Prof. Dr. Valentin Stoyanov: Allergic rhinitis causes polyps in the nose

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Prof. Dr. Valentin Stoyanov: Allergic rhinitis causes polyps in the nose
Prof. Dr. Valentin Stoyanov: Allergic rhinitis causes polyps in the nose
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In today's issue of "Doctor" we will discuss non-inflammatory diseases in the ear-nose-throat (ENT) area with prof. Dr. Valentin Stoyanov - ENT specialist, head of the Department at Thrace University, Stara Zagora. For the first time in Bulgaria, he introduced balloon dilatation into clinical practice as an alternative method to prevent the formation of stenoses after chemical burns of the esophagus and the application of the surgical checklist (recommended by the WHO as a result of the "Safe Surgery Save Life" program). He is a national expert in ENT and chairman of the Board of Experts in ENT at the Medical Union; vice-president of the Bulgarian Scientific Association of Otorhinolaryngology, Head and Neck Surgery.

Prof. Stoyanov, in our previous conversation we discussed inflammatory diseases in your medical field, now it is our turn to talk about non-inflammatory ones. What are the most common?

- The most common non-inflammatory diseases of the nose are allergic rhinitis and vasomotor rhinitis. The difference between them is that in allergic rhinitis there is always an antigenic reaction in general, i.e. allergen that caused this reaction. Whereas with vasomotor rhinitis, it is more about a dysfunction of the autonomic nervous system. In general, they proceed in the same way: with frequent sneezing, difficulty breathing, often tearing and itching of the eyes. Unfortunately, it is difficult to find the specific causes, and therefore the treatment is rather non-specific, which means that we react with antihistamines and other drugs that generally suppress this reaction. And they are not specifically targeted at the allergen.

In this regard, let me ask you the polyps in the nose and do they belong to non-inflammatory diseases?

- Polyps in the nose are always a secondary manifestation of a given disease, i.e. there must be a previous one. Very often they are a consequence of allergic rhinosinusitis or rhinitis. But they can also be a consequence of classic bacterial sinusitis. So polyps are a special form of non-inflammatory disease, but with the caveat that they are always secondary, i.e. they arise on the basis of already damaged terrain.

Besides being in the way, are they dangerous in any way? How do you deal with them?

- I would not say that nasal polyps should be ignored and there are many reasons for this. Not only because they make nasal breathing difficult and create a certain discomfort. They impair the sense of smell too. Also

due to impaired nasal breathing, they also affect the lower respiratory tract

Since breathing is mainly through the mouth, the air is unable to moisten and purify, which is the normal function of the nose. Often times they could have a negative impact on the cardiovascular system as well. Their behavior is definitely operative, but this does not end the course of treatment. Efforts must then be directed towards eliminating the primary focus - be it an allergic or bacterial premise.

- Let's continue with the other organs, throat and ears…

- Before that, let me point out that there is a large group of non-inflammatory diseases regarding both the throat and the nose. We are talking about oncological, cancerous diseases in these organs, but we will do a separate interview about them, because they are an extensive topic. And now we will continue with an ear disease - otosclerosis. It occurs exclusively in women. It is often hereditary, leading to permanent hearing loss, and in women at a young active age, i.e. when they are socialized. Therefore, in these cases, modern medicine can solve the problem operatively. These young ladies should consult a specialist doctor and after the specific hearing test, which very clearly and accurately confirms the diagnosis, proceed to adequate treatment. Unlike in the past, when medicine did not have such opportunities.

When and how does this disease manifest itself?

- It usually manifests itself in periods when there is, I would call it a hormonal revolution in the body of women. That is, in the first pregnancy, childbirth, second pregnancy, etc. This has been proven on the basis of many years of experience, because in most cases, after menopause, any worsening of this disease ceases. It simply manifests itself in stages, in fits and starts in completely normal physiological conditions for a woman. The problem worsens, then remains at the same level for a long time until the next similar attack occurs.

The symptoms are only two - hearing loss and tinnitus

And they cannot be explained by anything, i.e. no inflammatory process, no work in a harmful, noisy environment, no rhinovirus disease. So always with the occurrence of sudden noise with hearing loss in such a period, one should think about this disease. Which accordingly means consultation with a specialist.

The other non-inflammatory disease that this time occurs in both sexes and is very common is auditory neuritis, more commonly known as sensorineural hearing loss. It manifests itself in people working in conditions of production noise and vibrations from production machines and devices. It is also characterized by hearing loss and subjective tinnitus. However, the characteristic of this noise is that it is of a higher frequency.

Let me at this point insert a question from our reader because I think it is related to what we are talking about. He asks if people with professions such as DJ, sound directors, radio journalists, i.e. those who work for a long time with headphones, or are under the influence of loud music, get neuritis of the auditory nerve?

- This definitely applies mostly to DJs, otherwise I personally am not familiar with the extent of the damage caused by these factors for sound directors and radio journalists. Whereas for DJs, this is definitely a risk moment for auditory neuritis, the same sensorineural hearing loss we're talking about. Especially with exposures longer than 3-4 years of work experience in this field.

And in this case, perhaps the action of the provoking factor should be interrupted, or is there some treatment?

- Unfortunately there is no treatment. The aim is to prevent further damage to the hearing aid ie. not to become worse than the state to which they have brought themselves. Yes, there is prevention, these are the so-called antiphons - specific headphones. Naturally, this often times

causes people discomfort,

who use them as they are forced to wear them for hours on end. This is one type of prevention especially against noise. For vibrations it is more difficult, there is no way to eliminate them, they can be reduced but not eliminated.

Prof. Stoyanov, tell me why nosebleeds occur?

- Epistaxis is called and means bleeding from the nose. It is also a non-inflammatory disease, but like polyps, we could not call it a primary true disease. It is rather a symptom of some general disease. There are many reasons: diseases of the hematopoietic system such as leukemia, leukosis and a number of others; cardiovascular diseases, especially those occurring with stasis; kidney diseases etc.n. But the most common cause, especially in adulthood, is hypertensive disease. More than half of patients with epistaxis are hypertensive. So it's a symptom, a secondary disease. I want to point out that to some extent it is even "helpful", because in addition to being a signal of high blood pressure, it prevents the occurrence of cerebrovascular disease, stroke.

Allow me a few flash questions from our readers. They expect to read the opinion of a specialist. The first question: how dangerous are external ear injuries from further complications?

- The so-called othematoma - bleeding from the earlobe is common among wrestlers, boxers and other strength athletes. I wouldn't say that any serious complication is possible when it comes to external ear trauma. Otherwise, we can refer to this type of trauma as a traumatic rupture of the eardrum, i.e. ruptured eardrum - it occurs more often in domestic injuries.

The next question is should the earwax be cleaned or is such a procedure not desirable?

- After bathing, a good dressing of the ear is enough, nothing else is necessary.

Is it possible to treat complete, congenital deafness?

- This question cannot be answered unequivocally, but in principle there is an option. This is the so-called cochlear implantation. Unfortunately, it is not yet administered in that volume that would satisfy every patient. The important thing is that it is available, of course, under strict indications and after a good medical examination.

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