Nose & Sinuses
There are many nose and sinus problems that can be treated or resolved through surgery. For a brief description of some of the more common scenarios, please choose from the list below. Should you have a situation not mentioned here, please contact us to discuss your condition.
A blocked nose can be caused either by the structure of the nose or by a swelling of the lining of the nose (rhinitis). The main reason why the structure of the nose can cause a problem is the middle part of the nose, called the septum, is deflected to one or other side thereby reducing airflow through the nose. If this is the case this can be corrected with an operation called a septoplasty, this involves an incision on the inside of the nose and an operation to straighten the septum. This is done as either a day case or an overnight stay and does in itself cause a degree of nasal blockage which lasts for a few weeks.
If the lining of the nose is inflamed (rhinitis) this is normally treated with topical medication in the form of nasal steroids. Occasionally surgery can be performed to reduce the bulk of the lining of the nose, again this can be performed as a day case or more commonly an overnight stay. The lining can be reduced either by taking some away or using the laser to reduce the lining of the nose. For further information see the rhinitis section.
Rhinitis or rhinosinusitis is by definition an inflammation of the lining of the nose and the sinuses. This can be either allergic or non allergic rhinitis. Allergic rhinitis can be further sub divided in to seasonal i.e. hay fever or perennial which is normally an allergy to house dust mites, but also cats and dogs are common allergens.
The diagnosis of allergic rhinitis is made with a good history and examination and also skin prick testing to determine the allergen. If we can determine the allergen the treatment is steroid sprays and the use of antihistamines, usually of the non sedating variety. Surgery can be occasionally of benefit if the nose is refractory to treatment and blockage is the main problem. Attempt to avoid allergens is also useful, but may be impracticable if the allergen is house dust mite.
Non Allergic Rhinitis
The commonest non allergic rhinitis is infective usually due to viral infections that are often associated with a common cold or influenza. These would normally settle without much intervention.
Sinusitis is the inflammation of the sinuses and is normally associated with rhinitis becoming a rhinosinusitis. There are four sets of sinuses, these are called the ethmoid sinuses, situated between the eyes, the frontal sinuses which are the forehead, the maxillary sinuses which are over the cheeks and the sphenoid sinuses which are deep inside the head. Any or all of these sinuses can be involved and affected and usually the treatment is with medication and this is normally a combination of steroids and antibiotics. Occasionally surgery on the sinuses is indicated for severe or recurrent acute sinusitis.
Facial pain is a common condition and involves pain in part or all of the face. It is often attributed to sinusitis, although this is not always the case and it is important to get the correct diagnosis in order to get the correct treatment. Sinusitis is usually associated with a blocked nose, pain is worse on leaning forward and can be treated medically. Other causes of facial pain are neuralgias, this is when nerves fire off signals of pain when there is no pain present. Surgery is of no use for neuralgic pain and the treatment is anti neuralgic drugs. Migraine can also present as facial pain and as sinusitis. In order to get the treatment for this pain the correct diagnosis needs to be made.
Nasal polyps are caused by chronic inflammation of the lining of the nose which gets so swollen it causes polyps and blocks the nose. Polyps are benign swellings that often are treated medically with steroids, but are amenable to surgery should the blockage not resolve. Unfortunately, surgery may not cure the polyps as they often recur but will certainly aide the symptoms. Bad polyps are associated with asthma and a sensitivity to aspirin and similar drugs.
For more information on nose and sinus conditions, please visit the ENT UK website.