Evaluation of nasal symptoms begins with a careful history of the problem and examination of the upper airway. Nasal congestion is often due to a combination of allergies and structural abnormalities. Allergies are an abnormal response of the immune system to a substance known as an allergen. Allergens are substances to which particular individuals have extreme sensitivity. When a person is exposed to an allergen, the body releases chemicals including histamine, which produce the allergic reaction.
Structural causes for nasal obstruction include deviation of the nasal septum (the midline wall separating the two sides of the nose), enlargement of the turbinates (rolls of tissue in the nose that normally swell and shrink throughout the day), and allergic polyps. Tumors in the nose are rare. Nasal polyps are benign growths that develop within the lining of the nasal passages or sinuses. If large enough, these growths may block the passages and cause breathing difficulties, sinus infections or other complications. Nasal polyps are most common in adults, especially those who have asthma or allergies.
Most nasal obstruction is initially treated with medications including nasal steroid sprays, nasal antihistamine sprays, oral antihistamines, and/or nasal saline sprays.
Sinusitis
Sinusitis refers to an inflammation of the lining within the paranasal sinuses. Most acute cases of sinusitis are caused by an inflammation of the sinuses that eventually lead to a bacterial infection. With chronic sinusitis, the membranes of both the paranasal sinuses and the nose are thickened because they are constantly inflamed, possibly due to allergies, nasal polyps or asthma.
Sinusitis can be treated through courses of antibiotics, nasal steroid sprays, saline sprays or oral steroids. When medical therapy fails, surgery may be an alternative.
In-Office Sinus CT Scan
Sinus CT imaging is a minimally invasive exam in which images are taken of your sinuses, similar to an x-ray. This exam is helpful in diagnosing sinusitis and many other conditions of the sinuses. We use in-office CT scans so that you can conveniently have your imaging done right in our office. This high resolution machine provides us with immediate imaging and a faster diagnosis. It also emits less radiation than a traditional CT imager and allows you to sit upright in an unenclosed space.
Surgical Options for Nasal Symptoms
Septoplasty
Septoplasty is an outpatient surgical procedure to correct deformities of the septum that are causing nasal obstruction not responsive to medications. Under general anesthesia, incisions are made inside the nostrils to straighten the cartilage and bone. This surgery usually results in dramatic improvement in nasal breathing. Septoplasty is often combined with partial reduction of the inferior turbinates.
Sometimes, patients request cosmetic rhinoplasty (reshaping the outside of the nose) to be done at the same time as a septoplasty. The recovery is similar and this can be cost effective for the patient. Be sure to let your surgeon know if this is something that interests you.
Nasal Polyp Treatment
Treatment for nasal polyps is often provided through allergy medications that can reduce the size of the polyp and associated symptoms.
Surgery may be required if medication is unsuccessful, and may include involve office polypectomy or endoscopic sinus surgery. A polypectomy is a surgical procedure that completely removes polyps to relieve symptoms and reduce the chance of recurrence. This procedure can sometimes be performed in your doctor’s office under local anesthesia. More extensive polyps are removed in the operating room under general anesthesia.
Image-Guided Endoscopic Sinus Surgery
Endoscopic sinus surgery (ESS) is done under general anesthesia as an outpatient. Scopes and instruments are passed through the nostrils to remove polyps and enlarge sinus openings to improve drainage. CT image-guided navigation provides our surgeons with the most detailed, real-time views of the sinus anatomy during the procedure, allowing safer, more complete surgeries.
In-Office Balloon Sinuplasty
Balloon sinuplasty is an FDA-approved advanced treatment option to relieve the symptoms of chronic sinusitis. This minimally invasive procedure uses a thin, flexible balloon catheter that is passed into the naturally small sinus openings. The balloon is briefly inflated to restructure the thin bone and soft tissues, improving natural sinus drainage. Patients go home minutes after the procedure, and pain and bleeding are mild. Balloon sinuplasty is regarded as a safe and effective procedure with no serious complications. Many patients return to their regular activities within 24 hours. The physicians of Desert ENT are pleased to provide the full spectrum of medical and surgical care for your nasal symptoms.