Category: Sinus Surgery

Invasive Fungal Rhinosinusitis (IFS)

In immunocompetent patients, IFS typically presents with nasal congestion and periorbital discomfort.  In immunocompromised patients however, IFS often presents with masses, proptosis and bony erosion, typically with rapid progression.

Acute invasive fungal rhinosinusitis (AIFR) is a rare but frequently fatal infection that occurs primarily in immunocompromised individuals and diabetics.i It is characterized by fungal invasion into the mucosa and submucosal structures of the paranasal sinuses with frequent extension into adjacent structures, including the paranasal soft tissues, orbit and cranial vault.  Short term mortality has been reported to range from 20-68% across studies.[i]i

Surgery is the primary approach to IFS. Photodisinfection is a potent anti-fungal therapy that can help to address the IFS patient population with its minimally invasive advantages. 



[i] http://www.medscape.com/viewarticle/408751_2

ii Monroe Marcus M. et al, Invasive Fungal Rhinosinusitis: A 15 Year Experience with 29 Patients. The Laryngoscope 2013 Feb.

 

Sinuwaveis only available in Canada 

Bacterial Biofilms Implicated in Chronic Rhinosinusitis

Blockages can occur in the sinuses due to a number of factors causing trapped mucus to accumulate inside the sinuses and encouraging the growth of microorganisms in sessile layers known as biofilms.   One recent study found that biofilms were present on the mucosa of 75% of patients undergoing surgery for CRS.[i]

Different biofilm species are associated with different disease phenotypes.  H. influenzae biofilms are found in patients with mild disease, whereas S. Aureus is associated with a more severe, surgically recalcitrant pattern.[ii] [iii] Recent studieshave demonstrated that biofilm infections, involving known super-antigen producing bacteria such as S. aureus and P. aeruginosa, are implicated in CRS and reduce the effectiveness of antibiotics.[iv]

Eradication of these biofilm infections and associated virulence factors is important in effectively and successfully dealing with the disease.  Repeated antibiotic exposure and increasing antibiotic resistance is a treatment challenge faced by this patient population.

Photodisinfection has been proven to effectively target and destroy biofilms and associated virulence factors, offering a clear advantage over other therapies.[v]

 



[i] Ragab A. et al., Evaluation of bacterial adherence and biofilm arrangements as new targets in treatment of chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2012 Feb; 269(2): 537-44.

[ii] Foreman A., et al. Different biofilms, different disease? A clinical outcomes study. Laryngoscope. 2010 Aug; 120(8): 1701-6.

[iii] Foreman A. et al. Do biofilms contribute to the initiation and recalcitrance of chronic rhinosinusitis? Laryngoscope. 2011 May; 121(5): 1085-91.

[iv] Leid Jeff G. et al., The Importance of Biofilms in Chronic Rhinosinusitis. Biofilm Infections. Chapter 8

[v] Darveau Richard,  DNA and Cell Biology, Volume 28, Number 8, 2009, Pg 1-7.

Sinuwave Photodisinfection: Making a Difference for Refractory Chronic Sinusitis Patients

Carolyn Cross (CEO) with Sinuwave patient

Christina is from Winnipeg, Manitoba. She has been suffering for about ten years from recurring Chronic Rhinosinusitis (CRS). Over time, Christina found that she has become unresponsive to the medical and surgical treatments currently available. She is dealing with tenacious biofilms in her sinuses that have become resistant to antibiotics. She has had 5 or 6 surgeries and countless trips to an array of specialists. Christina lives with debilitating pain from recurring sinus infections and the ongoing concern about her future. Affecting her head and her breathing, this painful condition is hugely disruptive to everyday living. She is frustrated also, that by affecting her, CRS also impacts her entire family.

Otherwise a very healthy person, Christina worries that one day her medical options will run out. New technologies, like Sinuwave™ Photodisinfection, are important to people like Christina as they offer hope for a better quality of life. Christina is one of about 50,000 Canadians suffering from recurring refractory Chronic Rhinosinusitis. In the US, the refractory CRS population exceeds 500,000 and is growing by about 10% (50,000) each year.

Christina came to Vancouver from Winnipeg seeking help with her uncontrollable sinus infections. I had the privilege of spending time this week getting to know Christina and got a better understanding of the nature of the suffering that she gallantly endures. Seen here with me having her second Sinuwave treatment, I was thrilled to learn that her initial Sinuwave treatment the day before had already yielded some positive results for her.  It has taken us about 14 years to develop our innovative non-antibiotic antimicrobial technology to the point where it is now helping refractory CRS patients like Christina. I would like to take this time to thank each member of my very talented team for their personal efforts, sacrifices and dedication that contributed to an important new CRS treatment to help people like Christina.

— Carolyn Cross, CEO

Sinus Surgery: Is It The Only Treatment For Chronic Sinusitis?

A treatment for chronic sinusitis? “Sign us up!” they’re saying. Over 500,000 Americans each year are opting to undergo sinus surgery, also known as FESS, or functional endoscopic sinus surgery. Chronic sinusitis is, as the name denotes, a prolonged infection of the sinuses – the air-filled spaces around the nasal cavity, although someone with sinusitis would hardly call them hollow. Their sinuses are clogged by years of mucus from infection and inflammation left, right, and centre (literally). Sinus surgery is performed, relatively non-invasively, through the nostrils, so as to flush out the infected material and open up the sinus passages that have been blocked for years.

As effective as this surgery is, we aren’t all to go running to the hospital to sign ourselves up at the slightest stuffy nose. There is a certain severity standard that must be met by a candidate before they can get the go-ahead.  Ideally, the candidate is someone who has turned to surgery as a last resort; generally, it is that they have sinusitis that persists even after aggressive medical treatment. Others who should consider the surgery are those who suffer from: sinus disease caused by fungal infection, nasal polyps (growths in the nasal cavity), structural abnormalities of the sinuses, a sinus infection that has spread to the bone, or cancer of the sinus. These cases demand a more drastic treatment because of their more permanent nature.

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