasal saline irrigation in pediatric rhinosinusitis: A systematic review. Int J Pediatr Otorhinolaryngol. 2018 May;108:155-162.

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7 June 2021

Treating Allergic Rhinitis

christine Allergic Rhinitis, Allergy, ΕΥ-LLLT, ENT > NOSE, Pediatric ENT, ENT > PEDIATRIC ENT

Allergic rhinitis is a disease that affects many people around the world and 10% in our country. The pathology is multifaceted, thus treating allergic rhinitis has many components.

Treating Allergic Rhinitis

Seasonal allergic rhinitis is a common condition caused by allergies to various allergens. These allergens can be pollen suspended from trees, flowers, grasses or even weeds. Allergens can also be fungal spores. Pollen and spores are abundant in the air at certain times of the year, especially in spring.

Treating Allergic Rhinitis

The main treatments used to treat the symptoms of allergic rhinitis in our specialized center EYiasis are avoidance of allergens, pharmacotherapy, acupuncture, therapeutic intranasal EY-LLLT and alternative therapies such as gemmotherapy and medical essential oils.

In addition, specific immunotherapy is the only treatment, which not only relieves patients’ symptoms, but also neutralizes their causative agents in our body. Immunotherapy is applied after the identification of the allergen, to desensitize the patient.

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13 January 2021

Treatment for Nasal Polyps and Chronic sinusitis

christine Allergic Rhinitis, Allergy, ENT > NOSE, Sinusitis

Chronic rhinosinusitis (CRS) with or without nasal polyps is a common inflammatory disease of the nose and paranasal sinuses that has a significant impact on patients’ quality of life. Nasal blockage, facial pain, headaches, nasal discharge and loss of smell are the main symptoms that trouble these patients.

Treating CRS and its symptoms can sometimes be disappointing and tiresome, so many patients search for alternative medical approaches to relieve their symptoms. EYiasis medical centre provides effective results with a combination of holistic treatments in order to manage chronic rhinosinusitis and the bothersome symptoms.

Acupuncture is an ancient and very effective treatment for ailments of the nasal passages and sinuses. Immediate relief occurs, after a few acupuncture sessions, such as reduction of nasal congestion and pain relief or pressure in the sinuses. Acupuncture has anti-inflammatory and analgesic effects on the body, helping to reduce the inflammation in the sinus cavities and decrease pain levels. Acupuncture also naturally helps with the movement of fluids inside the body, and can assist in the breakdown of congested mucous (1).

EY-LLLT treatment for Nasal Polyps

Adjuvant Low level laser therapy (EY-LLLT) is also implemented in the holistic therapeutic protocol, as EY-LLLT has important therapeutic effects such as biostimulation, anti-inflammatory, anti bacterial and analgetic effecst. Applying EY-LLLT decreases and eventually eliminates nasal inflammation and nasal congestion (2,3,4). Review studies have shown that anti inflammatory effects of low-level lasers are the same as anti inflammatory effects of non-steroidal ant-inflammatory drugs NSAIDs (2). In cases of blockage due to nasal polyps in EY-LLLT causes shrinkage and disappearance of polyps thus improving nasal breathing.

EY-LLLT has been shown to significantly decrease CRS and Nasal Polyps symptoms such as:

Need to blow nose,
sneezing,
runny nose,
post nasal discharge and
thick nasal discharge.

Coughing also decreases and sleep related symptoms such as:

Lack of a good night’s sleep,
Difficulty falling asleep,
Waking up at night,
Waking up tired are significantly improved.

Psychological symptoms also improve significantly as does sense of taste, smell and nasal congestion.

References

1) Pfab F, Schalock PC, Napadow V, Athanasiadis GI, Huss-Marp J, Ring J. Acupuncture for allergic disease therapy–the current state of evidence. Expert Rev Clin Immunol. 2014 Jul;10(7):831-41.

2) Naghdi S, Ansari NN, Fathali M, Bartley J, Varedi M, Honarpishe R. Pilot study into the effect of low-level laser therapy in patients with chronic rhinosinusitis. Physiother theory Pract. 2013;29:596–603.

3) Isser DK, Sett S, Saha BP. The role of laser radiation therapy in maxillary sinusitis: Indian J Otolaryngol Head Neck Surg. 2002;54:208–15.

4) Krespi Y, Kizhner V. Phototherapy for chronic rhinosinusitis. Lasers Surg Med. 2011;43:187–91