Nose and Sinus

At our office, you will receive a thorough ear, nose, and throat examination. During that physical examination, one of our doctors will explore the facial features where swelling and erythema (redness of the skin) over the cheekbone exist. Facial swelling and redness are generally worse in the morning; as the patient remains upright, the symptoms gradually improve. The physician may feel and press the sinuses for tenderness. Additionally, the physician may tap the teeth to help identify an inflamed paranasal sinus. Other diagnostic tests may include a study of a mucous culture, endoscopy, x-rays, allergy testing, or CT scan of the sinuses.

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Sinusitis

Experts estimate that 37 million people are afflicted with sinusitis each year, making it one of the most common health conditions in America. That number may be significantly higher, since the symptoms of bacterial sinusitis often mimic those of colds or allergies, and many sufferers never see a doctor for proper diagnosis and treatment.

Sinus Headaches

Sinus headaches are associated with a swelling of the membranes lining the sinuses (spaces adjacent to the nasal passages). Pain occurs in the affected region – the result of air, pus, and mucus being trapped within the obstructed sinuses. The discomfort often occurs under the eye and in the upper teeth (disguised as a headache or toothache). Sinus headaches tend to worsen as you bend forward or lie down. The key to relieving the symptoms is to reduce sinus swelling and inflammation and facilitate mucous drainage from the sinuses.

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Sinus Surgery

Surgery should be considered only if medical treatment fails or if there is a nasal obstruction that cannot be corrected with medications. The type of surgery is chosen to best suit the patient and the disease. A careful diagnostic workup is necessary to identify the underlying cause of acute or chronic sinusitis, which is often found in the anterior ethmoid area, where the maxillary and frontal sinuses connect with the nose. This may necessitate a sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected blood tests to determine an operative strategy.

Deviated Septum

Estimates are that 80 percent of all nasal septums are off-center, a condition that is generally not noticed. A "deviated septum" occurs when the septum is severely shifted away from the midline. The most common symptom from a badly deviated or crooked septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.

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Nasal Fractures

If you've been struck in the nose, it's important to see a physician to check for septal hematoma. If you make an appointment within two weeks of your injury it may be possible to repair your nose immediately, restoring the previous appearance of your nose. At your appointment we will examine your nose and face, inlcuding the surrounding areas of the eyes, jaw, and teeth, to look for bruising, lacerations, and swelling. We may recommend an x-ray or CT scan to determine other possible injuries.

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Post-Nasal Drip

Post-nasal drip often leads to a sore, irritated throat. Although there is usually no infection, the tonsils and other tissues in the throat may swell. This can cause discomfort or a feeling that there is a lump in the throat. Successful treatment of the post-nasal drip will usually clear up these throat symptoms. A correct diagnosis requires a detailed ear, nose, and throat exam, and possibly laboratory, endoscopic (procedures that use a tube to look inside the body), and x-ray studies.

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Nose Bleeds

If frequent nosebleeds are a problem, it is important to consult an otolaryngologist. Our specialists will carefully examine the nose using an endoscope prior to making a treatment recommendation. Two of the most common treatments are cautery and packing the nose. Cautery is a technique in which the blood vessel is burned with an electric current, silver nitrate, or a laser. Sometimes, a doctor may just pack the nose with a special gauze or an inflatable latex balloon to put pressure on the blood vessel.

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Smell and Taste

If you experience problems in smelling or tasting, try to identify and record the circumstances surrounding it. When did you first become aware of it? Did you have a cold or flu then? A head injury? Were you exposed to air pollutants, pollens, danders, or dust to which you might be allergic? Is this a recurring problem? Does it come in any special season, like hayfever time?

Bring all this information with you when you visit our office. Proper diagnosis by one of our trained professionals can provide reassurance that your illness is not imaginary. You may even be surprised by the results. For example, what you may think is a taste problem could actually be a smell problem, because much of what you taste is really caused by smell.

The extent of loss of smell or taste can be tested using the lowest concentration of a chemical that a person can detect and recognize. A patient may also be asked to compare the smells or tastes of different chemicals, and how the intensities of smells and tastes grow when a chemical concentration is increased.

Diagnosis may also lead to treatment of an underlying cause for the disturbance. Remember, many types of smell and taste disorders are reversible.