Methods of treating polyps in the nose: surgery and folk remedies
Last reviewed: 23.04.2024
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Today, polyps in the nose have become almost one of the most basic problems that otolaryngologists have to face. This is a problem whose success is the result of joint actions of the doctor and the patient himself. The doctor should be able to correctly choose the optimal therapy, timely diagnose, clearly differentiate polyps from other similar pathologies. For example, polyps are often difficult to distinguish from adenoids, cancerous tumors. In order to accurately diagnose, you need to conduct a number of laboratory, instrumental studies, differential diagnosis.
The treatment protocol
The patient, in turn, must pay attention to his health. When the first signs of the disease appear, you need to consult a doctor and conduct all necessary studies. It is necessary to treat concomitant diseases, to comply with all the recommendations of a doctor. It is important not only to attend the prescribed procedures, but also to comply with all the requirements of the house.
Drops from polyps in the nose
Polyps in the nose often use different drops. Well proven fatty, oil droplets. They provide an opportunity to soften the mucous membrane, reduce the inflammatory process, eliminate irritation. Drops can be purchased at the pharmacy, or you can cook at home on your own. From commercial preparations I use pinosol, sanorin. Drip 1-2 drops 3-4 times a day.
To prepare drops at home, it is recommended to take olive oil, or grape, apricot, peach seed oil as a base. They have a softening effect, positively affect the mucous membranes, nourish and saturate with vitamins, which significantly increases local immunity, accelerates recovery and promotes resorption of compacted tissues.
For example, a glass of olive or other base oil is boiled in a water bath for 30-40 minutes. Add 2-3 cloves of garlic and a quarter of the onions. They boil for another 3-4 minutes. Then remove from heat, give the opportunity to brew for several hours. Drip 3 drops 4 times a day.
The oil is boiled in a water bath. Add 2-3 teaspoons of chamomile flowers. They boil for another 2-3 minutes. Remove from the fire. Insist for an hour. Drip 2-3 drops 3-4 times. A wonderful anti-inflammatory drug that quickly removes inflammation, redness, eliminates nasal congestion and swelling.
As a counter-infection, drops from calendula are used. To prepare a tablespoon of flowers and marigold seeds, pour a glass of boiling base oil, insist for an hour. Drip up to 5 times a day for 2-3 drops.
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Sprays from polyps in the nose
Sprays are used after the treatment with oil droplets is completed. They proved themselves well in the recovery period after operations, for the prevention and treatment of polyps.
Many patients are helped by such sprays as: allergoodil, nazivin, baconase, fliksonase, tafen. Most of them have anti-inflammatory, anti-allergic action, eliminates edema and flushing. Apply them for a long time - at least a month. Sprays contain an installed dispenser, which makes it possible to establish the same and accurate dosage. Assign 1-2 doses to each nostril. Depending on the severity of the disease, apply 2-4 times a day.
Ointments from polyps in the nose
Different ointments are good for polyps. They can be purchased at the pharmacy in ready-made form, or prepared independently. Lubricate the nasal cavity with a thin layer. It is recommended to apply after the nose has been previously cleaned. Can be applied after washing. In the pharmacy are sold such ointments as sanorin, lanolin, salicylic ointment.
You can prepare the ointment yourself. Well proven to pine or fir ointment. To prepare, you need 100 grams of butter. Melt it on a fire or a water bath. Gradually introduce a tablespoon of pine needles or fir. Cook on low heat for 2-3 minutes with constant stirring. They set it aside and cool it. They give the opportunity to freeze. After that, the ointment is ready for use. It is applied a thin layer on the nasal mucosa 2-3 times a day.
Also apply a honey-creamy ointment. For cooking, butter melts on low heat, gradually pour in honey. Stir until completely dissolved, then remove from heat, allow to freeze. Apply to the nasal cavity with a thin layer up to 5 times a day. Do not take people who are allergic to honey and propolis.
Inhalation with polyps in the nose
Polyps are well assisted by inhalation. It is possible to carry out special physiotherapeutic procedures, for example, KUF, inhalation effects of extracts and drugs.
At home, you can carry out inhalation over the steam. For example, inhalations with the help of decoctions of herbal remedies have proved well. To prepare the broth take 3-4 tablespoons of herbs per liter of water, pour boiling water, insist for half an hour, wrapped the kettle with heat. Then the broth is poured into the pelvis. If the broth has cooled down, and steam does not go, it should be heated.
After that, bend over the pelvis, top cover the top with a towel and breathe over the steam. The duration of the procedure is 10-15 minutes. Contraindicated for people with diseases of the cardiovascular system. Also it is impossible to spend in the period of sharp exacerbations, at the raised temperature.
Herbal remedies can be used different. Remove the inflammatory process will help chamomile, calendula, mint, sage. Anti-viral and immunostimulating properties are possessed by nettle, stevia, ginseng, and eluurotococcus. Remove allergic reaction will help the leaves of mint, birch buds, bark of oak. You can prepare mixtures of several plant components.
Also saline inhalations have proved to be good. Salt eliminates swelling, relieves inflammation. To prepare a solution for inhalation, a tablespoon of salt is added to a liter of water. You can use sea salt. In the absence of sea salt, you can prepare it yourself. To do this, mix a spoonful of salt, soda and add 2-3 drops of iodine.
A positive effect can be achieved with the use of essential oils. The most effective for polyps are coniferous oils. You can use oil of thuja, eucalyptus, juniper, fir, cypress, pine, spruce. To prepare a solution for inhalation, 1-2 drops of oil are dissolved in a liter of boiling water.
Perform inhalation should be at night. After the execution it is necessary to go to bed as quickly as possible, warmly hiding.
Nebulizer with polyps of nose
In polyps for inhalation, you can use a nebulizer. This is a special mini-device that contains a spray can with a drug, a device for spraying. In addition, the kit includes a mask for inhalation. The mask is used mainly for children.
In this form, many inhalation agents are manufactured, for example, avamis, bioropox, fliksonase. The advantage of this method is that the dosage of the drug is strictly calculated. One inhalation contains the required amount of active ingredient. It allows you to quickly remove inflammation, eliminate swelling.
Antibiotics for polyps in the nose
Antibiotics are used when polyps have appeared against the background of a bacterial infection, or if a concomitant infectious process, caused by bacteria and their toxins, develops in the body. Antibiotics should be taken after an analysis of antibiotic sensitivity. It makes it possible to isolate the microorganism, which is the causative agent of the disease, to identify it, to study the basic properties. An antibiotic agent is selected which has the most pronounced bacteriostatic effect in relation to the excretory pathogen. Its optimal dosage is selected. Only after this drug is prescribed to man.
If it is not possible to conduct such an analysis, a routine bacteriological culture can be carried out, which will make it possible to detect a microorganism or a group of microorganisms that contribute to the development of the infectious process. On the basis of this, an approximate selection of the medicinal product or group of preparations that have a bacteriostatic action with respect to this causative agent is made. It is possible to prescribe a broad-spectrum antibiotic that has moderate activity against many groups of microorganisms.
Often used drugs such as amoksiklav, erythromycin, ciprofloxacin, penicillin, amoxicillin, streptomycin. The course of treatment is from 3 to 7 days. It is important to complete the course of treatment, even if the state of health has improved, and the polyp has decreased in size. This will make it possible to completely eliminate the infectious process and avoid relapse in the future.
In addition, if you do not complete the course, the bacteria that survive, mutate, become resistant. The next time the antibiotic will be ineffective. The danger is that bacteria acquire resistance not only to this antibiotic, but to the entire group of drugs. In the future, bacteria can acquire multiple resistance with cross reactions. Thus, even other groups of microorganisms will not have an impact.
The best hormonal drugs from nasal polyps
The best hormonal drugs are those that have minimal effect on the body and have virtually no side effect. Under this category, drugs that have a local effect, that is, they act exclusively locally on the hyperplastic mucosa of the nose and nasal sinuses. Systemic action on the entire body, these drugs should not be given, they should not be absorbed into the blood either. Such preparations exist and are most often represented by injections, sprays, drops for the nose. Well-proven drugs such as nazoneks, fliksonase, beclomethasone, nasobek.
Injection from nasal polyps
Today, more often in otolaryngological practice, hormonal injections are used, which are injected directly into the polyp. Gradually, it resorbs. The polyp completely dies after the end of the full course of treatment. Then the doctor removes it, or he himself is eliminated, for example, by sneezing.
The number of injections and their dosage is determined individually and depends on the prevalence of the pathological process, the degree of its severity, the presence of concomitant diseases. The hormonal agent is selected individually, first checked. If it came up, then within a month you can expect positive results. There are all chances for complete disposal of polyps and prevention of relapses.
The method is used as an alternative to surgical intervention when surgery is impossible. After the polyp is removed, the immune system is adjusted. Immunity is adjusted in accordance with individual and age norms, the imbalance is eliminated, which allows to normalize the body's defenses, mobilize internal resources, increase the body's resistance and its speed of recovery.
Diprospan with polyps of the nose
The main injecting agent used to remove polyps in the nose is diprospan. It is a hormonal drug that is injected directly into the polypous neoplasm. It is a wonderful alternative to surgery, allows you to quickly get rid of polyps. It is also important that this drug makes it possible to avoid side effects, since it does not have a systemic effect on the body.
When passing the therapy it is important to follow certain rules. The daily dosage of the drug is 1 ml. With a strong atrophy of the mucous layer and its excessive hyperplasia, 1-2 injections are enough to notice a tangible result.
Also it is necessary to consider, that it is possible to introduce hormonal means not more often, than once a week. This will make it possible to avoid side effects and reduce the burden on the body, at the same time, it will allow to remove polyps in the nose without relapses and complications. As a result of such therapy, the polyp is rejected by the mucosa. He can be removed, or he will fall away. It is important after the therapy to undergo a recovery course aimed at correcting the immune system and preventing repeated growths.
Beet from polyps in the nose
Beetroot increases immunity, clears the body of toxins and toxins. Contains a large number of vitamins. It has antioxidant properties. Can be added to a variety of salads. You can cook puree from fresh beets. For cooking 2-3 fresh beets in raw form are rubbed on the grater, add salt to taste. Use three times a day. For the day you need to eat all the mashed potatoes. The next day they prepare a new one.
Also a mixture of beets with honey has proved to be very good. To prepare mashed potatoes add 1-2 tablespoons of honey, mix until a homogeneous mass is formed. Use during the day.
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Beetroot juice from polyps in the nose
From polyps in the nose well-proven beet juice. A day is recommended to drink 50-100 grams of juice. In it you can add a teaspoon of honey. Also in the juice can be added a pinch of coriander, basil, mint. This will enhance the taste and medicinal properties of the juice.
Treatment of polyps of the nose with honey
Honey has long been used as a remedy for fighting many infectious and somatic diseases. Honey has a wide range of effects. It reduces inflammation, eliminates irritation, swelling, and flushing. Has an emollient, antiseptic, wound-healing effect. Promotes resorption of small tumors, restrains the growth and development of tumors. In addition, it normalizes metabolic processes, removes toxins and toxins, normalizes the state of the immune system, increases the body's resistance to infectious diseases.
Honey is used inside and outside. It can be used for compresses on the nasal septum, as an ointment for application to the nasal mucosa. Honey solutions can gargle, wash the nose. From honey prepare tortillas, which are imposed on the area of the nose for warming. Honey is added to the composition of inhalation solutions, doses and mixtures to soften the mucous membrane. Cough candies, syrups, medicines, tinctures, decoctions are prepared for children.
Apply mainly linden honey. It has a beneficial effect on the mucous membranes: restores, relieves inflammation, eliminates flushing, edema, hyperplasia. It has powerful antiseptic properties. Honey is contraindicated only to people with allergies to honey and people suffering from diabetes. In the rest, the remedy has practically no side effects.
To prepare a decoction for washing the nose and rinsing, take a tablespoon of honey on a glass of water. Instead of water, you can use a decoction of chamomile, sage, calendula. So you can strengthen the effect of the procedures, achieve a greater positive effect.
To lubricate the nasal cavity and resorption of polyps, honey is used with eucalyptus. To prepare the mixture take 50 ml of eucalyptus oil, add a tablespoon of honey, mix thoroughly. Used as an ointment. Before use, stir it.
For ingestion with polyps, some remedies are also recommended. They help to increase immunity, body resistance, normalize health. Accordingly, the inflammation decreases, the tumors of the neoplasm dissolve.
Well-established plant collection. For cooking, you will need chamomile flowers, calendula flowers, sage leaves, oak bark. The plants are mixed together. The dessert spoon of the mixture is boiled, then placed in a thermos for infusion. Add honey, mix thoroughly. Drink a third of the glass from 14 to 28 days.
Infusion of honey also has a positive effect. It will take 100 grams of honey. Pour 500 ml of vodka or alcohol, allow to stand for several days. After that, the product is ready for use. It is recommended to drink a quarter cup twice a day. It is also possible to lubricate this nasal cavity with a copious discharge of mucus, especially purulent.
Honey is used as part of inhalation. For the inhalation, 2 tablespoons of honey is added per liter of hot water. Dissolve, then pour into the pelvis, lean it hell. Top covered with a towel or sheet. The duration of the procedure is 10-15 minutes. Instead of water, you can use various vegetable decoctions, medicines.
Mummy with polyps of nose
The mummy is a thick, hard mass that dissolves easily in water. It is a substance of organic origin, which is produced by animals. Toxic properties do not. It is widely used for the treatment of inflammatory and infectious diseases, promotes the body's resistance, normalizes the immune system, increases the endurance of the organism, significantly improves well-being.
Take recommended early in the morning, before you get out of bed. After the drug is drunk, it is recommended to lie down for 30-40 minutes, it is better to sleep. To prepare the solution, use 0.5 to 1 gram of mummy per liter of water.
Also, to lubricate the nasal cavity, ointment from the mummy can be used. To prepare the ointment, 1 gram of mummy is dissolved in 100 ml of warm water. Take 100 grams of butter, melt it over low heat. While stirring constantly, pour the previously prepared mummy solution in water. Stir thoroughly, until a uniform mass is formed. After that we remove from the fire, we give the opportunity to freeze. Store the ointment in the refrigerator. It is used mainly at night. It is necessary to lubricate the nasal cavity with a thin layer. After that, you need to go to bed, warmly hiding.
Also used for compresses. Take the prepared ointment, spread a thin layer on the nose and around the nose. From the top you can cover with cellophane or polyethylene, which will preserve heat, humidity. Then dry heat is superimposed on top, a fabric made from natural wool is better. This compress should be kept for 20-30 minutes. Then the compress is removed by wiping with a damp cloth.
Treatment of the polyp of the nose with propolis
Propolis, or bee glue is a substance that is mainly used by bees to make beehives. Many of the components are irreplaceable substances that are not synthesized in the body, but only come from outside.
Propolis is used with a preventive and restorative purpose, for treatment. It is used in the composition of broths, infusions, syrups. It can also be used for compresses, wraps, as part of inhalations, rinses for rinsing.
Well proved to be an ointment from propolis and alcohol. Alcohol should be a small amount, which will allow propolis to dissolve. After that, in a separate bowl, approximately the same amount of Vaseline is melted, mixed. Boil for about 5-10 minutes. Filter the ointment. Finished stored in the refrigerator. Lubricate the skin surface, nasal cavity mucosa. Sometimes it is similarly prepared for lanolin ointment, adding lanolin as a base.
Propolis oil is also used as an ointment. You can take a piece of butter, you can dissolve in a glass for drinking. For the preparation of propolis oil, about 100 grams of butter is melt, after complete dissolution, separately dissolved propolis in alcohol is added, allowing to infuse. Eat a small slice every 10 hours. You can dissolve the oil and drink it as a drink.
Propolis extract is prepared from 50-100 grams of propolis and 300 ml of 96% alcohol. Insist for 5 days. The extract is taken immediately, but only after preliminary dissolution, since it is concentrated. Do not take it undiluted. It must be diluted with water to a solution of the desired concentration.
Leeches from polyps in the nose
Hirudotherapy, or treatment with leeches, is gaining popularity both in non-traditional and in traditional medicine. The treatment is based on the effects of enzymes, which are contained in the saliva of leeches. When barking the skin, the leech injects into the skin a special set of enzymes, which has a therapeutic effect on the person. First, these enzymes have an analgesic effect. Secondly, enzymes are anticoagulants, which prevent blood clotting, dilute blood.
They also have an anti-inflammatory effect, promote the dissolution of certain components, dissolve seals, polyps, neoplasms. Slows the growth rate of malignant tumors. Hirudotherapy is contraindicated in people who have problems with blood coagulability. Contraindicated treatment leech to people with hemophilia, diseases of the cardiovascular system.
Saline solution for polyps in the nose
Salt removes the inflammatory process, eliminates swelling of the tissues, and also removes excess fluid from the body. This eliminates the inflammatory process, and also prevents the formation of exudate, mucus. Saline solutions are used to wash the nasal cavity, to rinse the throat. Also can be used as a means for lotions and compresses. Salt as a means for inhalation has proved itself well.
For cooking, usually take a tablespoon for 500 ml of warm water. Dissolve the salt. Then apply, depending on the method of application. So, for washing and rinsing, use only a warm solution.
For compresses and lotions, gauze should be moistened in a warm solution. After that, apply gauze to the nasal septum. The lotion is left this way for 10-15 minutes. Compress on top covered with cellophane and dry heat, woolen cloth. Take off after 15-20 minutes.
To conduct inhalations, the hot salt solution is poured into the basin for inhalation, tilted over it. Top with a towel. Breathe in pairs of salt for 15-20 minutes. After that, you need to go to bed as soon as possible.
Sea salt from polyps in the nose
The sea salt has a good effect on the respiratory system. Thanks to the content of trace elements, other compounds, it normalizes metabolic processes in the body, restores mucous membranes. Very quickly eliminates edema and flushing.
If there is no ready-made sea salt, you can prepare it yourself. To prepare, you need a teaspoon of salt, half a teaspoon of soda and 2-3 drops of iodine per 500 ml of warm water. It is used for rinsing, rinsing, inhalation.
Avamis with polyps in the nose
Avamis is a hormonal steroid that has a local anti-inflammatory effect. Produced in the form of a spray and a nebulizer for inhalation. The advantage of this method is that it allows only local impact. Due to the fact that the drug does not have a systemic effect, the risk of side effects is minimized. There are almost no contraindications.
Treatment of polyps in the nose with onions with honey
To prevent the further development of polyps and their resorption, the onion proved to be well established. Its properties are enhanced when combined with honey. Onions have anti-inflammatory and antiseptic effects. Honey softens the mucous membranes, stimulates the immune system, increases the resistance of the body.
Well-established onion puree with honey. For cooking, take one large onion, rub on a grater or pass through a meat grinder. Mix with honey (tablespoon). Stir until a homogeneous mass is formed. Take during the day. The next day you need to prepare a new remedy.
Also take onion juice with honey. For 50 ml of juice add a teaspoon of honey. Mix, drink on a teaspoon three times a day.
Puree onions with honey can be applied to the nasal septum as a lotion or compress, which also promotes the resorption of hypertrophied tissue by reducing the size of the polyp.
Garlic with polyps in the nose and sinus
Known for antiviral and antibacterial properties. Removes inflammation, eliminates irritation, swelling.
To make a broth of garlic, pour a glass of boiling water. Bring to a boil, then insist for an hour. Take 2 tablespoons three times a day.
Infused with garlic. One head of garlic is ground, passed through the scabbard. For pouring, 500 ml of alcohol is required. The product is thoroughly mixed with honey.
Removal of polyps in the nose with urine
Urine contains a complex of enzymes that lyse bacterial microflora, foreign entities. Urine is a sterile liquid. It has long been used as an antibacterial agent. In the field and during the war years, urine was used to disinfect wounds, treat damaged surfaces, treat gangrene and wound infections.
To remove polyps with urine, urine was used. The nasal cavity is washed with a fresh portion of urine, while it is warm. Washings are done 3-4 times a day, until the polyp does not come out, or dissolve.
Black pepper from the polyp of the nose
Black pepper improves blood circulation, thereby providing full blood access to the inflamed area. Damaged cells, metabolic products and toxins are rapidly excreted from the body, the resorption of exudate occurs. Accordingly, edema and hyperplasia of the tissue are significantly reduced, the polyp decreases in size.
Black pepper can be added to drinks. Drink at the rate of approximately 5 grams per 200 ml of tea. After that, it's better to go to bed, do the procedure better in the evening.
You can also pour a little ground pepper on a glass of vodka, drink a volley, and go to bed.
Iodine from polyps in the nose
Iodine is useful in that it is included in the metabolism, and normalizes both the structural and functional state of the body. In addition, iodine normalizes the endocrine state of the body, positively affects the function of the thyroid gland.
You can draw iodine mesh on the surface of the skin (on the bridge of the nose). In this case, iodine will be absorbed by the skin, and included in the metabolic processes. It will promote resorption of seals and neoplasms, healing of wounds, reduction of bleeding. Iodine can also be used as a part of the throat rinse and nose wash.
Treatment of polyps in the nose celandine
To prepare a broth a teaspoon of grass is poured a glass of boiling water, insist for 30 minutes. Gradually increase the concentration to three tablespoons. Then filter, take in a warm form for a quarter cup for 30 minutes before eating. Take three times a day. If there is weakness, discomfort, you need to start with lower concentrations, gradually increasing them.
Also, celandine is a part of many medicinal charges. To prepare a collection for the treatment of polyps, tumors, it is recommended to mix 1.5 tablespoons of celandine with 1.5 tablespoons of three-color violets. Pour a glass of boiling water. Drink within a day in small sips. From the same broth, you can use medical baths, carry out inhalations.
White lily from polyps in the nose
Vodka and alcohol infusions of white lily, which have long been used as a means for ingestion, as well as for resorption of tumors, hematomas, have become very popular. They were used to wash fresh and purulent wounds, to treat diseases of the nose. Gorda, for the treatment and prevention of inflammatory and infectious diseases. To prepare the infusion, all parts of the lily were used: roots (bulbs), stems, leaves, flowers.
Prepared at the rate of 1: 5, where 1 part - vegetable and 4 parts - alcohol. Apply lime infusion, both in its pure form, and in the composition of plant charges. For the preparation of fees, all components are taken in equal parts. Well-established lily infusions with the addition of rhizomes white, lingonberry, two-year-old octopus, magnolia vine, ovary, chickenpox, rosemary. Take infusions usually on a tablespoon three times a day.
Kalanchoe from polyps in the nose
Kalanchoe has anti-allergic and anti-inflammatory properties, and significantly reduces swelling. Degrades the seals.
Most often used in the form of drops in the nose. To do this, it is required to squeeze the juice from the leaves of the plant, allow to stand for 10-15 minutes. Then dig into each nostril for 5 drops, thrice a day. Causes a strong sneeze, since the juice is a potent substance, contains a large number of flavonoids and phytohormones. It has an irritant effect on the receptors. At the same time, there is a powerful therapeutic effect.
New in the treatment of polyps in the nose
Today, this method of endoscopic surgery, such as removal by shiver, is widely used. This is a relatively new method in surgery, in which the image is displayed on the monitor screen, and the doctor has the opportunity to see the whole picture, evaluate the situation as a whole, and monitor it. The removal procedure is carried out under anesthesia.
Shaver is also called a microdebridge, it makes it possible to remove the polyp completely, down to a healthy tissue. This almost completely eliminates the risk of recurrence and re-growth of polyps. In addition, the risk of injury and traumatic procedure are minimized. This is due to the fact that using this device you can grind the polyp. Then it is completely absorbed.
After the operation, the mucosa remains as healthy as possible, the recovery occurs very quickly. There are practically no bleeding. The postoperative period lasts 3-5 days, after which the patient can be discharged home. At this time, it is necessary to carry out lavage. Most often use a saline solution. With the help of this tool, not only the edema and inflammation is removed, but also the remnants of tissues are removed, the risk of complications, bleeding decreases. To prevent the risk of infection, prescribe antibiotics. The procedure is contraindicated in acute inflammatory processes and with pronounced allergic reactions.
A laser is also used. The procedure can be performed even on an outpatient basis. A special preparation is not required. Except that you can not eat on the day of the procedure. An analgesic is injected into the polyp area. Then an endoscope with a camera and laser equipment are introduced. The camera allows you to display the image on the screen.
With the help of a laser beam, the doctor performs heating of the cells from which the polyp consists. Evaporation of these cells occurs. The laser simultaneously seals the blood vessels, so bleeding does not occur. Due to minimal interventions, the risk of infection is significantly reduced. Such a procedure can be carried out even for people suffering from bronchial asthma.
In a few days, you need to visit a doctor in order to check the condition of the mucosa. After the procedure, a recovery period may be required. Assign special ointments, sprays, aerosols, which prevent the re-growth of tissue and reduce the likelihood of inflammation, infection.
Such an operation is contraindicated in obstructive and asthmatic bronchitis, asthma, with multiple polyps. This method has one serious drawback - the inability to open sinuses. Accordingly, the polypous tissue in them is not removed.