Nose & Sinus Treatment - Coastal Ear Nose & Throat

1. Nose&SinusCausesandTreatment Coastal ENT is a premier center of excellence in the region of diagnosis and treatment of diseases related to the nose, sinuses, and skull base. We have two fellowship trained physicians, Dr. Josef Shargorodsky and Dr. Qasim Husain, as well as an experienced staff equipped to handle the most difficult cases with both medical and surgical management. Nasal Endoscopy / Culture A small camera through the nose allows us to identify the problem & formulate the right treatment plan. Minimally Invasive Sinusitis Treatment Endoscopic sinus procedures, In-office balloon sinuplasty Chronic Rhinitis Treatment In-office turbinate reduction and cryoablation Nasal Airway Relief Repair of nasal valve collapse with rhinoplasty or in-office stent placement

2. Balloon Sinus Surgery (Sinuplasty)A balloon sinuplasty is a minimally invasive endoscopic procedure used to treat chronic sinusitis. Sinusitis is an inflammation of the lining within the paranasal sinuses. Once inflamed, the sinus cavities become a fertile ground for viruses, bacteria, and occasionally fungi to grow, resulting in infection. If it becomes chronic there may be a structural problem in the nose or sinuses. In those cases, a balloon sinuplasty may be recommended. • Coastal ENT physician gently places a sinus guide catheter and a flexible sinus guidewire through the nostrils to access the target sinus. Next, a sinus balloon catheter advances over the sinus guidewire. • The sinus balloon catheter is positioned across the blocked ostium and gently inflated. • The Balloon Sinuplasty system is removed, leaving an open sinus passageway and restoring normal drainage and function.

3. Adenoid HypertrophyThe tonsils are two masses of tissue found on either side of the back of the throat. The adenoids are located high in the throat behind the nose and roof of the mouth. Together they form part of the ring of glandular tissue at the back of the throat. The tonsils and adenoids assist the body in defense against infection by “sampling” entering bacteria and viruses and becoming infected themselves. They then help form antibodies to resist and fight future infections. However, the tonsils and adenoids often become susceptible to recurrent bacterial infections and can even trigger airway obstruction. While the tonsils can be seen by physical examination, the adenoids cannot. However, diseased adenoids have certain telltale signs, including yellow or white spots near the tonsils or tongue, swollen lymph nodes, or irritated red spots in the mouth, that enable their diagnosis. The adenoids themselves may be seen through the use of a special mirror in the mouth, or through a tube called an endoscope, which is inserted through the nose. Other tests to diagnose problems with the adenoids may include sleep studies or X-rays of the area.

4. AllergicandChronicRhinitis Allergic rhinitis (hay fever) is an especially common chronic nasal problem in adolescents and young adults. Allergies to inhalants like pollen, dust, and animal dander begin to cause sinus and nasal symptoms in early childhood. Infants and young children are especially susceptible to allergic sensitivity to foods and indoor allergens. When Should My Child See a Doctor? If your child’s cold-like symptoms (sneezing and runny nose) persist for more than two weeks, it is appropriate to contact a physician. Emergency treatment is rarely necessary except for upper airway obstruction causing severe sleep apnea or an anaphylactic reaction caused by exposure to a food allergen. Treatment of anaphylactic shock should be immediate and requires continued observation and care.

5. PituitaryTumors Pituitary tumors are abnormal growths in the pituitary gland, a small gland at the base of the brain. The pituitary gland is extremely important because it both releases its own hormones and controls hormones released by other endocrine glands, such as the thyroid and adrenal glands, and is thus responsible for regulating multiple systems in the body. For this reason, pituitary tumors can have serious medical consequences. Treatment of Pituitary Tumors Since most pituitary tumors are not malignant, there is usually no danger of metastasis. Nonetheless, as a pituitary tumor grows, the pressure on significant blood vessels and nerves can cause serious, and sometimes dangerous, complications. Treatment of a pituitary tumor most often involves surgical excision, especially if the tumor is pressing on the optic nerve. Most pituitary tumors can be removed through the nose and sinuses, but some require transcranial surgery. For patients who are not candidates for surgery, radiation therapy may be used to shrink the tumor. Radiation therapy may also be used in conjunction with surgery to make sure the entire tumor has been removed. For certain types of pituitary tumors, medications are also administered.

6. NasalFracture In cases of facial trauma, nasal fractures are a common type of bone injury. This is largely due to the prominence and central location of the nose on the face and the weakness of the nasal cartilage. A nasal fracture is commonly the result of an injury from a car accident, a fall, a physical altercation, or a sports related injury. Untreated nasal fractures can negatively affect both the appearance and the function of the nose. Functional problems include chronic nasal obstruction or blockage, and a predisposition for sinusitis, infection, and nose bleeds. Diagnosis of Nasal Fractures A nasal fracture is commonly diagnosed by a doctor by reviewing the patient’s symptoms and performing a physical examination of the nose. Additional diagnostic tests may include: CT Scan X-Ray

7. NasalObstruction • Nasal obstruction is a symptom rather than a stand-alone diagnosis, and there is a wide range of medical and structural problems that can affect your ability to breathe properly. Structural problems caused by deformities of the cartilage or bony structures of the nasal framework are common causes of nasal obstruction. These include a deviated nasal septum, nasal polyps, large adenoids, as well as swollen turbinate tissue, and nasal valve collapse. Other causes may be non-anatomical and due to conditions that cause the nasal lining to swell, including chronic sinusitis or severe nasal allergies. Each of these nasal obstructions can often be corrected using a variety of surgical techniques. • How is inferior turbinate hypertrophy diagnosed? • Nasal speculum and light examination in the office • Nasal endoscopy – a small camera with a bright light and monitor is used to look inside the nose • A CT scan can demonstrate enlarged turbinate as well, but these scans are mainly looking for evidence of sinusitis.

8. NasalPolyps Nasal polyps are benign growths that develop within the lining of the nasal passages or sinuses. If large enough, these growths may block the passages and cause breathing difficulties, sinus infections or other complications. Nasal polyps can affect anyone, but they occur more frequently in adults. Medications may shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Diagnosis of Nasal Polyps Nasal polyps are commonly diagnosed by a doctor or otolaryngologist who will review the patient’s symptoms and perform a physical examination of the nose. A lighted instrument is commonly used to look inside the nose through a procedure called a nasal endoscopy. Additional diagnostic tests may include: Allergy tests CT Scan MRI Cystic Fibrosis test for children

9. Nosebleeds(epistaxis) What is an anterior and posterior nosebleed? How do I stop a nosebleed? Tips to prevent a nosebleed and more… The nose is an area of the body that contains many tiny blood vessels or arterioles that can break easily. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 years. Nosebleeds are divided into two types, depending on whether the bleeding is coming from the front or back of the nose.

10. PostNasalDrip Insight Into Treating a Runny Nose: What is Post-Nasal Drip? How is Swallowing Affected? How is Post-Nasal Drip Treated? Glands in your nose and throat continually produce mucus (one to two quarts a day). Mucus moistens and cleans the nasal membranes, humidifies air, traps and clears inhaled foreign matter, and fights infection. Although it is normally swallowed unconsciously, the feeling of it accumulating in the throat or dripping from the back of your nose is called post-nasal drip. This sensation can be caused by excessively thick secretions or by throat muscle and swallowing disorders.

11. Insight into sinus problems in adults and children How are sinusitis symptoms different than a cold or allergy? When does acute sinusitis become chronic? What treatments are available? Have you ever had a cold or allergy attack that wouldn’t go away? If so, there’s a good chance you actually had 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.

12. Minimally Invasive Office ProceduresA balloon sinuplasty is a minimally invasive endoscopic procedure used to treat chronic sinusitis. Sinusitis is an inflammation of the lining within the paranasal sinuses. Once inflamed, the sinus cavities become a fertile ground for viruses, bacteria, and occasionally fungi to grow, resulting in infection. If it becomes chronic there may be a structural problem in the nose or sinuses. In those cases, a balloon sinuplasty may be recommended 4. After the procedure, there is only slight discomfort and a cooling sensation which resolves quickly. Most patients (80%) have an improvement in between 2-6 weeks from treatment. 1.Patients with out-of-balance nasal nerves suffer from chronic runny nose and post-nasal drip. If symptoms are refractory to allergy medications and ipratropium bromide spray, then cryotherapy can be a great option. 2.ClariFix3.Thetreatmentisperformedin interruptsthenervetheofficewithonlytopicalandlocal signals that tell the nose to drip, run, and swell which leads to decreased stuffy and runny nose symptoms. anesthesia. The ClariFix device and nasal camera is placed in the back of the nose where the out of balance nerves are located. The cold therapy is applied using a cooling probe and only takes a few minutes.

13. TearingAndEyeSurgery Grave’s disease is an autoimmune disorder that causes the thyroid gland to produce an excessive amount of thyroid hormone within the body. This overproduction creates more hormones than the body needs and causes many important bodily functions to speed up. The thyroid is a butterfly-shaped gland located in the front of the neck and controls metabolism, heart and nervous system functions as well as other metabolic functions. An overproduction of the thyroid hormone can lead to hypertension, weight loss, irregular heartbeat and eye problems. In addition to other symptoms, Grave’s disease may also cause a condition known as Grave’s ophthalmopathy in which the immune system attacks the muscles and other tissue around the eyes. This causes an inflammation and a build-up of tissue around the eye, which in turn, may cause the eyeballs to bulge out. Additional eye- related symptoms caused by Grave’s ophthalmopathy may include:

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