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Education Summary - Dr Jayne Ingham - 'Snorters & Snorers' 21.03.16

Dr Daniel Timperley, who is an ENT specialist from the Sunshine Coast, has started consulting and operating at the North Lakes Day Hospital. Daniel talked to us about snorers and snorters.  We covered a lot of ground in 90 minutes with questions afterwards so I will try and pull out the salient points.  

Allergic Rhinitis

Intranasal steroids are effective.  Need to aim the tip of the nasal spray when inserted into the nose toward the ear so the spray doesn't hit the septum and cause bleeding.  Intranasal steroids do not affect growth in children.  Dymista is useful.  Can use a combination such as nasonex, an antihistamine and singulair.  (Singulair helps allergic rhinitis bu thte indication is for asthma in children.)

Saline lavage helps control and can be used in pregnancy.  

Immunotherapy is useful and effective but is a big commitment to three to five years of SC densitisation. There is a growing evidence for a sublingual treatment.

Non Allergic Rhinitis is when people react to such things as perfume, smoke or red wine.

Steroid sprays are not effective.  Atrovent for vasmotor rhinitis.  Capsaicin in the form of Sinol nasal spray can be used daily.  Olapatidine (Patanol) antihistamine eye drops dropped in the nose can also help.

Turbinate Surgery is sometimes needed for nasal obstruction not responding to medical treatment.


Mucociliary transport is affected in sinusitis.  Bacteria and fungus form biofilms which are difficult to move. (Photos of very thic mucous being pulled out of the sinus and nose - yuk.) Maximum medical treatment for sinusitis needed two to three weeks of Augmentin of Klacid, three weeks of steroids instranasally and maybe a surfactant or wash such as sinus wash in a squeeze bottle.  If not settling to have a CT scan to look at thickening of the mucousa in the sinuses.

Some will need sinus surgery to open the sinuses to drain.  Post surgery need steroid washes - make up a solution using diprosone OV cream or pulmicort nebule in a bottle with saline solution or if there is crusting and biofilm, a surfactant wash with Johnson baby shampoo, bactroban ointment in warn saline solution.

Adult Obstructive Sleep Apnoea and ENT

Surgery decreases Obstructive Sleep Apnoea.  CPAP works but compliance is poor with some people not wearing masks and also taking them off in their sleep.

Need to assess what the problem is, where the obstruction is.  There may be a blocked nose, tonsils or adenoids enlarged.  Large tongue that falls back or a jaw that need splinting forwards.  The nose may collapse with inhalation.  The palate may need restructuring.  There are different operations depending ont he cause.

Once again, I learnt some new, useful information from our education event

In the last GPpartners' newsletter, in the summary of the 'Snorers and Snorters' there was a query about the use of nasal steroids in allergic rhinitis.  Nasal steroids are efficacious in allergic rhinitis but not vasomotor rhinitis.





17 November 2018 8.30am
27 November 2018 6.30pm

From the Chair

  • From the COO.  April 2018

    From the COO. April 2018

    Sorry for the gap in transmission but GPpartners Board has been busy working on our new strategy. Our ethos of 'Advancing General Practice' is being put into practice. By helping GPs in their day to day business, we improve GPs lives and consequently patient outcomes. GPpartners has been and will continue to provide education but this area is becoming more contested with the Pharmaceutical Companies, Private Hospitals, larger specialist groups and the PHN locally as well as all the online education, Private Medical Education and National Conferences. GPpartners is working with a local accounting firm to bring you an evening to help with your financial planning, self managed superannuation, business accounting, taxation and mortgages. These are the areas GPs tend to put aside until the end of the tax year approaches or your BAS is due. You are invited to come on the 2nd of May to learn more and to put in place some financial planning ideas to improve your financial health. GPpartners is partnering with GPpartners Australia who are based in Adelaide. (They did ask if they could share our name.) GPpartners Australia is setting up a company to support start up companies who will directly improve the working of Primary Health Care and General Practice. This is an exciting opportunity to be there at grass roots identifying problems and subsequent solutions. This fits with our mission of 'Advancing General Practice'. GPpartners has a project that we would like to advance through this company. It is early days but from our initial investigations it seems to tick the boxes not just for General Practice but other areas of Primary Health Care and Specialist Services. I am afraid it is a secret for the moment but in the near future we will be coming to practices to explain the concept and offer Foundation Membership. GPpartners Board Directors feel that we are heading in the right direction and with kindred spirits in Adelaide with their GP network and experience, are in for exciting times. If you would like to find out more about what is happening please email me on jayne.ingham@gppartners.com.au  Jayne InghamChief Operating Officer, GPpartners

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