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"Exploring Post-Grommet Complications: What You Need to Know"

 Navigating Postoperative Complications of Grommet Insertion: A Comprehensive Guide Grommet insertion, a standard surgical procedure to alleviate symptoms of middle ear disorders, can sometimes be accompanied by postoperative complications. Among these, one of the most frequently encountered issues is otorrhea or ear discharge. Understanding the nature of postoperative complications and their management is crucial for patients and healthcare providers. Types of Otorrhea Postoperative otorrhea manifests in various forms, including early, delayed, chronic, and recurrent. Early otorrhea occurs within four weeks of surgery, while delayed otorrhea surfaces four or more weeks post-surgery. Chronic otorrhea persists for three months or longer, while recurrent otorrhea involves three or more discrete episodes. Studies suggest that ear discharge after grommet insertion affects a significant proportion of patients, with rates varying from 16% to as high as 80%. Prophylactic Measures and Treatmen

Nasal Decongestants



Nasal decongestants are used by people when they get nasal allergies like catarrh and sinusitis. They are also used in common colds, hay fever and flu. A nasal decongestant aims to shrink the swollen blood vessels, the leading cause of congestion. Specific problems can arise from their consistent use.   


Some most commonly used nasal decongestants are 

 • Oxymetazoline (Sinex, Vicks)

 • Phenylephrine (Sudafed PE) 

• Pseudoephedrine 


 Addiction is defined as the compulsive physiological need for a particular substance. Those substances develop tolerance, and their withdrawal results in apparent symptoms. But when we talk about nasal decongestants, they are not considered genuinely addictive because they do not cause physiological cravings to the person using them.   


Why Do People Get Addicted To Nasal Decongestants?  


Here are some reasons why people think they are getting addicted to nasal decongestants:


• Rebound effect  Rebound effect means that when a person uses the nasal spray for the first time, it provides more significant relief. Still, after continuously using it for three days or more, there was more congestion in the nose. So, you have to keep using it. The rebound effect must not be confused with addiction because they are not hard to leave when you know they are damaging and does not cause cravings.  


• Damage To Blood Vessels and Tissues Their continuous use can also result in tissue damage or blood vessels resulting in more swelling. This worsens the congestion, and as a result, people keep using it to get rid of congestion. When people continuously use nasal decongestants because when they use them consistently.  




What Happens In Your Nose After You Use Nasal Decongestants?


When the blood vessels in the nose dilate, this leads to a congested nose. This most commonly happens in allergies. The cause of allergies differs from person to person. Nasal decongestants do not treat the actual cause of allergy but provide relief from the congested nose. A blocked nose cause headache, discomfort and also interrupt a person's sleep patterns. 


Which Conditions Can Be Helped by The Temporary Use Of Nasal Decongestants? 


Using nasal decongestants temporarily can avoid the following conditions temporarily:

• Rhinitis

• Nasal passage swelling

• Headache

• Turbinate hypertrophy

• Restlessness

• Dry mouth

• Irritation of the lining of the mouth  


Why Is It Harmful To Keep Using Nasal Decongestants Long Term?  

It is harmful to keep using nasal decongestants long term because of the following reasons:


• As mentioned above, the rebound effect leads to more congestion, and people start having congestion soon after using the decongestants.  


• This gives the people the impression that the nasal decongestant does not work anymore.  


• A condition called rhinitis medicamentosa, also known as rebound nasal congestion, can occur if their consistent use is not stopped.  


• Nasal decongestants, when overused, increase the blood flow in the nose cause more congestion. And the cycle of congestion repeats and becomes worse.  


• The nose contains cilia and hair, whose function is to move the mucus out of the sinuses and back to the mouth. Overuse of nasal decongestants alters cilia's structure, resulting in loss of normal function.  


• Our nose also has a mechanism of air conditioning to heat and humidity the inspired air. Air conditioning cushions do this air conditioning, but decongestants might make those cushions thicker than usual, causing more nose blockage. This condition is referred to as turbinate hypertrophy.  


• Severe allergic reactions like anaphylaxis can also happen by the overuse of nasal decongestants, but it is rare.   




Is It Safe To Use Nasal Decongestants During Pregnancy, Breastfeeding And With High Blood Pressure?  


During pregnancy, non-medicated saline mists and sprays are considered safe. Pseudoephedrine and phenylephrine are suitable for most pregnant women. But pregnant women with high blood pressure should not use pseudoephedrine because this further raises the blood pressure. So, pregnant women should never use nasal decongestants of any kind without a doctor's advice. While breastfeeding, some nasal decongestants are entirely safe for use, e.g. Pirinase, Nasacort. But visit a doctor before using any of this. As nasal decongestants shrink or narrow the blood vessels in the nose, they might sometimes affect other vessels, resulting in increased blood pressure. 



Who Should Not Use Nasal Decongestants?  

Children younger than six years and people suffering from the following conditions must not use nasal decongestants

 • Diabetes

 • Phenylketonuria

 • Glaucoma

 • Liver disease

 • Prostate problems

 • People with kidney diseases

 • If a person is taking other medications

 • Alcohol dependence

 • People with heart problems

 • Thyroid problems (most commonly hyperthyroidism) 


In the conditions mentioned earlier, Patients must avoid the substances of the nasal decongestants and should not use them without the doctor's recommendation.   



What Can Be Done If You Get Addicted To Nasal Decongestants?  

It is not hard to recover from nasal decongestants. It takes less than a week, and some withdrawal symptoms can occur. The best way to get rid of nasal decongestants is to stop using them, but if still, congestion is extreme, it is advised to use a steroid nasal spray. The most common steroid nasal spray is Pirinase and Beconase. This will help to fight the congested nose while the body recovers. And after six months of stopping nasal decongestants, the person is no longer dependent on them. It is more than enough to eradicate the tolerance developed by the rebound effect. Patients should not use nasal decongestant sprays more than three times a day. Its further use can make you dependent on them by developing tolerance. Also, they should not be used for more than a week to avoid their addiction.   


It is essential to treat the cause of nasal congestion rather than the symptom. Discussing with an ENT consultant about the treatable causes of nasal congestion can help improve your symptoms and quality of life.


"No matter what nasal decongestants a person uses, it is always advisable to use them with a doctor's consent. By following the things mentioned above, one can avoid getting addicted to nasal decongestants and treat them if someone has already developed tolerance." 





Mr Gaurav Kumar


Consultant ENT Surgeon


Helping Patients with specialist expertise and kindness


Book Appointment Online




entsurgeonclinic@gmail.com

07494914140


Disclaimer:


For General Information Only

Always seek advice from your treating consultant




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