Rush Uses "Resurrected" Chemical Cautery Treatment To Bring Relief

In the early part of the 20th Century, researchers developed chemical cautery, a superficial chemical treatment of the nasal passages, to promote drainage of the sinuses and relieve sinus pain sufferers of their ongoing symptoms. Physicians at the Midwest Sinus Center at Rush have revived the in-office procedure and have satisfied many patients.

Mast cells, the cells that release histamine and other inflammatory mediators, congregate in the sinus cavities and are often the culprit for the sinus pain, swelling and inflammation. Chemical cautery can destroy the mast cells through a process similar to a chemical peel for the face. The fewer mast cells, the less congestion the patient will experience.

Chemical cautery is recommended when symptoms persist and medications are producing only moderate relief. The relatively painless treatment consists of a series of short steps that begin when the physician coats the inside of the patient's nostrils with a topical anesthetic agent. Next, a decongestant is sprayed in each nostril to prepare the lining to absorb the next sprays of the treatment's active ingredient, phenol. Phenol, an organic anti-oxidant, acts gradually as an acid burn of the cells lining the sinus cavity. Then, the patient tips his or her head forward and the sinus discharge seeps out. After draining, a menthol-like rinse is sprayed up into the nose and a sterilized oil is rubbed onto the nasal lining to prevent dryness.

"By intentionally irritating the lining of the nose, we desensitize it to make it less reactive to irritants from the environment. Desensitization will result in less congestion so the patient will be able to breathe better and their sinuses will drain more freely. Sinuses that drain efficiently will heal infection more effectively," said Rush otorhinolaryngologist Dr. Neal Lofchy. Chronic sinus pain, diagnosed with a flexible scope or a sinus CT scan, is differentiated from seasonal or acute sinus pain and allergies by the symptoms: yellow or green discharge, headaches (above the brow, between the eyes, behind the eyes or cheeks), bad breath, post nasal drip or coughing for more than three months of the year.

Chemical cautery is a more aggressive treatment that can be used alone or in conjunction with medications. Ideal for patients who have multiple antibiotic intolerance, the treatment often gives people immense relief without having to resort to surgical approaches.

Because chemical cautery has a cumulative effect, on average people receive this treatment three to four times a year after an initial monthly treatment for three months.

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Rush-Presbyterian-St. Luke's Medical Center includes the 809-bed Presbyterian-St. Luke's Hospital; 154-bed Johnston R. Bowman Health Center for the Elderly; Rush University (Rush Medical College, College of Nursing, College of Health Sciences and Graduate College); and seven Rush Institutes providing diagnosis, treatment and research into leading health problems. The medical center is the tertiary hub of the Rush System for Health, a comprehensive healthcare system capable of serving about three million people through its outpatient facilities and eight member hospitals.