Optimizing Diagnosis Medical Treatment and Timing of Surgery

Nasal Turbinates With Infection

The decision to operate is often made when medical treatment has failed or has only provided a small or temporary improvement in the patient's symptoms. This does not mean that medical treatment should be put to one side because it has not cured the patient. For the timing of surgery, it is important to maximize medical treatment just before operating so that the patient's mucosa is as healthy as possible. For example, ensuring that any allergic component is fully treated will minimize the...

Who Patient Selection

Adenoid Hyperplasia

Who Will Most Likely Profit from Surgery In determining which patients to select for surgery, the decision must be founded on the likelihood that surgical treatment is capable of offering the desired improvement. Patients with a diagnosis of rhi-nosinusitis and nasal polyposis who have not become symptom-free after maximum medical treatment are most likely to profit from surgery. These patients may have had a very good response to oral steroids, but their symptoms of hyposmia and congestion...

Accessory Ostia of the Maxillary Sinus Anterior to the Uncinate Process

Accessory Maxillary Sinus Ostium Scan

If an ostium to the maxillary sinus can readily be seen by endoscopy in outpatients, it is probably an accessory ostia. The accessory ostium that is most readily seen lies anterior to the edge of the uncinate process Fig. 6.26a-d . Such ostia are said to be the result of recurrent acute maxillary infections, but this is conjectural. Fig.6.26a-d Anterior accessory ostium and its appearance on CT. Fig.6.26a-d Anterior accessory ostium and its appearance on CT. Fig. 6.27 a An endoscopic view of a...

Principles of Practice

Hyperplastic Mucosa Allergy

Accurate Diagnosis Is the Key to Success A good surgeon is also a good physician. The best surgical results are often obtained by optimizing medical treatment both preoperatively and postoperatively Fig. 1.1a, b . Optimizing medical treatment before surgery makes it less traumatic, reduces the chances of complications, and helps preserve olfactory mucosa. In order to optimize medical treatment, the surgeon needs to have an understanding of the mucosal disease. Postoperative medical treatment...

Adenoid Hypertrophy Ct Scan

Down Syndrome Adenoid Hypertrophy

Fig. 2.14 A harmless-looking polyp medial to the middle turbinate and an infective-looking polyp at the origin of the turbinate at histology an adenocarcinoma. Fig. 2.15 Children below the age of 6 years average eight upper respiratory tract infections a year. Clear periods between infections will help distinguish upper respiratory tract infections from other causes of rhinosinusitis. Fig. 2.15 Children below the age of 6 years average eight upper respiratory tract infections a year. Clear...