Kshara application for turbinate hypertrophy

Abstract

Nasapratinaha (nasal obstruction) is a commonly encountered disease in clinical practice. It is one of the nasal disorders, explained in Ayurveda, having nasal obstruction leading to difficulty in breathing as the main cardinal feature. In contemporary science, this condition can be correlated with various diseases such as turbinate hypertrophy, deviated nasal septum, nasal mass, mucosal congestion, allergic rhinitis, and others; among which turbinate hypertrophy is a common cause. Turbinate hypertrophy can be treated with surgical and medical methods. The medical treatment has limitation for prolonged use because of health purpose, surgical approaches too have failed to achieve desired results in turbinate hypertrophy due to complications and high recurrence rate. The medical and surgical managements have their own limitations, merits, and demerits like synechiae formation, rhinitis sicca, severe bleeding, or osteonecrosis of the turbinate bone A parasurgical treatment explained in Ayurveda, known as kshara pratisarana, which is a minimal invasive and precise procedure for this ailment, tried to overcome this problem. ‘Kshara Karma’ is a popular treatment modality in Ayurveda, which has been advocated in disorders of nose like arbuda (tumor) and adhimamsa (muscular growth). Clinical observation has shown its effectiveness in the management of turbinate hypertrophy. A case report of 45-year-old male who presented with complaints of frequent nasal obstruction, nasal discharge, discomfort in nose, and headache; and diagnosed as turbinate hypertrophy has been presented here. The patient was treated with one application of Kshara over the turbinates. The treatment was effective and no recurrence was noticed in the follow up.

Review of Pain: An Ayurvedic Approach

“…Thermal cauterization (agnikarma) [48][49][50] It is one of the para-surgical procedures to give instant relief from pain in musculoskeletal and arthritic conditions using metal probes. Chemical cauterization (ksharakarma) [51][52][53] Herbal alkali application on warts.…”

Management of nasal synechiae with Kshara Sutra - A case report

“…Synechiae are one of the most common unwanted outcomes following functional endoscopic sinus surgery (FESS), with an incidence rate of 10%–40% [ 2 ]. Nasal synechiae or turbinate synechiae is a condition in which there is adhesion of one turbinate to another, to another part of same turbinate, to the lateral wall or less commonly to the nasal septum [1] . It is typically a complication of chronic nasal lesions with epithelial ulceration or other mucosal changes like inflammatory, degenerative, necrotic, hyperplastic or metaplastic lesions.…”

“…A case report of a 48-year old-male has been presented here with complaints of nasal blockage and difficulty in breathing, diagnosed as nasal synechiae after anterior rhinoscopy and endoscopic examination and managed with Ayurvedic intervention. Kshara karma with Apamarga Kshara is the choice of management in case of nasal polyp and turbinate hypertrophy [ 1 ]. But in nasal synechiae, since we have to cut open the adhesion precisely, Kshara Sutra , which is meant for cutting open the tract in case of fistula-in-ano was chosen.…”

Microdebrider-Assisted Turbinoplasty and Submucosal Diathermy for Inferior Turbinate Hypertrophy: A Randomized Clinical Trial

“…Nasal cavities offer transmission, warmness, humidification, filtration, and chemosensation of air which is mostly done through mucosa and interaction with the turbinate. 1 About 20-30% of the population suffers from disturbance of airflow through the nose. 2 The inferior turbinate is 50-60 mm long, 3.8 mm wide, and 7.5 mm in height and is a dominant structure of the inferior nose.…”