Diseases/Conditions We Treat
Sinusitis and Nasal Polyps
The sinuses are air-filled structures within the bones of the face. They are thought to have multiple roles, including acting as a cushion to protect the brain from injury, humidifying and warming the air you breathe in, and contributing to your voice quality. Sinusitis is inflammation in one or more of these sinuses. Symptoms include stuffy nose (nasal obstruction/congestion), facial pressure/pain (sinus headache), decreased smell or taste, and thick or discolored nasal discharge/drainage.
The most common cause is blockage of the sinus openings due to inflammation. Viruses, bacteria, fungi, and nasal allergies are frequent causes of inflammation. Diagnosis is made based on symptoms you have, findings from the examination, and imaging/additional testing performed.
Acute sinusitis is inflammation typically caused by an infection lasting less than 4 weeks, treated with medical therapy including antibiotics. Chronic sinusitis is inflammation lasting more than 12 weeks, with both medical and surgical treatment options. A sinus can sometimes become so inflamed that it begins to swell and form a grape-like structure that can block the sinus, called a nasal polyp.
Nasal Allergy, Hay Fever, and Allergic Rhinitis
This condition is caused by your body reacting hyperactively to the environment. Common culprits in the environment include hay, weeds, grass and tree pollen, molds, dust mites, and animal dander.
Common nasal symptoms include stuffy nose (nasal congestion or blockage), runny nose, and sneezing. Diagnosis is made based on symptoms you have and skin or blood allergy testing. Treatment options include avoidance/environmental control measures, medications, and allergy shots. There are also minimally invasive procedural options that are individually tailored depending on the symptoms you are having.
Deviated Nasal Septum
The nose is a central and prominent feature of the face. The septum is the wall in the middle of the nose that divides it into left and right sides. A deformity or deviation of the septum can impact the functioning of your nose, contributing to difficulty breathing, noisy breathing, snoring, decreased smell or taste, nosebleeds, or recurrent sinus infections. A deviated nasal septum may be hereditary or the result of multiple other factors, such as trauma, surgery, mass or growth, aging, or certain medical conditions.
Diagnosis is made based on symptoms and test results. An otolaryngologist (ENT) has 5 or more years of surgical training in operating on the nose and is therefore well-trained to handle the correction of a deviated nasal septum.
Our abilities to smell and taste are intricately linked and critically important to our daily lives. They alert us to hazardous odors, such as the smoke from a fire, and allow us to detect rotten and spoiled foods. In addition, they factor substantially into our quality of life.
The part of the nose that senses smell is high up in the roof of the nose. Special cells here receive smells and send a signal to the brain via the smell nerve. Issues with our smell sense frequently impair taste. Common causes include physical obstructions, for example from swelling-related inflammation, anatomic deformities like a deviated nasal septum, or masses/growths. Other health problems such as neurodegenerative (degeneration of the nervous system) diseases can also cause smell loss.
Diagnosis is made based on the exam and special smell testing. Treatments are varied and are dependent on the cause of smell loss. It is important to seek medical attention to determine the cause, some can be treated, and in some cases, treatment may be more effective if initiated soon after the onset of loss.
Nosebleeds and Epistaxis
Nosebleeds are caused by bursting of a blood vessel in the nose. They are rarely life-threatening and often stop on their own. There are many causes, they may occur spontaneously or as the result of trauma, medications, tumors, surgery, or environmental factors.
There is no single treatment for nosebleeds. Care is tailored to each individual patient. Common treatment options include direct pressure and nasal sprays and minimally invasive in-office procedures like packing and cautery. Embolization or surgery, which can be done in a minimally invasive way, are reserved for the most severe cases.
Cerebrospinal Fluid Leak
Your brain is surrounded by a “water bed” filled with a fluid known as cerebrospinal fluid or “CSF.” A hole or tear in the lining of this can result in a leak of this fluid. A common symptom is constant nasal dripping of this fluid. Causes are broadly classified into two categories, one is spontaneous and the other is due to injury of the bone separating the brain and nose, related to for example trauma, surgery, or tumors.
Diagnosis is made based on symptoms, test results, and special laboratory and imaging workup. Treatment options include both medications and surgical repair depending on the underlying cause. Successful treatment requires experience and often multidisciplinary collaboration with other specialties, such as neurosurgery and ophthalmology.
Sinus/Nasal Mass or Tumor
A tumor is a mass or growth and is rare in the nose and sinuses. They can be either benign (non-cancerous) or malignant (cancerous). The more common benign lesions are papillomatous (inverted and squamous papillomas), fibro-osseus (bone-based including osteoma and fibrous dysplasia), vascular (from a blood vessel, such as juvenile nasopharyngeal angiofibroma), and neurogenic (from a nerve, such as schwannoma or neurofibroma).
Malignant tumors include the following:
- Cell carcinoma
Each of these Tumors vary widely in appearance and presenting symptoms.
Diagnosis is made by symptoms, examination, and imaging. The treatment is complex and typically requires multidisciplinary collaboration with otolaryngology (ENT), radiation/medical oncology, neurosurgery, and others. Treatment options include surgery, radiation, and chemotherapy, and recommendations vary depending on the tumor. If surgery is recommended, some tumors can be removed through minimally invasive “endoscopic” approaches. Evaluation by an otolaryngologist (ENT) with experience in the management of these tumors is critical.
Blocked Tear Duct
The tear duct, which empties tears from the corner of your eye into your nose, is called the nasolacrimal duct. When the tear duct is blocked, tears cannot drain properly from the eye. Symptoms include constant and severe tearing and recurrent eye and tear duct infections.
The diagnosis is made by an ophthalmologist. Our providers collaborate with our ophthalmology colleagues at UI Health to surgically manage these patients.
Thyroid Eye Disease
This condition is typically associated with Graves’ disease, which involves an overactive thyroid gland. In thyroid eye disease, there is swelling of the tissue in the orbit, creating bulging of the eyes. Symptoms including eye pain, dry and itchy eyes, double vision, and vision loss.
Our providers collaborate with our ophthalmology colleagues at UI Health to surgical manage these patients. The minimally invasive “endoscopic” approach provides a safe and effective way to reduce pressure on the eye and restore it to a more natural position, without the use of external incisions.