Station 13

Look at the image below and answer the following questions. 

Not including chronic rhinosinusitis provide 3 situations or conditions that this may be used? (Marks -3)

  1. Post operatively in septoplasty or functional endoscopic sinus surgery.
  2. It can be used in autoimmune conditions affecting the nose and in allergic rhinitis.
  3. It can also be used following epistaxis to help soften dry blood.  

Give 2 alternatives to this. (Marks – 2)

  1. Sterimar isotonic nasal spray.
  2. Homemade nasal douches. 
  3. Vaseline

In the context of chronic rhinosinusitis with nasal polyposis other than Dymista give 4 other medical treatments that may be used. (Marks – 4)

  1. Oral steroids
  2. Nasal steroids,
  3. Antihistamines
  4. PPI if giving oral steroids
  5. Baby shampoo. 

What are the active ingredients of Dymista? (Marks – 2)

  1. Azelastine hydrochloride
  2. Fluticasone propionate

What are the diagnostic criteria for chronic rhinosinusitis? (Marks – 6)

Presence of 2 or more symptoms for >12 weeks:

  •  One should be nasal congestion / blockage or nasal discharge 
  • +/- facial pain/pressure +/- reduction n sense of smell
  • Or nasendscopic signs of mucopurulent discharge or polyps
  • CT showing mucosal changes within the osteomeatal unit or sinuses

What CT score is used in chronic rhinosinusitis?

Lund-Mackay Score

Additional reading

EPOS guidelines –

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