In principle, patients with sinusitis should not swim, so as not to cause infections caused by pool water pouring back or being inhaled into the nasal cavity, thus aggravating the condition. He stressed that replacement therapy is the ideal treatment for patients with sinusitis.

Not all nasal congestion is rhinitis

In fact, if the nasal congestion continues to be bad, pus, recurrent nose bleeding, occasional headache or abnormal smell, may not be rhinitis.

These minor symptoms can mean that a benign nasal tumor called a nasal papilloma is working. Although nasal papilloma is a benign tumor, it is easy to relapse, easy to become malignant, easy to infiltrate the surrounding tissue, and needs early diagnosis and treatment.

As a common benign tumor of the nasal cavity and sinuses, nasal papilloma mainly includes three types: eversion papilloma, inverted papilloma and columnar cell papilloma.

Among them, inverted papilloma accounts for 70% of all sinus and nasal papillomas and is the most common manifestation type.

The main age of incidence of varus papilloma is concentrated in 50~70 years old (average age 53 years old), children are rare, mainly middle-aged and elderly males, male and female incidence ratio is as high as 5:1, the incidence site is often located in the lateral wall of the nasal cavity, followed by the sinus.

Advanced tumors tend to grow in multiple sites, and are easy to spread to the tissues around the nasopharynx, intracranial, orbital and other sites, resulting in space-occupying lesions or malignant changes in other sites.

The etiology of inverted papilloma has not been clearly defined. HPV virus infection, immune abnormalities, chronic sinusitis, abnormal proliferation of nasal polyps, carcinogens, and smoking may affect the disease.

Studies have found that the HPV virus, which can cause cervical cancer, condyloma acuminatum and other diseases, is not only the main influencing factor of nasal inverted papilloma, but also closely related to the deterioration of papilloma.

At present, many studies have reported that the detection rate of HPV virus infection in the nasal mucosa of patients is 0-80%. Therefore, timely detection and treatment of HPV virus infection plays an important role in the prevention of nasal papilloma.

Intranasal inverted papilloma often has a polypoid mass in the nasal cavity on one side and persistent unilateral or bilateral nasal congestion due to mass obstruction or nasal septum destruction. The stimulation of the nasal mucosa by the mass can lead to chronic rhinitis and sinusitis, and recurrent pyose-nose; The surface of the mass is rich in blood vessels, tough in tissue, easy to bleed, and often manifested as recurrent epistaxis.

The volume compression of the tumor itself can cause a range of other symptoms, such as loss of smell, headache, tears, and decreased vision.

The diagnosis of papilloma is mainly divided into two types: invasive and non-invasive. The anterior rhinoscope or nasal endoscope can directly observe the shape of the tumor, and the sinus CT or MR Can find whether it has invaded other tissues. However, to confirm the diagnosis of papilloma, the "gold standard" is the pathological examination of biopsy specimens.

Treatment: Surgery is the cure

Varus papilloma is insensitive to chemoradiation and the preferred treatment is surgical resection of the mass.

After surgical treatment, papilloma still has a high recurrence rate: the recurrence rate of stage I and II is concentrated in 10%~20%; The postoperative recurrence rate of stage III and IV is as high as 20%~30%, and a large number of studies have shown that incomplete resection of the tumor will lead to postoperative recurrence and deterioration of the disease. Therefore, choosing the correct surgical method and surgical path will effectively reduce the postoperative recurrence rate.

At present, most of the major surgical methods are transnasal endoscopic resection, and the postoperative recurrence rate is not much different from that of traditional open surgery such as lateral nasal resection, and it has the advantages of less trauma, beautiful appearance and short postoperative recovery time.

During endoscopic nasal surgery, the identification of the root attachment site of the tumor, adequate burning of the nasal mucosa at the attachment site, adequate opening and drainage of the nasal sinus orifice, and the use of low-temperature plasma radiofrequency ablation technology are conducive to complete resection of the tumor and reduce the postoperative recurrence rate and malignant transformation rate of papilloma.

Epidemiological studies have found that about 10% to 15% of patients with nasal papilloma are accompanied by or later malignant squamous cell carcinoma.

Therefore, adhering to regular follow-up and physical examination after surgery can detect pathological changes in the early stage.

At the same time, actively find the precursors of self-papilloma, such as HPV virus infection, smoking, immune function abnormalities, and early targeted treatment will effectively reduce the recurrence and deterioration rate of the disease.