Sunday, May 29, 2011

THE TYPES nasal polyps

THE TYPES nasal polyps
Nasal polyps is a disorder of the nose and paranasal sinus mucosa especially osteomeatal complex (OMC) in the meatus nasi medius stemmed form a soft mass, shape round or oval, grayish white. Its surface is smooth and somewhat translucent because it contains a lot of fluids. Often bilateral and multiple. Polyp is a manifestation of various diseases and is often associated with sinusitis, allergic rhinitis, asthma, and others.

Etiology of nasal polyps

Etiology of nasal polyps is not known with certainty. But there are 3 factors that play a role in the occurrence of polyps rice, namely:
Inflammation. Inflammation of the nose and paranasal sinus mucosa of chronic and recurrent.
Vasomotor. Impaired vasomotor balance.
Edema. Increased interstitial fluid pressure sehin

ARF resulting edema nasal mucosa. This edema can be explained by the Bernoulli phenomenon.
This phenomenon is an explanation of Bernoulli's law of the laws of air flowing through narrow places will cause negative pressure on the surrounding area so that the network of weak ties will be sucked by the negative pressure. As a result there arose a mucosal edema. This situation continued until there was a nasal polyp.
There is also a variation called nasal polyps koana polyps (polyps koana antrum).

Koana polyps (polyps koana antrum) is a large polyp in the nasopharynx and maxillary sinus originating from the antrum. Polyps are out through the ostium and maxillary sinus ostium and accessories into the nasal cavity and then continue to the koana and enlarged in the nasopharynx.

Diagnosis of nasal polyps

How to diagnose nasal polyps, namely:
Physical examination. Visible external nasal deformity.
Rinoskopi anterior. Easy to see polyps that have been entered into the nasal cavity.
Endoscopy. To view the polyps are still small and not yet out of the complex osteomeatal.
Plain X-rays and CT-scan. To detect sinusitis.
Biopsy. We recommend that if there are mass unilateral in elderly patients, resembling malignancy on macroscopic appearance and there is a picture of bone erosion on plain x-ray images.

Anamnesis for the diagnosis of nasal polyps:
Nasal congestion.
There was a mass in the nose.
Difficult to blow her nose.
Olfactory disorders: anosmia & hiposmia.

Secondary symptoms. When accompanied by abnormalities in the surrounding tissues and organs such as post nasal drip, headache, face pain, nasal voice (bindeng), the ear feeling full, snoring, sleep disturbance and decreased quality of life.
Therapy nasal polyps

There are 3 kinds of therapeutic nasal polyps, namely:

Medical: corticosteroids, antibiotics and anti-allergic.
Operation: polipektomi & etmoidektomi.
Combination: medical & surgery.
Give corticosteroids in polyp is still small and not yet entered the nasal cavity. It can be systemic, intranasal, or a combination of both. Use of high dose systemic corticosteroids and a short time. Give antibiotics if there are signs of infection. Give anti-allergy if the trigger is considered an allergy.

Polipektomi an act of removal of polyps using a string of polyps with the aid of local anesthesia. Category polyps are removed is a large polyp but have not packed the nasal cavity.

Etmoidektomi or functional endoscopic sinus surgery (BSEF / FESS) is the act of removal of polyps as well as sinus surgery. Criteria polyp is a polyp is removed a very large, repetitive, and there are clear abnormalities in the complex osteomeatal.

Antibiotics as combination therapy in nasal polyps can we give before and after surgery. Give antibiotics if there are signs of infection and for post-operative prophylactic measures.