TREATMENT OF BAD NASAL BREATHING,REDUCTION OF SNORING CAUSED BY HYPERTROPHY OF LOWER NASAL TURBINATE, USING AN ULTRA-SOUND DEVICE

One of the most frequent reasons for patients to visit a laryngologist is the difficulty of nasal breathing; a respiratory distress, more commonly known as nasal congestion, which may be caused not by a virus or a cold but the persistence of which may aggravate snoring or worse, may be the cause of the hypopnea syndrome or else sleepapnea. And when snoring is accompanied by episodes of apnea durinh sleep, the merely social problem becomes a health problem.

As a result of the above, the cardiac and brain functions are affected. During sleep, people who suffer from an obstructive syndrome open their mouth to breath. On the other hand, many people have a relaxed and soft palate, in other words the palate and uvula are relaxed or flaccid and vibrate, causing this annoying sound. The can also be huge and obstruct the area, preventing breathing. This can be treated by ultrasounds (excision or reduction of the uvula). During this interval of apnea, the heart, receiving signals of hypoxemia from the brain, in other words becoming aware of the reduced oxygen input, starts beating faster in order to provide more oxygen hence causing palpitations. Now should the hypopnea syndrome be acute and remain untreated, it will cause cardiac hypertrophy, hypertension and cardiac insufficiency.

Nasal diaphragm scoliosis, namely the “nasal septum deviation” and hypertrophy of nasal turbinates is one of the most frequent causes of nasal breathing difficulties.

Often, after an intervention to straighten the nasal septum, patients complain that they still have difficulty to breathe and that is because they might have developed, after a few months, a hypertrophy of lower nasal turbinate.

This change in the size of the nasal turbinates creates a feeling of fluctuations in nasal breathing separately in each nostril.

There are three nasal turbinates and they are located on the lateral walls of the nose. They consist of exceptionally vascularized erectile tissue with numerous sero-mucous glands which harbor the capacity to increase and decrease in size.More particularly, in every case of rhinitis (viral, microbial, allergic,etc.) they tend to significantly expand, causing the obstruction of the nostril and ultimately a difficulty to breathe. When the rhinitis is constant, a permanent hypertrophy and nasal respiratory distress will result. The same will also occur because of the irrational use of vasoconstrictive drugs.

The modern therapeutical approach for hypertrophic rhinitis includes a range of interventions, from simple changes of daily life and conduct, such as avoiding any irritants connected with the appearance of the ailment, to aggressive surgery. The pharmaceutical treatment on the other hand, which offers temporary relief of the symptoms of chronic obstruction, bears also a very high percentile of unwanted side effects.

More particularly, as far as surgery in otorhinolaryngology is concerned, the use of ultrasounds has been adopted since it constitutes a more efficient method than all other modern technologies.

For example, as far as the nose is concerned, in case of acute respiratory difficulty which may be caused by the hypertrophies nasal turbinates, we now have the possibility to significantly reduce same using the appropriate waveguide along the whole length thereof and not only the head as it is the case with other methods and without affecting the mucosa- which is extremely important since when the mucosa is not affected, submucosal fibrosis is induced and the reduction lasts forever. With other methods the engorgement of turbinate tissue occurs causing again a hypertrophy.

The ultrasonic method presents very signifact advantages over classical traditional surgical approach:

-Ultrasounds are here to replace the scalpel, diathermy, radiofrequency and laser used surgically. With ultrasounds and special waveguides the surgeon is able to effectuate any procedure noninvasively and without cauterization, closing blood vessels up to 3mm in diameter, without causing any irritations and burning the tissues.

-the maximum duration of the intervention is 10 minutes

-it is painless, since no scalpel and sutures are used.

-it is effectuated with local anesthesia, specifically using xylocaine spray

-it is generally a very mild intervention and patient is in a position to go home soon after and to go out even the same day. Indeed, unless patient tells, no one will be able to understand that he had a surgery as no gauze is needed where there is neither bleeding , pain or swelling.

-patient suffers absolutely no post-operatory pain and may easily go back to everyday activities.

-ultraounds can de used irrespective of patient’s age.

ADDRESSING CHRONIC REDURRING TONSILLITIS WITH ULTRASOUNDS

Tonsils are part of the lymphatic-immune system. In the same area, and performing the same function, we also have the adenoids and the amygdala. Tonsils contribute to the completion and maturation of the immune system, creating matrices for the production of antibodies against noxious pathogens.

The main problems caused by tonsils are:

1.       Snoring

2.       Frequent inflammation of the tonsils

3.       Bad breath

4.       Rheumatic fever

5.       Polyserositis

6.       Glomerulonephritis and focal nephritis

7.       endocarditis, pericarditis or myocarditis

8.       pemphigus of the palms and soles

9.       chronic urticarial

10.   children’s psoriatic rash

11.   ocular inflammations (iridocyclitis, uveitis)

12.   nerve or neurovegetative disorders

13.   recurring thromboagiitis or tuberus vasculitis

In the tonsillar crypts of people who suffer from recurring tonsillitis, even during the interval without inflammation, pathogen microbes are found clinically, which may be responsible for the recurrence of the tonsillitis. It is now possible to eliminate the recurrence of the tonsillar crypts using an ultrasonic device.

With ultrasounds, we are not compelled to perform a tonsillectomy. Instead we are now able, with the ultrasonic scalpel, to eliminate tonsillitis, by cleaning the tonsillar crypts with the ultrasonic device, noninvasively, without pain, easily and without anesthesia. We do not need to remove tonsils since there is a special waveguide for tonsils which allows us to perform cryptolisis, causing the biological cleaning of the tonsils, ( sterilization of the focus of infection) and the epithelialization and unblocking thereof. Hence, tonsils are not destroyed, they remain in place, are cured (cleaning up of the tonsils) and function normally without any recurrences. Patient is able to drink and eat cold things from the first day, without any fear of recurrence. More than 97% of patients suffering from chronic recurring tonsillitis and having an ultrasound intervention did not need any surgical removal of the tonsils.

Pediatricians are  100% against performing a tonsillectomy on young children between 2 to 5 years. Therefore, the cleaning up of the tonsils is extremely important because we are in a position, thanks to the special waveguide, to act on every crypt projecting the pathogens (pus) and subsequently leave the body proceed with the fibrosis. Hence, any problems of tonsillitis or bad breath are eliminated since the large crypts are closed. Furthermore, when we have problems at an older age, such as abscesses, it is recommended to remove the tonsils after the drainage of the abscess in order to prevent any recurrence which may threaten patient’s life. However, in such cases we cannot proceed with a tonsillectomy since there is a great risk of haemorrhage due to the age of the patients and therefore it is recommended to proceed with ultrasonic cleaning. We have hence managed to save pathological tonsils without losing their precious contribution.