Overuse of nasal steroids

POSTOPERATIVE CARE

Prophylactic antibiotics are prescribed for up to 2 or 3 weeks. In the first postoperative visit the packing is removed , and this is routinely scheduled on the second or third postoperative day. The patients are instructed to begin instilling Ponaris (Jamol Laboratories, Inc, Emerson, NJ) drops into each nasal cavity three times a day for lubrication. One to two weeks later the middle turbinate gloves or, if still present, the absorbable gelatin packs are removed from the nose, and direct endoscopic visualization and debridement of crust and thickness secretions is instituted on a weekly to biweekly basis until the ethmoid cavities are clean and healed. Daily saline nasal douching utilizing a Water Pik at home is also instituted at this time. Nasal saline pray is also helpful. Occasionally postoperative injections of 40 mg/mL triamcinolone acetonide into persistent maxillary sinus polyps and oral doses of prednisone are necessary to minimize inflammation and speed healing. Triamcinolone accetonide spray may be used to minimize scarring, granulation tissue, and polypoid mucosa is essential for a successful outcome and to prevent the need for subsequent revision surgery.

Care of the external nose is identical to that recommended if rhinoplasty were performed without concomitant sinus surgery. The Aquaplast thermoplastic splint is generally removed about 1 week postoperatively and Steri-Strips are replaced as necessary and left in place for up to 3 weeks in all. Triamcinolone acetonide 10 mg/mL is infiltrated beneath the skin -soft tissue envelope if persistent supratip edema appears likely to predispose to a pollybeak deformity.

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Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis
Allergic rhinitis: Clinical manifestations, epidemiology, and diagnosis
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Pathogenesis of allergic rhinitis (rhinosinusitis)
Pharmacotherapy of allergic rhinitis
Recognition and management of allergic disease during pregnancy
Etiologies of nasal symptoms: An overview

Overuse of nasal steroids

overuse of nasal steroids

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