Githa Ayu Astarika 01.208.

5662

Questions 1. Could you explain about how to diagnose chronic rhinosinusitis with or without nasal polyp? Answer: Diagnosis CRS, with or without nasal polyps in adults is defined as: inflammation of the nose and the paranasal sinuses characterized by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip) facial pain/pressure reduction or loss of smell for $12 weeks. This should be supported by demonstrable disease with endoscopic signs of: nasal polyps, and/or mucopurulent discharge primarily from middle meatus and/or edema/mucosal obstruction primarily in middle meatus. and/or computed tomography (CT) changes: mucosal changes within the ostiomeatal complex and/or sinuses. 2. Whether the teraphy of chronic rhinosinusitis in this journal can be applied in Indonesia? Answer: Yes, it can. Because teraphy of chronic rhinosinusitis in this journal same with in indonesian. Other country Indonesia Treatment of CRS includes medical and Treatment of CRS in indonesia includes surgical therapy. medical and surgical therapy. Medical therapy often requires Medical therapy often requires combining multiple medications combining multiple medications including antibiotics, nasal including antibiotics, nasal decongestants, topical nasal steroids decongestants, topical nasal steroids and/or oral steroids, and saline irrigation. and/or oral steroids, and saline The rationale of this regimen is to irrigation. control precipitating factors, treat the The rationale of this regimen is to infection, reduce mucosal edema, and control precipitating factors, treat the facilitate drainage. However, some infection, reduce mucosal edema, and patients do not respond with full medical facilitate drainage. However, some treatment alone; in these cases patients do not respond with full medical treatment with endoscopic sinus surgery treatment alone; in these cases should be considered as an alternative. treatment with endoscopic sinus surgery should be considered as an alternative.

3. Can you explain what the purpose of this journal? Answer: The aims of treatment in CRS include elimination of the infection, reduced sinonasal inflammation, and maintained patent sinonasal passage drainage. In addition, CRS may be associated with precipitating factors including allergies, cystic fibrosis, gastroesophageal reflux, sinonasal anatomic obstruction in the ostiomeatal unit, and immunologic disorders. Therefore, the management of these risk factors should also be optimized. 4. In your presentations there is a SNOT- 20 ? what is that? Could you explain the advantages of SNOT-20? Answer: SNOT-20 is Sinonasal outcome test. SNOT-20 is a tool to measure the quality of life on Rhinosinusitis chronic contains 20 questions there are symptomps of emotional and sosial impact of rhinosinusitis. The advantages of SNOT-20 is a short charging time 5- 10 minutes and concise the format. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Questions Attempt to eject the snot Sneezing Dilute mucus in the nose Cough Mucus in the throat Thick mucus in the nose Clogged ears Dizzy Ear pain Facial pain Insomnia Wake up at night Cant sleep soundly Tired when waking up Tired Doesnt work Desperate Sad Shame Cant consentrate

5. Can you explain about esofageal reflux was considered a potential cause of CRS? Answer: Esofageal reflux caused Rinosinusitis chronic blockage of the sinuses due to decreased imun system so easy to inflamation infection sinuses membrane thick and blockage working of the mucous membrane and bacterial growth.

6. According to the journal , explain the purpose and side effect of the use of systemic and topical corticosteroid for chronic rinosinusitis with or without polyps? Answer: Corticosteroid Side effect Corticosteroid Side effect Oral Topical CRSsNP The efficacy of Topical oral steroids as corticosteroids part of a are used as multidrug part of a regimen in multidrug children with regimen. There CRS and are numerous asthma. preparations statistically that can be significant classified by reduction of systemic inflammatory bioavailability infiltration in all as first children , generation significant intranasal decrease of corticosteroids interleukin (IL)including 4 in allergic beclomethason children, e dipropionate, significant triamcinolone increase of acetonide, interferonflunisolide, and gamma in budesonide; allergic and the newer children. generation includes fluticasone propionate, mometasone furoate, ciclesonide, and fluticasone furoate CRSwNP Include It reduced side effects Prednisolone Cushings nasal including and syndrome, symptoms to a epistaxis, dry methylprednisol steroid greater extent nose, nasal one are most induced than placebo burning, nasal commonly diabetes, together with a itching, sinusitis, used. gastric ulcers, significantly pharyngitis,

gastrointestin al bleeding, and avascular necrosis of the femoral head

greater reduction in facial pain. In addition, Lavigne et al39 found a decrease in CD3 and eosinophils, and a decrease in the density of cells expressing IL-4 and IL-5 messenger RNA after treatment.

otitis, change of taste, eczema, nausea/diarrhea s, nasal irritation, and common cold.