scholarly journals Penggunaan terkini oksimetazolin pada praktik klinik sehari-hari dan rekomendasi Kelompok Studi Rinologi Indonesia

2016 ◽  
Vol 46 (2) ◽  
pp. 171
Author(s):  
Retno Sulistyo Wardani ◽  
Azmi Mir’ah Zakiah ◽  
Yoan Levia Magdi ◽  
Dolly Irfandy ◽  
Anna Mailasari Kusuma Dewi ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Literature Review ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Google Scholar ◽  
Sinus Surgery ◽  
Study Group ◽  
Chronic Rhinitis ◽  
Hemostatic Effect

Latar belakang: Oksimetazolin adalah bahan aktif dekongestan topikal yang digunakan untuk rinitis alergi maupun inflamasi mukosa hidung lainnya. Cara pemakaian oksimetazolin yang baik dan benar akan memengaruhi keberhasilan pengobatan. Efek samping rinitis medikamentosa merupakan komplikasi yang sering terjadi dan sebaiknya dapat dicegah. Tujuan: Penulisan tinjauan pustaka ini untuk memberikan pemahaman terkini tentang berbagai indikasi oksimetazolin pada praktik klinik Telinga Hidung Tenggorok sehari-hari, cara pemakaian yang tepat, efek samping dan komplikasi yang terjadi berdasarkan studi kepustakaan yang dipublikasikan di PubMed, Google Scholar, dan Scopus dalam 10 tahun terakhir (2007–2016) oleh tim adhoc anggota Kelompok Studi (KODI) Rinologi Indonesia. Tinjauan pustaka: Oksimetazolin memiliki indikasi yang diperluas jika digunakan bersama dengan bahan aktif lain. Oksimetazolin semprot hidung 0,05% yang digunakan bersama dengan steroid intranasal dilaporkan memberikan manfaat pada penatalaksanaan rinitis alergi, rinitis kronis, dan polip hidung. Oksimetazolin digunakan juga dalam bedah sinus endoskopik untuk mendapatkan visualisasi lapang operasi yang baik karena efek hemostatik vasokonstriktor intranasal. Keuntungan yang dilaporkan juga diiringi dengan kemungkinan efek samping dan komplikasi yang sudah dikenal sampai yang membahayakan hingga kematian akibat koarktasio aorta, infark miokard elevasi non-ST, dan krisis hipertensi. Kesimpulan: Rekomendasi yang dibuat oleh KODI Rinologi berdasarkan analisis secara sistematik dengan telaah kritis, diharapkan dapat meningkatkan pengetahuan dan pemahaman tentang penggunaan oksimetazolin yang bermanfaat dan dapat mencegah efek samping yang berbahaya.Kata kunci: Oksimetazolin, dekongestan intranasal, indikasi, efek samping, komplikasiABSTRACT Background: Oxymetazoline is an active ingredient of topical decongestant in treating allergic rhinitis and other nasal mucosal inflammation. A good and proper usage of oxymetazoline will influence a beneficial outcome. Rhinitis medicamentosa is a common complication that should be avoided. Purpose: Content of the literature review is the indications of oxymetazoline usage in daily ENT clinical practice; the proper usage, side effects and complications are appraised from Pubmed, Scopus and Google Scholar publications within the last 10 years (2011 – 2015). The work was performed by adhoc team consisted of member of Rhinology Study Group Indonesia. Literature Review: Oxymetazoline broader indications obtained when applied together with other active ingredients. Oxymetazoline 0.05% nasal spray with topical intranasal steroid was reported as having efficacy in management of allergic rhinitis, chronic rhinitis and nasal polyps. Oxymetazoline is used as topical vasoconstrictor during endoscopic sinus surgery to get clear endoscopic visualization due to its hemostatic effect. Combination of oxymetazoline with topical intranasal steroid, was reported to be beneficial in the management of allergic rhinitis, chronic rhinitis and nasal polyps. Oxymetazoline is also used as topical vasoconstrictor during endoscopic sinus surgery to get clear endoscopic visualization due to its hemostatic effect. The good result of oxymetazoline was reported along with its side effects, which could be fatal, such as coarctation of the aorta, non-ST elevation myocardial infarction, and critical hypertension. Conclusion: Recommendation from Rhinology Study Group Indonesia based on systematic analysis with critical appraisal that has been made, may widen the knowledge and understanding of oxymetazoline usage and indications, and also avoiding the dangerous side effects and complications.Keywords: Oxymetazoline, topical intranasal decongestant, indication, side effect, complication

scholarly journals Effects of Age on Recovery of Olfactory Function After Endoscopic Sinus Surgery and Related Risk Factors

2021 ◽  
pp. 014556132110129
Author(s):  
Weiping Qi ◽  
Liang Feng ◽  
Fengyan Yang ◽  
Weihuan Ma
Keyword(s):  
Risk Factors ◽  
Allergic Rhinitis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Protective Factor ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
The Poor ◽  
Related Risk ◽  
Good Improvement

Objectives: To study the effects of age on the olfactory function recovery of chronic rhinosinusitis patients after endoscopic sinus surgery and related risk factors. Methods: A total of 176 chronic rhinosinusitis (CRS) patients enrolled from February 2017 to October 2019 were divided into child, youth, middle-aged, and elderly groups. Their baseline data, T&T olfactory test score, visual analogue scale (VAS) olfactory score, sinus computed tomography (CT) Lund-Mackay score, and Lund-Kennedy score were compared. Based on postoperative olfactory function, they were divided into good and poor improvement groups. Results: Complication with nasal polyps, allergic rhinitis history, and sinus surgery history had significant differences among patients of different ages ( P < .05). Three months after surgery, T&T olfactory, VAS olfactory, Lund-Mackay, and Lund-Kennedy scores all rose with increasing age, with significant differences between any 2 groups ( P < .05). The improvement of postoperative olfactory function became poorer with aging ( P < .05). T&T and VAS olfactory scores had significant positive correlations with Lund-Mackay and Lund-Kennedy scores ( P < .001). Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications were risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment was a protective factor for good improvement. Conclusions: The improvement of olfactory function of CRS patients after endoscopic sinus surgery declines with aging. Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications are risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment is a protective factor for good improvement.

scholarly journals Rectal Staphylococcus aureus Carriage and Recurrence After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Prospective Cohort Study

2021 ◽  
pp. 014556132110197
Author(s):  
Yue Peng ◽  
Zhao Liu ◽  
Zhijian Yu ◽  
Aiwu Lu ◽  
Tao Zhang
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Regression Model ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Prospective Cohort ◽  
Multivariate Regression ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Multivariate Regression Model

Objective: Chronic rhinosinusitis with nasal polyps (CRSwNPs) remains a major challenge due to its high recurrence rate after endoscopic sinus surgery (ESS). We aimed to investigate the risk factors of recurrence among patients who underwent ESS for Chronic rhinosinusitis (CRS). Methods: Prospective cohort study including 391 cases in a single institution receiving ESS were included for analysis from 2014 and 2017. Baseline characteristics including rectal Staphylococcus aureus ( S aureus) carriage in patients receiving ESS for CRSwNPs. The primary outcome was the recurrence of CRSwNPs. Multivariate regression model was established to identify independently predictive factors for recurrence. Results: Overall, 142 (36.3%) cases with recurrence within 2 years after ESS were observed in this study. After variable selection, multivariate regression model consisted of 4 variables including asthma (odds ratio [OR] = 3.41; P < .001), nonsteroidal anti-inflammatory drug allergy (OR = 2.27; P = .005), previous ESS (OR = 3.64; P < .001), and preoperative carriage of S aureus in rectum (OR = 2.34; P = .001). Conclusions: Based on our results, surgeons could predict certain groups of patients who are at high risk for recurrence after ESS. Rectal carriage of S aureus is more statistically related to the recurrence of CRSwNP after ESS compared with skin and nasal carriage.

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 

scholarly journals Expression of Matrix Metalloproteinases and Their Tissue Inhibitors in Chronic Rhinosinusitis With Nasal Polyps: Etiopathogenesis and Recurrence

2020 ◽  
pp. 014556131989663
Author(s):  
Germano Guerra ◽  
Domenico Testa ◽  
Francesco Antonio Salzano ◽  
Domenico Tafuri ◽  
Eleonora Hay ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Matrix Metalloproteinases ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Polymerase Chain Reaction Analysis ◽  
Sinus Surgery ◽  
Control Group ◽  
Nonallergic Rhinitis ◽  
Tissue Inhibitors ◽  
Immunologic Diseases

Chronic rhinosinusitis with nasal polyps is a multifactorial disease of the nasal and paranasal sinus mucosa and it includes, as comorbidities, anatomic and morphologic alterations, allergic rhinitis, and immunologic diseases. We investigated matrix metalloproteinases (MMP-2, MMP-7, and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) concentration in different etiopathogenetical groups of patients with nasal polyposis (NP) in relation to recurrence after sinonasal surgery. The study group consisted of 45 patients with NP (those with allergic rhinitis, nonallergic rhinitis and asthma or nonallergic rhinitis, and obstruction of osteomeatal complex [OMC]) who underwent endonasal sinus surgery. We also collected 10 patients who underwent septoplasty as control. Immunohistochemistry of nasal mucosa fragments, Western blotting, and polymerase chain reaction analysis showed increased MMPs levels (MMP-9 more than MMP-2 and MMP-7) and decreased tissue inhibitors of MMPs levels (TIMP-1 less than TIMP-2), in patients with chronic rhinosinusitis with nasal polyps compared with control group, in particular in patients with nonallergic rhinitis and asthma compared to those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC. We observed a higher risk of recurrence in patients with nonallergic rhinitis and asthma than in those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC after 36 months from surgery. In this research, we evaluated pathogenesis of NP related to MMPs and their inhibitors concentrations in polypoid tissue.

“In-Office Balloon Sinus Ostial Dilation with Concurrent Antiplatelet and Anticoagulant Therapy for Chronic Rhinosinusitis without Nasal Polyps”

2019 ◽  
Vol 129 (3) ◽  
pp. 280-286
Author(s):  
Thomas S. Higgins ◽  
Bülent Öcal ◽  
Ridwan Adams ◽  
Arthur W. Wu
Keyword(s):  
Antiplatelet Therapy ◽  
Chronic Rhinosinusitis ◽  
Anticoagulant Therapy ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Bleeding Events ◽  
Safe Alternative ◽  
Systemic Complications ◽  
Snot 22

Objective: Functional endoscopic sinus surgery (FESS) and balloon sinus ostial dilation (BSD) are well-recognized minimally invasive surgical treatments for chronic rhinosinusitis without nasal polyps (CRSsNP) refractory symptoms to medical therapy. Patients on antiplatelet and anticoagulant therapies (AAT) usually are recommended to discontinue their medications around the period of endoscopic sinus surgery. The goal of this study is to assess the clinical experience of BSD in CRSsNP patients with concurrent anticoagulant or antiplatelet therapy. Methods: A review of prospectively-collected clinical data from October 2012 to March 2017 were used to perform a cohort study of subjects with CRSsNP who met criteria for surgical intervention while on antiplatelet and anticoagulant therapy. Data were collected on demographics, details of the procedures, type of AAT used, pre- and postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scores, and complications. Results: Thirty-five patients underwent in-office BSD while on antiplatelet and/or anticoagulant therapy. The mean difference in pre- and postoperative SNOT-22 scores of 9.9 (SD 14.4, P < .001) was both statistically significant and exceeded the minimal clinically important difference of 8.9. Absorbable nasal packing was used for persistent bleeding immediately post-procedure in two patients. Intraoperative bleeding was associated with aspirin 325 mg and warfarin. FESS was required for further management of chronic sinusitis in four patients after anticoagulant/antiplatelet therapy could be discontinued. There were no systemic complications. None of the patients experienced significant bleeding events postoperatively after leaving the office. Conclusion: In-office BSD appears to be a safe alternative to endoscopic sinus surgery in select patients who cannot discontinue antiplatelet and anticoagulant therapy. Levels of Evidence: IV

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