HNAR CHAWR ( Nasal polyp)

Hnar chawr kan tih hi a awmzia ber chu kan hnar(nose) tissues (mucosa leh submucosa) te an lo vung ( swelling) emaw, an lo puar lian emaw hi a ni a. Polyp hi fibro-oedematous tissue inhlawmkhawm a ni.

Polyp chi hrang hrang te: Polyp hi chi hrang hrang pathumah an then a, chungte chu-

(1)Simple mucous polyps: A common ber a, Antro-choanal polyp leh Ethmoidal polyp ah then hran leh theih a ni.
(2)Fungal polyps: Hei hi tun hnai mai atang hian a hluar ve ta hle. Histopathology hmanga awlsam taka hriat chhuah theih a ni.
(3)Neoplastic polyp: i. Benign tumour thenkhat heng- papilloma, haemangioma etc te hi polyp anga chhiar theih an ni.
ii. Malignant tumour thenkhat te pawh polyp a chhiar tel an ni ve chawk.

Simple Mucous polyp
Tun tumah hian a common ber simple mucous polyp chungchang hi I lo bih thuak the ang.
# A thlentu:-
(a)Allergy vanga polyp tam zawk hi lo awm a ni.
(b)Vasomotor/Vascular phenomenon:- Allergy nen a inang hle;mahse taksa huat ber ( allergen) hriat chhuah leh hmuh a ni lo.
(c)Virus emaw bacteria infection vangin a awm thin bawk.
(d)Allergy leh infection tangkawp vangin a lo thleng theibawk.
(e)Serum a IgE tam lutuk vangin a awm thei.
(f)Barnouilli phenomenon: Hnar kua chhunga middle meatus bul velah pressure a san chuan extra vascular fluid a titlem a, chu chuan tissue fluid a siam thin.

A. Antro-choanal ( of simple mucous polyp):
*Clinical features:
(i) Hei hi naupang leh tleirawl lamah a hluar. Mipa leh hmeichhia-ah a nasat lam a inang reng.
(ii) Hnar kaw leh lam chauhvah a hnawh a, leh lam erawh a normal thung. A hnawhtawt hi a permanent em em.
(iii) Dam lo chu a hahchhiau emaw, hnar atanga hnai chhuak( rhinorrhea) emaw a nei chawk. Hei hi a chhan chu allergy a neih vang a ni.
(iv) Mi thenkhatah erawh hnarkua leh lam v eve a hnawh thin. Hnar tawt tawng ( nasal intonation) a siam fo.
(v) Lu na a awm thei.
* Diagnosis:
(i) X-ray of nasopharynx.
(ii) Post-rhinoscopy.
(iii) CT Scan of nose and paranasal sinus.
*Treatment:
(i) Caldwell Luc or Radial antrostomy. Hei hi surgery chi khat a ni.
(ii) Naupangah chuan simple polypectomy hi a tawk viau. Caldwell Luc operation hi an tan chuan a hlauhawm zawk a ni.
(iii) Allergy thunun turin antihistaminic tablet ei tur.
(iv) Tun hnai mai atng khan FESS ( Functional Endoscopic Sinus Surgery) hmangin polyp te awlsam takin an paih thei ta.

B. Ethmoidal polyp( of simple mucous polyp)
* Clinical features:
(i) Hei hi chu kumupa leh middle age groupzingah a hluar. Mipa zingah a hluar zualdeuh.
(ii) Dan naranin damlo chuan hnarkua pahnihah hnawhtawt ( obstruction) a tuar a. Hnarkua pakhat chauha hnawh tawt chu a awm zeuh zeuh chauh a ni.
(iii) Hnar tawt tawng a hluar hle.
(iv) Lu na a awm fo.
(v) Hnar atanga hnai chhuak ( rhinorrhea) hi a hluar hle bawk.
* Treatment:
A enkawlna te hi surgical vek a ni. Polyp chu lo awm tan tir chauh anih chuan simple surgery hi a tawk ve mai thin. Amaherawhchu polyp chu a lo thang lian zel anih chuan Ethmoidal polypectomy tih ngei ngei a ngai thung.
1.Conservative treatment: A la hlimchhawn a nih chuan antihistaminic tablet ei hian polyp te hi a nuai bo ve thei mai thin. Tin, steroid nasal spray Beclamethasone, Budenase or Fluticazone te pawh hian a nuai bo ve thei mai thin.
2. Surgical treatment hrang hrang te:-
(i) Intra-nasal polypectomy with ethmoidectomy.
(ii) Sinus-ah infection a awm a nih chuan antihistaminic tablet ei tur. Metronidazole hi a tangkai hle.
(iii) Inzai zawhah a lo awm nawn leh turd an nan Steroid nasal spray leh antihistaminic tablet tee i ngei ngei tur a ni.
(iv) Transantral ethmoidectomy of Horgan.
(v) External ethmoidectomy.
(vi) FESS

.Surgical procedure te khi doctor ni lo tan sawifiah tula a lan loh avanga hetia rawn tarlan hi a ni.

MIPA vs HMEICHHIA

Mihringte hi Pathianin Ama anpuia duh taka a siamte kan ni a.( Gen.1:26). Mipaah leh hmeichhiaah te min siam a ni.( Gen.1:28). Hetianga Siamtu pakhatin a siam te hi inantlan awmtak a nih vei nen hian mipa leh hmeichhia te hi kan nihphung leh taksa ruangamah hian danglamna tam tak a lo awm a. Engpawh nise, A siam mihring te hi min Siamtu chungah hian thu kan neih loh em avang leh kan finin a khalh loh em avang hian Siamtu hian hetianga mipa leh hmeichhia te danglamna a lo siam hian chhan tha tak chu a nei phawt ang le. Aw le, tun tumah hian kan danglamna tam tak awm zinga point tlem te ilo tarlang thuak thuak teh ang u:-

(1) A hmasa berin kan ruhrel ( skeleton) awmdan hrim hrim hi a inang lo phawt a. Hetia mi nung leh dam tha, nula leh tlangvalte kan han thut ho hi chuan ruhrel hi inang lo pawhin alang lo niin kan hre maithei e. Nimahsela, upat lam inang tlangah rau rau chuan hmeichhiate aiin mipate ruhrel hi a lian zawkin a rit zawk bawk.
(2) Ruh sei chi ho(long bones) , entirnan: Ban ruh, ngal ruh, malpui ruh etc. hi mipa-ah a sei zawk tlangpui thin. Tin, hmeichhe ruhte hi dan naranin an mam(smooth) em em laiin mipaah erawh a thap/titoh(rough) thung.
(3) Dan naranin mipa luruh hi hmeichhia aiin a lian zawk zel a, a dung hi hmeichhia aiin a sei zawk bawk. Hmeichhe luruh hi a pan(thin) zawkin, a smooth em em bawk a ni.
(4) Mipa chal hi a awn/awih ( slanting) a ni a; hmeichhia-ah erawh a dingngil( vertical) thung.
(5) Mipa mitkhur hi square shape a ni a; hmeichhia erawh a bial thung. Mipa mitkhur hi a te zawkin a tlang hriam( sharp margin) nei ve lovin round margin a nei thung.
(6) Mipa biang ruh hi a langsar zawkin a pawng lian zawk bawk.
(7) Thluak atanga hnungzang-a Spinal Cord luh tlangna kua ( Foramen Magnum) hi mipa-ah chuan a lian/zau zawk em em.
(8) Mipa khaberuh hi hmeichhe khaberuh ai chuan a lian zawkin a chhah zawk bawk.
(9) Hmeichhe khingkhang ruh ( Clavicle) hi mipa aiin a tawi zawk a. Tin, a pan zawk bawk a, a kul(curve) lo zawk bawk.
(10) Hmeichhe mal/malpui hi cylindrical shape a ni a; mipa mal erawh conical shape a ni thung.
(11) Mipa-ah chuan dar pharh( shoulder) hi mawng bawr aiin a lian zawk a; hmeichhia-ah erawh mawng bawr a lian zawk thung.
(12) Mipa kut leh ke te hi kum inang tlangah rau rau chuan hmeichhia te aiin a sei zawk tlangpui.
(13) Body hair te hi mipa-ah chuan hmai-ah leh awm-ah a awm thin laiin hmeichhia-ah erawh a awm ve lem lo thung tlat.
(14) Mipa hrawk/ aw bawm ( larynx) hi 4.8 cm a sei a nih laiin hmeichhia erawh 3.8 cm a sei a ni thung.
(15) Mipa zunna dawt ( urethra) hi 18-20 cm a sei a ni a. Hmeichhia –ah erawh 4cm a sei a ni thung.
(16) Hmeichhe lung ( heart) hi 250 gm a rit a ni a; mipa lung erawh 300 gm a rit a ni thung.
(17) Natna laka kan taksa chak lam pawh hi a lo inang lo khawp mai:-
@ Inguinal Hernia hi mipa zingah a tam bik em em mai a; hmeichhe zingah erawh Femoral Hernia hi a hluar ve thung.
@ Gastric Ulcer hi chi hnih a awm a. A hlauhawm zawk( malignant ulcer) hi mipa zingah a hluar zawk a; a hlauhawm nep zawk Benign Ulcer erawh hmeichhe zingah a tam thung.
@ Hiatus Hernia hi nu upa lamah a awm duh em em a; pa upate zingah erawh a awm meuh lo thung.
@ Chil bawm ( Salivary gland) cancer hi hmeichhe zingah a tam zawk tlat.
@ Ri hriatna lam harsatna hi mipa te zingah a hluar zawk thung.
@ Lung natna chi khat Mitral Stenosis hi hmeichhia te zingah a tam bik a; Mitral Insufficiency erawh mipa zingah a tam ve thung.
@ Artery natna chi khat Atherosclerosis hi mipa zingah a tam bik.
@ Blood vessel natna chi khat Buerger’s Disease leh Africa kaposis sarcoma te hi hmeichhiain an vei ve meuh lo.
@ Mit ( Gall Bladder)-a lungte awm ( Cholelithiasis) hi mipa aiin hmeichhia-ah a hluar zawk tlat.
@ Ruh nget ( osteoporosis) natna hi hmeichhia-ah a tam bik.

Aw le, a chunga point tlemte hi tun atan chuan ilo duhtawk phawt teh ang.. Heng kan danglamna te hian kan biak Pathian ropuizia tarlang sela tih hi he thu ziaktu duh dan a ni e.