Nose

DEVIATED SEPTUM

The nasal septum is the divider between the right and left nasal cavities. It is made up of bone and cartilage. When the septum is off center or crooked, this can lead to difficulty breathing and chronic sinus conditions that will require treatment. In some cases, medications such as nasal steroid sprays, decongestants or antihistamines will help to relieve the obstruction. In more severe cases, surgery may be necessary to improve breathing and straighten the septum. This is usually done as an outpatient procedure and patients can typically get back to resuming normal activities in 7-14 days.

NASAL POLYPS

Nasal polyps are benign growths that occur within the nasal passages. These can lead to blockages of the sinuses, breathing issues, decreased sense of smell and chronic sinus infections. Typically, nasal polyps are found in patients with a history of allergies and/or asthma. Nasal polyps are usually diagnosed with inspection of the nose with a light or a small telescope in the office. Treatment can include nasal sprays, nasal rinses, antibiotics or steroids. In patients where medical therapy is ineffective, surgery can be an option to remove the polyps and open the natural drainage pathways to the sinuses.

SINUSITIS

Sinusitis is a condition that involves inflammation and swelling of the tissues that line the sinuses. This can lead to disruption of normal mucus flow causing breathing issues, facial pressure, and thick nasal drainage. Sinusitis is usually diagnosed based on a thorough medical history, inspection of the nasal cavities, and possibly imaging tests such as CT scans or MRIs. Treatment for acute, recurrent, or chronic infections can be managed medically with saltwater nasal sprays, steroid nasal sprays, antibiotics, or even oral steroids. In cases where medical therapy is inadequate, surgery can provide symptom relief by opening the sinuses to allow for better mucus drainage

NASAL CONGESTION

Nasal congestion, or colloquially a “stuffy nose”, is a common complaint that can affect your ability to smell, taste and breathe. This can occur when the nasal lining becomes swollen and inflamed. Treatment will depend on the cause of congestion but is usually managed by medication. Decongestants, antihistamines, saltwater nasal sprays or medicated nasal sprays can all help to relive the stuffy nose and help you breathe and smell better.

LOSS OF SMELL

Loss of smell can be partial or complete and can cause severe discomfort for suffering patients. Most commonly, this is a temporary condition related to a cold or upper respiratory infection. In some cases, it may be permanent and/or the sign of a serious condition. A thorough medical history and inspection of the nose by an otolaryngologist is required to find out the cause of the condition. In some cases, imaging such as CT scans or MRIs may be needed to further investigate. Treatment will be dependent on what the cause is, and in some cases, it cannot be treated effectively by medical or surgical therapy. In cases where sense of smell is permanently lost, it is important to take extra precautions to ensure safety; these include making sure your smoke detectors are in working order and checking all expiration dates on perishable food.

NOSEBLEEDS

Nosebleeds are unfortunately a quite common occurrence. These will typically affect younger children as well as older adults. Most of the time, these bleeding episodes will be caused by a dry and cracked nasal lining. Nosebleeds are more common in the winter months when the air is cold and dry. If nosebleeds become more frequent or severe, treatment by an otolaryngologist can help to relieve these episodes. In most cases, humidification of the nose with topical gels and sprays can help to prevent further episodes. In more severe cases, cauterization procedures, typically performed in the office, can help to treat the source of the bleeding, and help to prevent future bleeding episodes.

RUNNY NOSE

Also known as rhinitis, runny nose is a common occurrence in children and adults. It can be caused by a variety of factors including viral infections, airborne particle irritants, foods and beverages, certain medications, or allergies. Treatment is typically with nasal sprays or saltwater nasal rinses. In more severe cases, a new type of procedure called Clarifix can relieve symptoms by using cryotherapy to inactivate the nerve in the nose that causes nasal drainage.

FESS/ENDOSCOPIC SINUS SURGERY

In patients who are suffering from sinus disease where medical therapy has not relieved their symptoms, your doctor may recommend a surgical procedure known as functional endoscopic sinus surgery (FESS). This is typically done in the operating room but may be done in the clinic in certain situations. The procedure involves using an endoscope – or a small camera – to look inside of the nose and open the sinus drainage pathways. The entire procedure is performed through the nostrils, so it will not leave any scars on the face, swelling or facial bruising. This procedure is usually done on an outpatient basis and no overnight stay is needed. Recovery is typically mild, and patients will usually feel like they are back to themselves in less than one week.

BALLOON SINUS DILATION

In a certain group of patients who suffer from chronic sinusitis or frequent sinus infections, a newer procedure called balloon sinus dilation can be used to help open the sinuses in a minimally invasive approach. A small catheter with a balloon is guided into the natural sinus opening and then the balloon is dilated. This widens the natural sinus opening to allow for better mucus drainage. This procedure can be done in the operating room or the clinic and patients have minimal downtime afterwards.

TURBINATE REDUCTION

The nose has multiple sets of turbinates on either side which help to warm and humidify the inhaled air. In certain situations, these turbinates can become enlarged and restrict nasal breathing. Medical therapy is usually first line and can involve nasal steroid sprays, decongestants, and antihistamines. In patients where medical therapy is inadequate, surgery can be necessary to shrink the turbinates to allow for better nasal breathing. This is often performed in combination with correction of a deviated septum to allow for the most open and non-obstructed nasal passages

SLEEP APNEA AND SNORING

Sleep apnea, a condition where breathing is interrupted periodically during the night, is a relatively common condition that affects both children and adults. Snoring can be sometimes associated with sleep apnea, but not always. Sleep apnea is usually caused by an obstruction in the airway during sleep, which can occur in the nose, in the mouth or in the throat. Treatment for sleep apnea is dependent on where the obstruction is occurring. In children with sleep apnea, surgery to remove the tonsils and adenoids is typically the first line treatment. For adults, occasionally surgery is necessary, while in other cases CPAP (continuous positive airway pressure) devices can be used to help allow for more restful sleep. For adult patients who have been previously unable to tolerate CPAP, a newer device called Inspire can be used to help with their sleep apnea. This is an implantable device that allows for a significant decrease in sleep apnea symptoms. Surgery is typically performed outpatient and with minimal downtime.