Nasal and Sinus
At Northside ENT we treat the full scope of nasal and sinus disorders, including allergic rhinitis, chronic sinusitis, nasal polyps, septal deviations, nasal fractures, non-allergic rhinitis, nasal masses, and nosebleeds.
Since there is considerable overlap between different causes of nasal congestion or nasal drainage, we take the time to listen to you. Often a thorough history and detailed head and neck physical exam will help determine the underlying problem. Occasionally a nasal endoscopy is necessary to evaluate your nasal cavity and nasopharynx, which can be done easily and comfortably in the office. We have our own CT scanner in the office to help diagnose sinus disease quickly and accurately.
Many nasal symptoms will respond to medical treatment of the underlying allergies or infection. For persistent bacterial infections, we can obtain a culture from your nasal cavity allowing us to identify the bacteria in the lab and determine the best antibiotics to treat it.
For patients whose symptoms are refractory to medical management or would be best served by surgical intervention we offer the full range of rhinology services. Some procedures are best done under general anesthesia in the operating room (such as a septoplasty or more extensive sinus surgery), and others (like balloon sinuplasty or Clarifix procedures for a persistent runny nose) can be done with minimal sedation in the comfort of our procedure suite in the office.
Nosebleeds are extremely in both children and adults. While most nosebleeds are self-limited and respond well to direct pressure, some may require cauterization (which can be easily done with only local anesthesia in the office for most patients) or even prescription medication.
More than 37 million Americans suffer from at least one episode of acute sinusitis each year. An increasing number of people are suffering possibly because of increased pollution, urban sprawl and increased resistance to antibiotics.
Sinusitis is the medical term for inflammation or irritation and swelling of the sinuses. And it’s caused by an infection from viruses, bacteria or both.
Sinuses are the moist air spaces within the bones of the face around the nose. When we’re healthy, our sinuses are filled with air, making our facial bones less dense and much lighter in weight.
Acute sinusitis may be present with two or more symptoms and/or the presence of thick, green or yellow nasal discharge. It’s a short-term condition that responds well to antibiotics and decongestants.
Symptoms lasting a month or longer include:
- Nasal obstruction
- Nasal discharge
- Dental pain
- Facial pain/pressure
- Bad breath
- Diminished sense of smell
Whether it’s large or small, button-like or beak-like, your nose plays an important role in your health.
- It filters the air you breathe, removing dust, germs and irritants.
- It warms and moistens the air to keep your lungs and tubes that lead to them from drying out.
- Your nose also contains the nerve cells that help your sense of smell.
The stuffy nose of the common cold can make it hard for you to breathe, sleep or get comfortable. This “nasal congestion” doesn’t always happen because of too much thick mucus. In most cases, your nose becomes congested when the tissues lining it become swollen from inflamed blood vessels.
Nasal congestion causes include:
- Use of some nasal sprays or drops for more than three days
- Common cold
- Sinus infection
- Hay fever or other allergies
- Nasal polyps
- Vasomotor rhinitis
Other nose conditions include:
- Deviated septum
- Nasal polyps
- Broken nose
The shape of your nasal cavity could be the cause of chronic sinusitis.
The nasal septum is the wall dividing the nasal cavity into halves. And the ideal nasal septum is exactly in the middle, separating the left and right sides of your nose into passageways of equal size.
A “deviated septum” occurs when the septum is severely shifted away from the midline.
Nasal trauma is often the cause of a deviated septum.
Deviated septum symptoms include:
- Difficulty breathing through one or both nostrils
- Poor drainage of the sinuses
- Nasal congestion, sometimes one-sided
- Frequent nosebleeds
- Frequent sinus infections
- At times, facial pain, headaches, postnasal drip
- Noisy breathing during sleep
Septoplasty surgery for a deviated septum can help patients breathe better. This is performed entirely through the nostrils so no bruising or external signs occur.
A nosebleed occurs when the membranes lining the inner nose are disturbed or irritated enough to cause abnormal bleeding. The medical term for nosebleed is epistaxis.
There are 2 types of nosebleeds: anterior and posterior. If the bleeding is near the front of the nose, it is an anterior nosebleed. If the bleeding is from the back of the nose, it is a posterior nosebleed. An anterior nosebleed is usually not as severe or serious as a posterior nosebleed.
The most common causes of nosebleed are:
- A breakdown in the membranes lining the nose. This can be triggered by dry air or probing, bumping, picking, or rubbing your nose.
- Blowing your nose forcefully can also cause a nosebleed, especially if the nasal membrane is already inflamed because of allergies or an infection, such as a sinus infection.
- Injury to the face or nose.
- Rebleeding from an area of a previous nosebleed.
- High altitude.
- Drug abuse involving the nose, such as cocaine snorting or glue sniffing.
- High blood pressure.
- Medicine to keep your blood from clotting.
- Medical problems that prevent your blood from clotting normally.
- If you have a nosebleed after a head injury, it could mean you have a fractured skull. You should go to the hospital right away.
If you see your health care provider when you have a nosebleed, he or she will have you sit up and lean forward to determine the rate and site of the bleeding. Most nosebleeds are minor and respond to first aid.
First aid for a nosebleed includes these steps:
- When your nose starts bleeding, sit up and lean forward to prevent blood from passing into your throat.
- Pinch the nose gently but firmly between the thumb and index finger, just below the nasal bones, and hold it for 5 full minutes.
- If it continues to bleed, hold it again for another 5 minutes
After the bleeding stops, use a saline nasal spray or saline nose drops to keep the nose moist. Do not blow your nose for several hours after the bleeding stops.
If a nosebleed lasts more than 10 minutes in spite of first aid, see your health care provider.
If you go to your health care provider with a nosebleed, he or she will likely apply a cotton ball soaked in epinephrine, or a nose drop such as Neo-Synephrine or Afrin, to the site of the bleeding for 5 to 10 minutes.
If the bleeding starts again, your provider may apply a cotton ball soaked in stronger medicine for 5 minutes to numb and temporarily reduce the blood supply to the nasal membrane.
Your health care provider might use a procedure called cauterization to cause the blood to clot at the bleeding site. After numbing the area inside the nose, your provider will apply a tiny amount of electricity to the bleeding area. This will help stop it from bleeding again.
To prevent dryness, keep the lining of your nose moist. Gently apply a light coating of petroleum jelly inside your nose or use a saline nose spray twice a day. Avoid injuring the nasal membranes with nose picking, rubbing, or forceful nose-blowing. Keep your home humidified.