A prospective study on the usefulness of homoeopathic constitutional medicines in the management of chronic sinusitis

A prospective study on the usefulness of homoeopathic constitutional medicines in the management of chronic sinusitis in age group of 15-60 years  

Dr Bhagyasree B  MD(Hom)
Medical Officer, Department of Homoeopathy, Govt. of Kerala
Email : 
dr.bhagyasreeprakash@gmail.com

ABSTRACT
Background and objectives: Chronic rhinosinusitis is a condition characterized by mucosal inflammation of nose and paranasal sinuses with sino nasal symptoms persisting for greater than 12 weeks. Growing antibiotic resistance, biofilm formations, and bacterial super antigens, presence of other viruses, fungi and co-morbid conditions like atopy, aspirin sensitivity, asthma, unclear etiology and pathogenesis may usually cause failure of conventional treatments. Main objectives of the study are to assess the usefulness of homoeopathic constitutional medicines in the management of chronic sinusitis. 

Methods: Prospective study is conducted in randomly selected 30 patients attending the outpatient and inpatient departments of Government Homoeopathic Medical College, Kozhikode. Adults of age group 15-60 who satisfied the diagnostic criteria for chronic sinusitis were included. In this 1 year study, cases were reviewed in every 2-3 weeks. Outcome of study were measured by score changes in major diagnostic symptoms. 

Results and discussion: Higher prevalence of chronic sinusitis in middle aged females were noted.76% cases showed improvement. Pulsatilla and Nux vomica were indicated in maximum number of cases 20% .Natrum mur was indicated in 10% cases. Silicea, Thuja, Sulphur, Calcarea, sepia and Ars alb were also found effective. Presence of some anatomical variations and association of some co-morbid conditions also were observed. Higher prevalence of deviated nasal septum in 83% and hypertrophied turbinates in 66% of patients were noted. An association of allergic rhinitis and chronic sinusitis were shown in 33% cases. 

Conclusion: Homoeopathic constitutional treatment is very effective in management of chronic sinusitis. 

Keywords: Chronic rhinosinusitis; Refractory rhinosinusitis; Major symptoms ; Saline irrigation ; Homoeopathy ; Pulsatilla; Nux vomica. 

Chronic rhinosinusitis is considered as a group of heterogeneous disorders from a multitude of causes and characterized by mucosal inflammation of nose and paranasal sinuses with sino-nasal symptoms persisting for greater than 12 weeks. No effective medical or surgical management of chronic sinusitis is present in conventional treatment. Many studies already suggested the effectiveness of Homoeopathic constitutional treatment. 

In this present 1 year study 30 patients with diagnosed chronic sinusitis who attended the outpatient and inpatient departments of Govt. Homoeopathic medical college Kozhikode was included. The usefulness of homoeopathic constitutional treatment in the management of chronic sinusitis was evaluated. 

A great majority of patients were middle-aged females. 40% in age group of 25- 36 and 26% from 36-45 years. Out of 30 patients studied, 73% were females and 27% were males. So this study shown a higher prevalence of chronic sinusitis in middle aged females. 

83% of patients were from the urban area with a middle class socio economic background. In this 30 patients, 43% had been suffering from complaints for last 3-4 years and 27% for last 1-2 years. A majority were presented with chronic sinusitis with recurrent acute exacerbations. Minimum of 2 acute attacks were observed in 50% in previous year. 

Considering the type of sinus involved in sinusitis, 30% had maxillary and another 30% patients had frontal sinusitis. Fronto maxillary sinusitis in 20% patients and pansinusitis was observed in 13% patients. There was a higher involvement of maxillary and frontal sinuses were shown in this study. 

Higher prevalence of deviated nasal septum in 83%, hypertrophied turbinates in (66%) and polyps in 16% patients were noted. An association of allergic rhinitis and chronic sinusitis was observed in 33% cases. The Migraine in 26% cases and dental caries in 16% cases were also reported. 

A previous history of surgical procedure related to sinusitis was also noted. Sub mucous resection for DNS was performed in 23% and FESS, tonsillectomy and adenoidectomy were performed in 16%, 6% and 10% patients respectively. 

The major presenting symptom found in this study was nasal obstruction in 63% patients.40% patients were presented with facial pain and 33% with headache. Nasal discharge and post nasal drippings were founded in 23% cases and loss of smell in 16% of patients. 

In all 30 cases constitutional medicines are selected according to symptom similarity. Pulsatilla and Nux vomica were indicated in maximum number of cases 20% each. Natrum mur was found indicated in 10% cases. For management of acute attack Kali.bich was used in 33% patients of this study and Bryonia, Belladonna found effective in 23% each. 

After treatment in a majority of cases the main presenting symptoms either got reduced or absent. Out of 30 patients 76% got gradual relief, aggravation founded in 10% and standstill condition was noted in 13.3%. 

In this small attempt of study, it was noted that Homoeopathic constitutional treatment is very useful in managing all type of chronic rhinosinusitis. In cases like refractory rhinosinusitis resistant to standard medical therapy, associated conditions like of allergy, nasal polyps, aspirin sensitivity and history of revision surgeries or depression, Homoeopathy can offer a better relief. 

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