Nose & Sinuses

Your nose sinuses are extremely important to your health and overall well-being. Together they filter the air we breathe, removing dust, germs and irritants. They also warm and moisten our airflow to keep our lungs and respiratory tract from drying out. Your nose also contains the nerve cells that help us sense smell. When there is a problem with either our nose or sinuses, the whole body can suffer. For example, a stuffy nose from the common cold can make it hard to breathe, sleep or be comfortable.

Deviated Septum

Deviated Septum is frequently caused by facial trauma such as a blow to the nose/face. It can also occur just from the way the septum grows. A deviation in the septum can cause breathing obstruction and congestion, and sometimes lead to sinusitis issues. In most cases a deviated septum can be corrected with an outpatient surgical procedure known as a septoplasty.

Nasal Fracture

Nasal Fracture is the result of a fracture of the cartilage or bone of the nose. A broken nose will often be accompanied by a nose bleed, swelling and even “black eyes”. If you’ve sustained an injury to your nose, it is important that you visit your Ear Nose & Throat doctor within seven to ten days of the injury because the bones and cartilages can be moved back into their original position before any scarring sets in during this early post-traumatic time frame. Depending on the extent of injury, treatment can involve doing nothing (other than rest and caution not to bump your nose), stabilization, re-positioning of the bones or septum, or sometimes surgery.

Epistaxis (nosebleeds)

The nose has a high concentration of blood vessels combined with delicate/fragile nasal membranes. Common causes of nosebleeds include dry climates (like Colorado!!), injury to the nose or nasal mucus membranes, medications that thin the blood, infections, high blood pressure/hypertension, alcohol abuse, and allergic and non-allergic rhinitis.

You should go to the doctor or emergency room if:

• You experience heavy bleeding or significant blood loss.
• You experience a headache, or a fever while having a nose bleed.
• You faint or feel weak from blood loss.
• Your baby has a nose bleed – contact your pediatrician.
• You have any concerns

Treatment of nosebleeds can involve moisturizing the membranes, avoiding trauma (i.e. no heavy nose blowing, no tissues or fingers in the nose), chemical cauterization, electrocautery, local application of blood clotting medicine, and in some cases nasal packs for persistent bleeds. Though somewhat rare, severe cases are occasionally admitted to the hospital for further assessment including surgical intervention.

Allergic Rhinitis

Allergic Rhinitis occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. During an allergic attack, antibodies (Immunoglobulin E- IgE) attach to mast cells (cells that release histamine) in the nasal mucous membranes. Once IgE connects with the mast cells, a number of chemicals are released. One of the chemicals, histamine, opens the blood vessels and causes swollen membranes, congestion, sneezing, skin swelling and redness, watery eyes, and itching.

Seasonal allergic rhinitis or hay fever occurs in certain seasons every year- like spring or late summer. Hypersensitivity to ragweed, is the primary cause of seasonal allergic rhinitis in 75 percent of all Americans who suffer from this seasonal disorder. People with sensitivity to tree pollen have symptoms in late March or early April; an allergic reaction to mold spores occurs in October and November as a consequence of falling leaves.

Rhinitis

Non-Allergic Rhinitis does not depend on the presence of IgE and is not due to an allergic reaction. The symptoms can be triggered by cigarette smoke and other pollutants as well as strong odors, alcoholic beverages, and viruses (common cold), or bacteria.

Sinusitis (Acute, Sub-acute, or Chronic)

The sinuses are located behind the cheeks, eyes, forehead, and nasal bones. The sinuses are air filled space lined with mucus membranes. Sinusitis occurs when there is inflammation of the tissue lining the sinuses- the sinus mucus membrane, and can occur in a single sinus or multiple sinuses. The source of the inflammation can be viral, bacterial, fungal, or even non-infectious in some cases of chronic sinusitis. Healthy sinuses circulate air and allow mucus to drain. When the sinus is blocked, mucus is trapped and inflammation occurs, which is usually accompanied by an infection. Acute sinusitis is defined as symptoms lasting up to 4 weeks, Sub-acute sinusitis implies symptoms lasting 4 to 12 weeks, and Chronic sinusitis is defined as symptoms lasting over 12 weeks.

The signs and symptoms caused by sinusitis are varied and may include:

• Facial pain and/or pressure
• Nasal congestion or fullness
• Difficulty breathing through the nose
• Discharge of yellow or green mucus from the nose
• Teeth pain
• Loss of the sense of smell or taste
• Headache
• Fatigue
• Sore throat
• Bad breath
• Cough

Rhinitis/sinusitis

To clarify the relationship between rhinitis (inflammation in the nose) and sinusitis (inflammation in the sinuses), studies have concluded that sinusitis is often preceded by rhinitis and rarely occurs without concurrent rhinitis. The symptoms, nasal congestion, obstruction/discharge and loss of smell, occur in both disorders. Rhinitis often occurs first before the inflammation spreads to include the sinuses (sinusitis).