Posts tagged: sinusitis

How does Photodisinfection Work?

Photodisinfection is a topical, non-antibiotic antimicrobial therapy that destroys a broad spectrum of pathogens including fungi, bacteria and virus without damaging human tissue. Unlike antibiotics, Photodisinfection selectively kills virulence factors such as the endotoxins and exotoxins produced by pathogens, leading to a clinically observable anti-inflammatory effect. The treatment process takes only minutes, making it over 1,000 times more effective at biofilm killing than antibiotics.

Photodisinfection is a minimally invasive non-thermal therapy involving the light activation of a photosensitizer to eliminate topical infections in a highly targeted approach. Photodisinfection has been proven to be safe and effective in other applications such as for the dental, sinusitis and hospital acquired infection prevention markets. In dentistry, Photodisinfection has been proven to be highly effective for the treatment of caries, endodontics, restorative dentistry, periodontitis, peri-implantitis and halitosis. Many new applications of Photodisinfection are now under development.

The Photodisinfection Process: Instant Antimicrobial Therapy

Apply Photosensitizer to Infection Site & Illuminate with Appropriate Wavelength for Several Minutes

A photosensitizing solution is applied to the treatment site where the photosensitizer molecules preferentially bind to the targeted microbes.  The photosensitizer molecules are inactive at this stage.  A light of a specific wavelength and intensity illuminates the treatment site and a photocatalytic reaction occurs.  The wavelength is carefully chosen to maximize absorption of light energy by the photosensitizer.

This 2 step procedure results in the destruction of the targeted microbes and their virulence factors without damaging host cells.  This reaction involves the formation of short-lived, highly reactive free-radical oxygen species.  These radicals cause a physical disruption of the microbial cell membrane through oxidative reactions, resulting in immediate rupture and destruction of the cell.  This process occurs in seconds with total kills completed in minutes.

The Photodisinfection process has also been shown to eliminate a multitude of virulence factors, unlike antibiotics. When the light isremoved, the photocatalytic reaction ceases along with all antimicrobial action. Photodisinfection does not promote the development of resistance.

The Photodisinfection process is both pain-free and stress-free due to lack of side-effects or damage to human tissue.

Source: Eastman Dental Institute, UK

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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Brush your teeth, save on Kleenex.

Who knew that teeth were such devious little buggers?

Periodontal disease is like the Stewie Griffin of maladies: small, easily overlooked, but man, when he gets mad, watch out.

Gum disease has already been linked to heart disease, impotence, cancer, and even artificial joint infections. But that’s not the end of it.

In 2011, an estimated 29.6 million adults were living with non-diagnosed sinusitis, an estimated 12.8% according to the Centers for Disease Control and Prevention (CDC).

Sinusitis occurs when the air-filled spaces behind your forehead, nasal bones, cheeks and eyes (known as sinuses) become blocked, preventing the mucus from draining and causing bacteria and other germs to build up. Sinusitis can be caused by something as benign as allergies or a common cold, or more serious conditions like a deviated septum or nasal polyps.

As far back as 1996, scientists were already examining the links between periodontal disease and sinus inflammation or infection. A study published in the American Journal of Roentgenology (say that last word 5 times fast) by J.J. Abrahams and R.M. Glassberg of Yale School of Medecine’s Department of Diagnostic Radiology, showed that patients with known periodontal disease were twice as likely to have maxillary sinusitis, and that the two were causally related.

The maxillary sinus is the largest of the paranasal sinuses, and also the closest to the molars of your upper jaw. As mentioned in a previous post, our mouths are teeming with bacteria. When you “forget” to brush your teeth, that bacteria accumulates in the gaps between your gums and your teeth, causing inflammation of the gums (gingivitis). The longer that goes untreated, the more likely you are to develop periodontal disease (periodontitis).
Periodontal disease causes the gums to recede from the teeth, creating little pockets – the bacterial equivalent of a white picket fence in the suburbs.
Because the maxillary sinus is so close to these little bacterial hideaways, infection is more likely.
Another study, conducted by the Oral Health Group and aptly billed as “A Review for the Dental Practitioner,” explained that the physical proximity between the maxillary sinus and the mouth should also be of concern to dentists because sinusitis is often misdiagnosed as dental disease.
As such, the study recommended that dental practitioners study up on the “anatomy, physiology, and pathology of this complex region.”

If undertreated or ignored, regular sinusitis can develop into something chronic, which is definitely not something you want.

The bottom line? Brush your teeth.

And just for kicks, watch Stewie battle a tooth ache on “Family Guy”:

Sinuwave™ Photodisinfection for Invasive Fungal Sinusitis of Immunocompromised Patients

Acute invasive fungal sinusitis is the most aggressive form of fungal sinusitis. It is most commonly seen in immunocompromised patients and is the source of significant morbidity and mortality. Common causes of immunosuppression are diabetes, advanced AIDS  and neutropenia (low levels of white blood cells (neutrophils) in the blood). Patients with neutropenia include those with solid organ transplants, bone marrow transplants, leukemia, radiation therapy, chemotherapy, and any medication that affect bone marrow.

Ordinarily, fungi feed on dead organic matter, but not live human tissue. In the case of weakened immune defenses, however, fungi are able to attack and invade human tissue, hence the name “invasive fungal infections”.  With the patient having limited immune defenses, this invasive fungal infection can spread rapidly into the blood vessels, eye area, and central nervous system with devastating consequences. Within a few weeks, the disease results in vascular invasion and systemic dissemination. Roughly 12.5% of those with diagnosed fungal rhinosinusitis have invasive fungal rhinosinusitis- acute or chronic. Acute invasive fungal sinusitis is a rare condition with a high mortality rate when not recognized early and treated aggressively.

The key to successful outcomes is early detection and aggressive intervention. Invasive fungal rhinosinusitis is currently treated by aggressive medical (systemic antifungals) and surgical debridement to remove infected tissue in the sinuses using endoscopic sinus surgery. Sinuwave™ Photodisinfection, a non-invasive light activated therapy,  offers an effective alternative or adjunctive therapy for these vulnerable patients suffering from invasive fungal sinusitis. Photodisinfection has been proven to be safe over many years of experience in the dental and hospital acquired infection markets, and has proven to be highly effective at eliminating fungal organisms.

Sinuwave Photodisinfection System to Augment Current Endoscopic Sinus Surgery and Balloon Sinuplasty Procedures

When patients with Chronic Rhinosinusitis (CRS) are not responsive to medical therapy, they may be candidates for an endoscopic procedure that includes endoscopic sinus surgery, balloon sinuplasty, or a hybrid of a combination of these two. Endoscopic sinus surgery involves identifying and removing blockages of the sinus passages using high definition cameras, monitors, and a host of tiny articulating instruments. The operation is commonly performed with a general anesthetic, with instruments that access the sinuses through the nose, and only involving incisions of the face for the most severe of conditions.

The combination of endoscopic procedures and Sinuwave may help improve patient outcomes with minimal tissue removal. Balloon sinuplasty is also a surgical intervention but operates on an entirely different principle. It uses a balloon on a wire catheter to attempt to dilate the sinus passageways, widening the walls of the sinus passageway with the goal of restoring normal drainage without permanently damaging the sinus lining. Side-effects such as scarring of sinus tissue is unlikely using sinuplasty, unlike with surgery, but both of these current procedures are unable to address the underlying cause, only the blockages.

Hybrid procedures, which are becoming more popular as a result of improved patient outcomes, deploy both surgery and sinuplasty. Whether hybrid, surgery or sinuplasty, patient results can be further improved by the addition of Sinuwave™ Photodisinfection technology to remove the fungal and bacterial biofilm infections as well as their virulence factors within the sinuses, in addition to inactivating the host inflammatory cytokines. This 3 prong advantage of Photodisinfection enables ENT’s the ability to clear out the source of infection, and not just remove the blockage of the sinus passages. By clearing out the sinus cavities with several logs of kill, the body has a greater chance of returning to better health and avoid long term pain.

The Advantages of Sinuwave for Refractory Chronic Rhinosinusitis

Sinusitis is a disease in which the sinus cavities around the nasal passages become inflamed and swollen. When symptoms last for longer than12 weeks, the patient is described as suffering from chronic rhinosinusitis (CRS).  Patients typically first seek medical therapy to alleviate their symptoms as well as trying to address the cause. However, 20% of patients are unresponsive to any of the medicines and continue to suffer from the debilitating symptoms associated with CRS.

There are roughly 22 million office visits and 500,000 emergency department visits in the United States alone relating to CRS, indicating that it is a major health concern. The treatment regimen usually consists of the prescription of broad spectrum antibiotics, corticosteroids, and saline nasal irrigation. This disease most commonly affects young and middle aged adults, but may affect other demographics as well. Common symptoms include nasal congestion, throbbing facial pain, fever, headaches, difficulty sleeping and sensations of swelling around the eyes and face.

Sinuwave™ Photodisinfection System offers a unique method of treatment which has several distinct advantages over both medical and surgical CRS treatments. Photodisinfection is a minimally invasive approach to eliminating the pathogens and inflammatory host response involved in the disease process.  Photodisinfection is a 2 step process involving the application of a photosensitizer which is then activated by non-thermal laser light generating singlet oxygen based molecules, or free radicals that are lethal to fungal spores, bacterial biofilms and their virulence factors while not harming human tissue.

The major advantages of Sinuwave™ Photodisinfection for CRS patients are:

* pain-free procedure not requiring anesthesia

* immediate patient relief,

* no antibiotics or developed resistances,

* no removal of tissues are involved,

* no patient compliance requirements

* ease of use

Photodisinfection for Refractory Chronic Rhinosinusitis Patients: A much needed advance for an under-served patient population

Chronic rhinosinusitis (CRS) is one of the most common chronic conditions in the United States. There is a significant subpopulation of CRS patients who remain resistant to cure despite rigorous treatment regimens including surgery, allergy therapy, and prolonged antibiotic therapy. This refractory patient population is thought to exceed 500,000 in the US.

Photodisinfection, also known as antimicrobial photodynamic therapy (aPDT), is a noninvasive, non-antibiotic broad spectrum antimicrobial treatment that can improve outcomes for this under-served patient population by reducing inflammation of sinus tissue and eliminating biofilm in the sinuses. Patients  suffering from refractory Chronic Rhinosinusitis are likely to be infected by super-antigen producing bacterial such as Staph aureus and Pseudomonas aeruginosa. Photodisinfection has been proven to be highly effective at targeting these two pathogens and inactivating inflammatory cytokines.

Sniff, slice or swallow? All guesses are good when it comes to chronic sinusitis

We’ve all had colds that seem never-ending, and wondered if maybe, just maybe, we would one day be able to breathe without sounding like a foghorn.

Well for some people, that kind of nasal hell is just another day in the life.

Sinusitis causes swelling in the sinuses and nose, preventing the accumulated mucus from being drained out. The result is pain and pressure around the eyes, sore teeth, and constant headaches. People who suffer from chronic sinusitis go through that for days or even months at a time.

Physicians have recently come around to the idea that chronic sinusitis is an inflammation-related condition, rather than an infection to be treated with antibiotics. Treatment ideology has also shifted. Rather than relying on pills and other external treatments, doctors increasingly believe in getting medicine directly inside the sinuses, up close and personal.

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Let’s Clear Things Up: Chronic Sinusitis

You know that feeling, when your nose is so stuffed that you feel like your head is filled with wet cotton, your thoughts seem foggy and every breath is a burning struggle? Well, multiply that by ten, and you get chronic sinusitis.

What causes this case of the perpetual sniffles? Well that’s the big question.

An article by Inofei Chen, “When Sinus Problems Won’t Go Away,” published in The New York Times in 2011, explored the different theories explaining chronic sinusitis that have emerged over the last couple of years.

Clarification: sinusitis does not equal chronic sinusitis. Sinusitis is a short-term condition that lasts for a couple of weeks, and is usually caused by an infection.

But in millions of cases, boring old sinusitis can become recurrent, and drag on for weeks, months, even years – chronic sinusitis.  For a full list of symptoms, click here.

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How Do I Know I Have Chronic Sinusitis?

As a first year medical student, cancer and HIV/AIDS are two common illnesses that I without a doubt will encounter in my line of work. However, not many people know about chronic rhinosinusitis, or simply known as chronic sinusitis, which also affects many people. Each year, 37 million Americans are faced with combating a case of sinusitis, the fifth most common disease treated with antibiotics [1,2].

What exactly is chronic sinusitis? It is an inflammation of the tissue in our sinuses, the cavities around our eyes, nose, cheeks, and forehead. Usually they are full of air but due to various causes these spaces become filled with viruses, bacteria, and fungi.

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