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Thuy Tran Le Ph.D,
Quang Le Ph.D, Trang Tran Minh MD,
Thuy Tran ORL Clinic, 6 Do Quang Str. Ha Noi, Viet Nam
Keywords: Chronic Cough [CC], Chronic Rhino Sinusitis [CRS], Gastro Esophageal Reflux Disease [GERD], Thuy Tran Technique [TTT], Mini Functional Endoscopic Sinus Surgery [FESS]
We researched a new technical resolution to release a classical subject, that is Chronic Cough [CC] caused by Chronic Rhino Sinusitis [CRS] and sometimes with Gastro Esophageal Reflux Disease [GERD].  We are referring to the Thuy Tran Technique [TTT], which is excellent when used for the above purpose. Nasal passage-nasal cavity is a transits area of infectious liquid from CRS running down which ejects mucus and involves the larynx causing reflux of CC. The traditional technique of nasal endoscopy may be inadequate to clearly show the infectious materials which hides in the deep and narrow recesses of the nasal cavity whereas the TTT could control this. The slide and video shows the position of the patient for the TTT, with the local anesthesia in the middle and superior recesses, the special endoscopic procedure of cleaning irrigation nasal passage- nasal cavity have carried out for diagnosis, stopping the CC and radical treatment of CRS. TTT founded in 2003, recieved the copyright certificate of the Vietnamese government in December 2013. The excellent results of TTT in the treatment of different infectious diseases of Ear Nose Throat have been reported in the ORL Congress of Vietnam Sociate in 2012, 2013, 2014, 2015, 2016 and the International Scientific Conference of Chole2016, UK. Besides the main purpose, the results of research may show some new opinions concerning CRS symptoms, tonsillitis, should be discussed about in the final section.
STUDY: Retrospective review.
The author has offered a subjective judgment of the classification of the reasons for CC according to the group’s followings: First group of reasons is non-specific infectious diseases of the airways, allergies and GERD. The second group includes tuberculosis, tumors, and immunodeficiency disorders in the respiratory tract; this group was not mentioned here. In our study the CC in CRS was researched. A collection of 434 patients with CRS, management was done at the Thuy Tran Otolaryngology Clinic, from June of 2011 to November 2015, patient ages ranged from 8-67 years old. Slide 1 and 2 with video shows the TTT unit. This technique discovers how CC happens to patients of CRS and how TTT can be used for the diagnosis and treatment of the root disease.  


Unit of TTT:   - Karl Storz Endoscopic System
                        -Thuy Tran Endoscopic bed
                        -Thuy Tran Suction tubes
                        - Adrenaline 0.1 % and Lidocain 2 % Cottons for the topical anesthesia,
                        - Natri Clorid 0.9 % and Antibiotic Solution
Routine diagnosis of CRS
Questionairing of symptom history, Examination by TTT, X-Ray and Fungi Test
Routine treatment of CRS- Quickly stopping CC
  1. By procedure of TTT, endoscopic irrigation cleaning nasal cavity & sinuses everyday with Natri Chlorid 0.9 %, topical antibiotic solution for a two weeks period.
  2. Antibiotic oral use: 7-10 days, without corticoid.
  3. A special Mini FESS combined if having the indication with local anesthesia: cutting a part of uncinate process or a thin lateral part of the middle turbinate or both without enlargement of maxillary sinus ostium for the irrigation cleaning nasal cavity and sinuses by TT
  4. Treatment of 434 CRC cases without Tonsillectomy.
  5. Treatment of 147 GERD cases by TTT, medicines and improving of the eating regime

Literature cited
1. Cole P.Physiology of the Nose and Paranasal Sinuses. Diseases of the Sinuses. Humana Press, 1996. Pp:33-51
2. Laza DC. Kennedy DW: Adults Rhinosinusitis defined, Otolaryngology Head and Neck Surgery 1997; 117:S1-S7
3. Robert C.K, Whitney L.: Pathogenesis of Chronic Rhinosinusitis. Saunders, 6 ed., 2015. Cumming ORL Head and Neck Surggey,Volume I, Pp:714-723
4. James N.P and Kennedy DW: Concepts of Endoscopic Sinus Surgery: Causes of Failure. Cummming ORL Head and Neck Surgery, Volume 1, Mosby Elsevier, 5 ed., 2010. Pp: 759-774
5. Shoaib F., Robert DM, Fabrice A., Alyn.H.M. On the definition of chronic cough and current treatment pathway: an international qualitive study. By BioMed Central, 2014
6. Reuben C. Setliff: Minimally Invasive Sinus Surgery. The ORL Clinic of North America.Saunders,1996, Pp:115-129 
7.  Alexander GC and James NP: Maxillary Antrostomy. Atlas of Endoscopic Sinus and Skull Base Surgery. Elsevier, 2013, Pp:65-83
8. Thuy Tran Le. The TTT for Diagnosis and Topical Treatment of CRS, Proceedings of the Yearly Congress of Vietnam ORL Sociate, Hue 2012, Pp:180- 185
Further Information
Website: taimuihongthuytran.com, earnosethroat.vn
Email: thuybudapest@gmail.com, thuyent12@gmail.com
URL video http://taimuihongthuytran.com/chronic-cough-and-chronic-rhino-sinusitis.htm 



Thuy Tran Le MD., Ph.D
Thuy Tran Otolaryngology Clinic,
6 Do Quang Str., Ha Noi, Viet Nam
Email: thuyent12@gmail.com
Website: earnosethroat.vn

Objective We have known that the treatment of Rhinosinusitis and Upper Respiratory Infections [URIs] in small children is a big challenge. In this study we would seek the main role of bacteria in RURIs and the active way to treat it. We have found a technique to diagnosis and topically treat URIs in children  as well as Chronic Rhino Sinusitis [CRS] in adults. The purpose of this report is to describe the technique used with pediatric patients under 7 years old, to evaluate the new technique and to show the results.
Study design Retrospective review study.  
Method/Material Chart review of 100 children under 7 years diagnosed with URI, who were out patients taking part in our treatment program.  Patients were seeing  at the Thuy Tran Clinic from December 2012 to December 2013. Beside of symptoms of rhinosinusitis and pharyngitis explored on all of 100 patients, in this patient group there were the following additional diagnoses: 87 Otitis Media, 31 Adenoiditis, 87 GERD.
With the patient on a bed, using a sinus endoscopic and small Thuy suction tubes, a special schedule was established by Dr. Thuy Tran Le. Using this technique with daily treatments of 5-10 days, duration infectious liquid and purulent exudates were suctioned from the sinus system, nasal passages and Eustachian tube. This was followed by irrigation with sodium chloride solution 0, 9% and a solution of topical antibiotics. In addition to this technique we also treated Otitis Media, GERD and Adenoidectomy.
Results The symptoms of URIs were completely resolved for all patients, who completed the recommended treatment. , The patients were seeing for follow up evaluation 12 months following treatment.
Conclutions 1/ The Thuy Tran technique is a safe effective method for the radical treatment of URIs in children. 2/ The technique is helpful in the treatment of patients with GERD symptom and Otitis Media. 3/ URIs are successfully treated without Tonsillectomy. 4/ Topical antibiotic therapy is much better than systemic antibiotic treatment
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