Nose & Sinus

Chronic sinusitis differs from chronic rhinitis in that it involves an ongoing inflammation of the sinuses that lasts for more than 12 weeks. It diers from Recurrent Sinusitis in that it is ongoing without a pause while a recurrent condition involves 4 or more episodes of sinusitis within a year, but periods without the condition in between.

Symptoms of chronic sinusitis include:

• Tenderness or pressure in the face (nose, eyes and forehead)
• Post nasal drip (mucus drips down the throat)
• Nasal discharge or a stuy nose
• Toothache, ear pain and/or headache
• Cough
• Fatigue or lethargy
• Loss of taste and smell
• Halitosis (bad breath)

Chronic sinusitis can include polyps or polyps may be absent. Medical therapies are available to slow the growth of polyps and they can be removed using various surgical procedures.

When polyps are not a contributing cause, there are a variety of other factors that contribute to chronic sinusitis, like asthma, allergies or cystic fibrosis, bacterial, viral or fungal infections, immune deficiency or abnormal nasal structures. Treatment for non-polyp sinusitis involves treating the cause of the condition using various forms of therapy like:

• Avoiding triggers (allergies and environmental factors)
• Intranasal corticosteroid sprays and leukotriene antagonists (to reduce inflammation) or antifungal medication
• Treating contributing conditions, such as allergies, asthma, and/or immune deficiency topical antihistamine, steroid, sprays or oral antihistamine
• Balloon sinuplasty, or sinus ostial dilation, which inserts a balloon into a sinus cavity to open it and make more room

A deviated septum is among the most common types of abnormal nasal structures that contribute to recurrent or chronic sinusitis as well as other breathing difficulties. The condition is characterized by an unequal or imbalanced division of the nasal cavity, which makes it difficult to breathe.

Although 80% of people demonstrate some form of nasal cavity imbalance, only the most severe misalignment causes breathing problems that require treatment. Individuals struggling with a deviated septum usually experience frequent nosebleeds, facial pain, headaches, postnasal drip, or loud breathing and snoring during sleep.

Medications can provide relief in some cases, but a surgical procedure called septoplasty may be necessary in order to repair the condition and improve breathing.

Nasal and paranasal tumors (including inverting papilloma) are abnormal growths within the nasal cavity that can be noncancerous or cancerous in nature. Nasal tumors begin in the nasal cavity, but paranasal tumors form in air-filled chambers around the nose, or the paranasal sinuses.

The symptoms of nasal and paranasal tumors include:

• Difficulty breathing through your nose
• Loss of smell
• Nosebleeds
• Discharge from your nose
• Facial swelling or pain
• Watery eyes
• Sore or lesions on the roof of your mouth
• Vision problems
• A lump in your neck
• Difficulty opening your mouth

Those most at risk of developing nasal or paranasal tumors include smoking or second hand smoke, breathing air pollution, long-term exposure to chemicals or irritants (wood dust, fumes from glue, rubbing alcohol and formaldehyde, dust from flour, chromium and nickel), and human papillomavirus (HPV) infection.

Surgical procedures to remove the tumor are the most common treatment options for nasal and paranasal tumors, which may be followed up by radiation or chemotherapy for cancerous forms.

A Cerebrospinal Fluid (CSF) leak is caused by a tear or hole in the membranes surrounding the brain or spinal cord, which allows the clear fluid that surrounds and cushions those organs to leak out. CSF leaks are caused by an injury, surgery, epidural or spinal tap, or a tumor, and can lead to an increased risk of meningitis.

Symptoms associated with CSF leaks include:

• Drainage from the nose (rhinorrhea)
• Salty or metallic taste in the mouth
• Post nasal drip
• Drainage from the ear (otorrhea)
• Cutaneous sinus tract drainage
• Loss of sense of smell (anosmia)
• Change in hearing or ringing in the ears

If bed rest and other conservative treatment options are not successful in treating CSF leaks, surgical procedures (including low invasive nasal endoscopy), an epidural blood patch, and/or the insertion of shunts to drain away excess fluid are among the solutions for treatment.

A nasal fracture, or broken nose, involves breaking or cracking the nasal bone above the bridge of the nose due to a fight, contact in sport, an accident or fall. Profuse bleeding, pain, along with swelling and bruising around your nose and under your eyes as well as altered cosmetic appearance of your nose and trouble breathing are among the symptoms of a broken nose.

Treatment usually includes procedures to realign your nose and protect it while the fracture heals, but surgical procedures are rarely necessary to treat a nasal fracture.

Triad asthma, also called aspirin-exacerbated respiratory disease (AERD), or ASA triad is a type of comorbid asthma in which asthma, aspirin sensitivity and nasal polyps exist at the same time. This triad of combined conditions usually shows up in patients between the ages of 20 and 40.

Common symptoms include coughing, wheezing, tightness in the chest, nasal congestion, headache, sinus pain and sneezing, but can also include rashes, flushing of the skin, abdominal pain, and diarrhea or vomiting. Aspirin desensitization therapy or the avoidance of aspirin and other NSAID medications is the most common treatment solution, but leukotriene-modifying agents and cutting back on foods containing salicylic acid can also help reduce symptoms.