Nose and Sinus

 

The function of Nose and Sinuses

The nose plays a vital role in your daily life. It serves three primary functions: to warm cold air before it travels to your lungs, to humidify the air, adding moisture to prevent dryness and filtering air and particles, like a pollen grain.

The sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. There are four pairs of sinuses: Frontal, Maxillary, Ethmoid and Sphenoid. In healthy sinuses, the channels are open and allow air from the nose to enter the sinuses, and mucus made in the sinuses to drain into the nose.

Headaches and Pressure

Patients often schedule an appointment with our physicians due to headaches and facial pressure. Headaches and facial pain or pressure can be caused by sinus infections like acute or chronic sinusitis, resulting in sinus headaches. However, headaches and pressure can be migraines or tension headaches. Scheduling an appointment is the best way to secure an examination, diagnosis and treatment recommendations.

Nasal Congestion and Blockage

Nasal congestion and blockage is a common complaint amongst patients. Nasal congestion and blockage can be explained through four main causes: structural abnormalities, infection, allergic and nonallergic rhinitis. All the causes of nasal congestion and blockage can be treated by our physicians.

Deviated Septum

One of the causes of nasal congestion and blockage is a deviated septum. The nasal septum is the wall dividing the nasal cavity in half. A deviated septum occurs when the septum is not perfectly midline, causing the left and right sides of the nose to be divided unevenly. A deviated septum will then block the flow of air through the nose. A deviated septum can be repaired surgically to improve airflow and nasal blockage, or medication can be used to treat congestion if it is exacerbated by chronic sinusitis.

Surgical Treatment

If the deviated septum is severe enough, it can be corrected through a surgical procedure called a septoplasty. During the outpatient procedure, the deviation is corrected. If your nasal congestion or blockage is also caused by chronic sinusitis, the septoplasty may be performed with other forms of sinus surgery.

Turbinates

What are turbinates? Turbinates are structures on the side wall of the inside of the nose. They consist of inferior and middle turbinates.  The function of turbinates is to help warm and moisturize air through the nose. Like other areas of the nose and sinus, turbinates can become inflamed and enlarged, restricting airflow into the nose. Hypertrophic, or inflamed, turbinates can be diagnosed by a simple in-office examination with a nasal endoscopy.

Hypertrophic turbinates can be treated using nasal steroid sprays or antihistamine sprays, or oral decongestants for short-term relief. If medical treatment is not effective, our ENT physicians may recommend surgical treatment. An outpatient procedure can be performed to reduce or shrink the turbinates, allowing for increased airflow and relief of symptoms.

Acute Sinusitis

Acute sinusitis occurs when viruses or bacteria infect the sinuses. The infection causes the sinus lining to swell, leading to a buildup of pus and mucus. Patients often experience nasal congestion, as well as pain, pressure or fullness in the face and head or around the eyes. Acute sinusitis is likely when your symptoms last up to 4 weeks. Acute sinusitis can be diagnosed during an appointment with our ENT physicians. Acute sinusitis is treated with either an antibiotic for a bacterial infection or pain relievers, steroid nasal sprays and saltwater irrigation for viral infections.

Chronic Sinusitis

Chronic sinusitis is generally caused by continued inflammation, as opposed to a lengthy infection as seen in acute sinusitis. Chronic sinusitis is likely when symptoms persist for 12 weeks or longer and patients experience similar nasal congestion, blockage and pain, pressure or fullness in the face. As chronic sinusitis is caused by inflammation, the treatment options can differ from acute sinusitis. Chronic sinusitis is diagnosed with an office examination and can be confirmed with a CT scan.

Medical Treatment:

After being diagnosed with chronic sinusitis, medical treatments to control inflammation can include saltwater irrigation, nasal steroid sprays, antibiotics, and oral steroids. Medical treatment is often effective for patients, but surgery may be recommended in certain cases.

Surgical Treatment:

In some cases, surgical treatment is recommended for patients with chronic sinusitis, particularly with patients suffering from nasal congestion worsened by a deviated septum. When symptoms cannot be controlled by medication alone, our ENT surgeons will recommend surgical intervention, in the form of endoscopic sinus surgery. The surgery is performed to widen the pathways between the sinuses and nose, allowing proper drainage and airflow and to remove chronically inflamed sinus tissue. Patients who undergo sinus surgery can find significant improvement in their symptoms post-surgery. This can include reduced congestion, blockage, facial pressure and pain and an overall increase in quality of life.

One form of sinus surgery is balloon sinuplasty. A balloon sinuplasty is a quick procedure, performed in the office by our ENT physicians. It is a minimally invasive procedure to open blocked sinus passages, using a balloon catheter. The procedure is a good option to help patients who suffer from pressure and congestion with sinusitis and can be preferable to an outpatient surgical option like traditional sinus surgery.

Septal Perforation

The nasal septum is the wall dividing the nasal cavity in half. A septal perforation is when the septum develops a hole or opening. Perforations can vary in size and severity. Patients with perforations can experience a variety of symptoms, from a whistling noise while breathing, nasal pressure, difficulty breathing, loss of sense of smell and bloody discharge. Septal perforations can be treated by our ENT physicians with a surgical procedure to repair the perforation.

Nose Bleeds

Nosebleeds, or epistaxis, are a common medical condition that many patients experience. Nosebleeds can occur at any age, but frequent nosebleeds are most common in young children aged 2-10 years and adults aged 50-80 years. Nosebleeds can be divided into two types, depending on the location of the bleeding source: anterior or posterior.

Anterior nosebleeds are bleeds that originate in the lower part of the septum. These nosebleeds are common in dry climates or during the winter when the lack of moisture in the air dehydrates the nose. Keeping the nose moisturized and hydrated in dry conditions is helpful in preventing anterior nosebleeds. Patients can use a humidifier to counteract dry air, or a saline nasal spray to moisten the nasal membranes.

Posterior nosebleeds are bleeds that originate in the higher part of the nose. Because of the location of the bleed, posterior nosebleeds are generally more severe than anterior nosebleeds and will nearly always require medical care. Posterior nosebleeds are more likely to occur due to injury to the nose or face, or in older patients or patients with high blood pressure.

If you experience frequent nosebleeds, it is important to schedule an appointment with our ENT physicians. Our physicians will perform an examination to determine the location and cause of nosebleeds and the correct treatment. One of the most common treatments for nosebleeds is cauterization. Our ENT physicians will determine the location of the bleed and can use silver nitrate to cauterize the enlarged or bleeding vessel. This is a brief and non-invasive treatment that can be performed in the office during your appointment.

Nasal Fractures

One of the most common complaints seen by our ENT physicians is nasal fractures. Nasal fractures, or “broken nose”, frequently occur after being struck in the face. Immediately after the injury, patients often experience bleeding, difficulty breathing through the nose, nasal swelling internally and externally, and bruising around the nose and eyes. If you experience a facial injury, it is important to see a doctor as soon as possible after the injury occurs. If a patient is seen within one to two weeks after the injury, our ENT physicians may recommend surgery to repair the fracture. If left untreated, a nasal fracture can lead to difficulty breathing and altered nasal appearance.

Once you schedule an appointment, our ENT physician will perform an exam to determine the proper course of treatment. If the nasal bone is out of position, surgery may be needed to reposition and repair the bone.