Typical Ear, Nose and Throat Treatments in PCD
- Nasal rinsing/irrigation
- Antibiotic drops
Nasal rinses are probably the single most important thing you can do to help with congestion and sinus issues in the nose. This is especially true if windows have been made to facilitate sinus drainage. There are over-the-counter solutions for irrigating the sinuses and antibiotics and steroids can be added by prescription.
Cleanouts Under Sedation
The sinuses can be more thoroughly cleared of mucus in a surgical setting where the patient is sedated and the sinus can be flushed and suctioned of excess mucus and debris.
Windows surgery (antrostomy) can be very helpful provided the face is full grown (by about age 12) and there is dedicated follow up in the period right after surgery to keep the windows from closing up. In PCD, special attention must be given to the placement of windows so gravity can assist with drainage since the cilia aren’t able to perform this function adequately.
Ear tubes (myringotomy tubes) are commonly used for PCD in North America both to relieve pain and pressure and to correct conductive hearing loss from fluid built up behind the ear drum. Some people like them, some don't. For some kids, the drainage after a tube is obnoxious and difficult to deal with. Most seem to respond well to antibiotic ear drops when this happens. If pressure continues to build behind the ear drum, the drum will eventually burst (called perforation), so for people with PCD and lots of ear fluid it almost comes down to whether you want to choose when and where to put the hole via tube or let nature decide with a perforation. Scarring of the ear drum—whether or not tubes have been inserted—is very common in PCD.
Some families prefer the use of hearing aids over tube insertion to deal with conductive hearing loss. Hearing aids won’t address the fluid build-up and drainage issues, so it is good to be aware of the sanitary issues that may be involved in inserting a hearing aid into a chronically draining ear. Many have successfully navigated this problem, so it can be done.