Tuesday 19 April 2011

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.

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