. Prof Livije KalogjeraENT ClinicZagreb .
Dražen Shejbal ENT depCity hospital Pakrac
. Kojić Psychiatry depSiniša Stevanović ENT depCity hospital Virovitica
.
NASAL COMPLIANCE ON PATIENT WITH PTSD
.We are here
PTSD
• Trigger- enviromental event
• Abnormal or disordered reaction to stress
• Amygdala and hyppocampus
BERSERK
“Tight me, my friends, because When I will hear this warrior song, I lost consciousness and I will hurt anyone
AMOK
If you accepted a stress impulse,you are going run to the street and try to kill so many people with your short knife and pedestrians try tostop you with (longer than your knife)wooden pitch fork.( killing animal is strongly forbidden)
MAD DOG WHO WANT S TO DIE
If you a Crow warrior, and you dissappointing in combat You have two possibilities
1. Became a “Mad dog who wants to die” and going in Another combat without Armours, only with howl
2. Became a woman
NOWADAY s
• PTSD expression is very painfull for patients, family and society
• PTSD going to most popular in modern science and entertaiment
Nowaday s we know (two way) pathways
WELL KNOWN
Olfactory n.
Trigeminal
Sympathetic
parasymphatetic
HYPOTHETIC
Cranial nerve zero
Vomeronasal
Nose shape
METHODS
• 15 patinets with CRS• 15 patients with PTSD/CRS• either obstruction or hypersecretion/postnasal
drip, • + hyposmia or facial pressure/headache
longer than 3 months, confirmed either by endoscopy and/or CT score Lund-Mackay greater than 5.
44
46
48
50
52
54
56
58
60
SNOT 22
CRS
PTSD/CRS
-50
-40
-30
-20
-10
0
10
20
PTSP/CRSGROUP
.12!
Nasalsymptoms
EmotionalSleepfatigue
-20
-10
0
10
20
30
40
50
CRS GROUP
EmotionalSleepfatigue
Nasalsymptoms
.12!
5849
5 most important items CRS PTSD/CRS
3. Runny nose 13. difficulty falling asleep 4. Nasal obstruction 14. wake up at night
0
10
20
30
40
50
60
70
SF 36
CRS
PTSD/CRS
0
10
20
30
40
50
60
70
80
90
CRS PTSD/CRS
Physicalfunction
Limit.Physicalhealth
Limit.Emo.Probl.
Energyfatigue
EmoWellbeing
SocialFunc.
pain General health
64 32
0
10
20
30
40
50
60
¸VAS SCORE
CRS
PTSD/CRS
39 56
0
10
20
30
40
50
60
70
80
CRS PTSD/CRS
Nasal crusts Vomiting Diarrhea
01020304050607080
Hea
dac
he
Nas
alo
bst
ruct
ion
Ru
nn
y n
ose
Dis
char
ge
Fee
lin
g o
ffu
lln
ess
CRS
PTSP/CRS
VAS
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