Role of Homoeopathy in Chronic Rhinosinusitis with Nasal Polyp

Role of Homoeopathy in Chronic Rhinosinusitis with Nasal Polyp

Rhinosinusitis

ABSTRACTS

Nasal polyps is an important clinical entity diagnosed by the presence of both subjective and objective evidence of chronic sinonasal inflammation. Symptoms include anterior or posterior rhinorrhea, nasal congestion, hyposmia and/or facial pressure or pain that last for greater than 12 weeks duration. Defects in the sinonasal epithelial cell barrier, increased exposure to pathogenic and colonized bacteria, and dysregulation of the host immune system are all thought to play prominent roles in disease pathogenesis.

KEYWORD: Nasal polyp, Chronic rhinosinusitis Homoeopathy, Homoeopathic treatment, Rhinoscopy

METHOD:  Various literature and journal regarding homoeopathic treatment in nasal polyp

INTRODUCTION: Nasal polyps are soft, painless, noncancerous growths on the lining of nasal passages or sinuses. They hang down sometimes likes pea size or grapes. They result from chronic inflammation and are associated with asthma, recurring infection, allergies, drug sensitivity or certain immune disorders.

Nasal polyps can affect anyone, but they’re more common in adults.

PREVALANCE

The general population the overall prevalence rate of nasal polyposis ranges from 1-4%. It is more common in adults than in children under 10 years of age except when associated with cystic fibrosis. It does not appear to be more common in atopics.

 OBJECTIVES

To assess the effectiveness of Homoeopathic Medicines in chronic rhinosinusitis with nasal polyps.

HISTOPATHOLOGY

Polyps are characterized by massive tissue oedema, resulting from a leakage of plasma through widened endothelial junctions in the blood vessels. The typical histological characteristics include oedematous fluid with sparse fibrous cells, and few mucous glands with no innervation, squamous metaplasia of the surface epithelium, proliferation of stromal and epithelial elements and a thickening of the basement membrane. [1]

TYPES OF NASAL POLYP

There are two primary types of nasal polyps: ethmoidal and antrochoanal. Ethmoidal polyps arise from the ethmoid sinuses and extend through the middle meatus into the nasal cavity.

Antrochoanal polyps usually arise in the maxillary sinus and extend into the nasopharynx and represent only 4–6% of all nasal polyps.[4]

However, antrochoanal polyps are more common in children comprising one-third of all polyps in this population. Ethmoidal polyps are usually smaller and multiple while antrochoanal polyps are usually single and larger. [4]

 Causes

They’re usually due to some cause of inflammation in the nose, such as [3]

  • Asthma.
  • Allergic rhinitis (hay fever) or other allergies, such as to aspirin or fungus/fungi.
  • Chronic rhinosinusitis (CRS).
  • Cystic fibrosis.
  • Repeat sinus infections or other infections.

Polyps develop because the mucous membranes lining the nose or sinuses change. The membranes become inflamed for a long time or become inflamed over and over again. The inflammation causes swelling, redness and fluid build up. Researchers believe that allergies and infections cause the inflammation

Symptoms

Nasal polyps are associated with irritation and swelling (inflammation) of the lining of your nasal passages and sinuses that lasts more than 12 weeks (chronic sinusitis). However, it’s possible to have chronic sinusitis without nasal polyps.

Nasal polyps themselves are soft and lack sensation, so if they’re small, it may miss to detect. Multiple growths or a large polyp may block nasal passages and sinuses.

Common signs and symptoms of chronic sinusitis with nasal polyps include [2]

  • A runny nose
  • Persistent stuffiness
  • Postnasal drip
  • Decreased or absent sense of smell
  • Loss of sense of taste
  • Facial pain or headache
  • Pain in your upper teeth
  • A sense of pressure over your forehead and face
  • Snoring
  • Frequent nosebleeds

DIAGNOSIS

Nasal polyps can be seen on physical examination inside of the nose and are often detected during the evaluation of symptoms. On examination, a polyp will appear as a visible mass in the nostril. [4]

CT SCAN

CT scan can show the full extent of the polyp, which may not be fully appreciated with physical examination alone.  On a CT scan, a nasal polyp generally has an attenuation of 10–18 Hounsfield units, which is similar to that of mucus. Nasal polyps may have calcification[5]

 

Differential diagnosis

Other disorders can mimic the appearance of nasal polyps and should be considered if a mass is seen on exam. Examples include Encephalocele, glioma, inverted papilloma, and cancer. Early biopsy is recommended for unilateral nasal polyps to rule out more serious conditions such as cancer, inverted papilloma, or fungal sinusitis.[5]

HOMOEOPATHIC TREATMENT

1.PHOSPHORUS especially effective in nasal polyps that bleed. people who have a tall and slender build and tend to develop a thirst for cold water as the polyp grows within them. The polyps may bleed regularly and also block the nostrils. polyp may have circular motion when breathing. [6]

2. Lemna Minor:  used when there is an intense level of nasal blockage and anosmia or a loss of the sense of smell.  Nasal polyps tend to worsen during the wet season and can even cause a thick white discharge from the nose which has a foul smell with much sneezing. [7]

3. Calcarea Carbonica: This homeopathic medicine for nasal pole useful in the cases of people who are overweight, person frequently affected by seasonal changes, such as hot to cold or cold to hot weather. Other symptoms where this medication is applicable are: [7]

  • Frequent sneezing
  • Profuse sweating during the night
  • Sore nose
  • Small amounts of white discharge
  • Nostrils are mostly dry

4.  Conium Maculatum:  Dry nose, which seems to get sudden discharge. Instead of a loss of smell, it has acute sense of smell. If the patient is suffering from frequent sneezes and complains of nasal blocks in the morning, conium can be an effective homeopathic remedy [6]

5. Sanguinaria Nitricum:  It is known to be a great remedy primarily for nasal polyps, which are right-sided or occur within the right nostril of the nose. Some of symptoms are, [7]

  1. Profuse amounts of nasal discharge
  2. Frequent sneezing
  3. Swollen nasal membrane
  4. Right-sided headache along with right-sided blockage of nostrils
  • THUJA: as a syocotic medicine thuja works best in reducing size and releasing pressure symptoms of the polyp. along with Chronic catarrh; thick, green mucus; blood and pus.  Dryness of nasal cavities. Painful pressure at root.
  • TEUCRIUM: Catarrhal condition of both anterior and posterior nostrils. Mucous polypus. Chronic catarrh; discharge of largeirregular clinkers. Foul breath. Crawling in nostrils, with lachrymation and sneezing. Coryza, with stoppage of nostrils.

Other second grade medicines for polyps are

ALLIUM CEPA

APIS MELLEFICA

CALCAREA PHOS

CALCAREA SULPH

GRAPHITES

KALI BI CHROME

KALI IOD

SEPIA

SILICEA

SULPHUR

REFERENCES:

  1. Seki H, Otsuka H, Pawankar R. Studies on the function of mast cells infiltrating nasal polyps. J J of Otolaryngology 1992; 95:1012-1021
  2. Mayo Clinic Staff. (2014). Nasal polyps: Definition.
    mayoclinic.org/diseases-conditions/nasal-polyps/basics/definition/con-20023206
  3. National Institute of Allergy and Infectious Diseases. Detailed Analysis of Nasal Polyp Tissue Sets Stage for Future Research. (https://www.niaid.nih.gov/news-events/nasal-polyp-tissue-analysis) Accessed 2/23/2021
  4. https://en.m.wikipedia.org/wiki/Nasal_polyp#cite_ref-Murr2016_5-3
  5. Richard M. Berger. “Diagnosis: Antral choanal polyp”. University of Kansas School of Medicine. Archived from the original on 2017-02-16. Retrieved 2017-02-15.
  6. Allen HC. Keynotes and characterstics with comparisons of some of    the leading remedies of the materia medica with bowel nosodes. Reprint Edition. B. Jain Publishers (P) Ltd, New Delhi, India (2004).
  7. Boericke W. Pocket manual of homoeopathic materia medica and repertory. (51st Impression), B. Jain Publishers (P) Ltd, New Delhi, India (2011).

About Author:

Dr Purnima singh (PGT), Dr Anshita khare(PGT)
State National Homoeopathic Medical college and
Hospital, Lucknow

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Homeopathy360 Team