Nasal & Sinus Disorders - Rhinology
Chronic nose bleeds (epistaxis)
Epistaxis - Nose Bleeds
Nose bleeds can have many different causes. The majority occur when the thin nasal mucosa overlying a blood vessel in the nose dries, scabs and falls (or is picked) off. Trauma is the second most common cause of nosebleeds. Frequent or chronic nosebleeds may also indicate an underlying illness or disease.
The majority of nosebleeds can be managed with pressure to the bleeding site and nasal packing. When the first approach is not successful, cauterization with silver nitrate or electric cautery may be necessary.
Recurrent or chronic nosebleeds with no apparent cause (trauma or nose picking) should be addressed with an otolaryngologist.
The septum is a thin "wall" made of cartilage and bone that divides the inside of the nose into two chambers. A deviated septum is when the septum is crooked. This can cause nasal obstruction resulting in breathing difficulties and sinus disease.
Surgery may be recommended if the obstruction is severe. A septoplasty is a surgical procedure performed to repair a deviated septum. The cartilage and bone are trimmed, reshaped or removed to straighten the septum and unblock the obstruction restricting air flow. Rhinoplasty is surgery to correct the external appearance of the nose. This procedure is not considered medically necessary by any insurance company. If revisions to the external structure of the nose are planned at the same time as septoplasty surgery, discussion of payment is necessary at the time of scheduling the surgery. For more information on rhinoplasty, click here.
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Sinuses are hollow chambers within the bones of the face and head. Four pairs of sinuses connect to the nasal cavity through small openings. The sinuses produce mucus which drains into the nose. If the drainage path becomes blocked, infection can result.
Symptoms of sinus disease can manifest in a variety of ways including:
- Nasal congestion
- Fullness in the ears
- Green, yellow or bloody discharge from the nose
- Trouble tasting food
- Frequent headaches
- Facial pain
Among the causes of sinus blockage are colds and infections, allergies, polyps and a deviated septum. Acute sinusitis is an immediate sinus attack that may follow an upper respiratory infection. Chronic sinusitis is a more long-term problem involving swelling of the sinus lining as a result of allergies or chronic infections.
Endoscopic exams are done in the doctors' office. Your nose and sinuses are treated with an anesthetic and decongestant to numb the areas. The doctor then guides the endoscope within the nasal passages to help diagnose the cause. CT scans also provide a detailed view of your nose and sinuses to assist the doctor in the diagnosis and treatment of sinus blockages.
Sinus problems can sometimes be managed with medications. Antibiotics and decongestants may be prescribed to treat bouts of acute sinusitis. Additionally, drinking plenty of fluids, saltwater irrigations and hot or cold packs may help. Use a humidifier regularly to keep your sinuses moist and allow your sinuses to drain better. Try to avoid smoke, alcohol and coffee, which also dry out the sinus linings.
If medications do not eliminate your symptoms, a FESS (Functional Endoscopic Sinus Surgery) may be recommended. The procedure is performed as an outpatient with follow-up in the office within 1-2 weeks later.
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