Sinus

Nasal Breathing Problems

close up of nose with sky behind

The nose serves three primary functions: to warm, humidify and filter air as it passes into the body. Breathing problems may impact one or multiple of these functions. Breathing problems can be temporary or chronic, mild or severe, but they usually increase with age. X-rays and CT scans may also be taken to get a visual picture of your breathing apparatus.

The Most Common Breathing Problems

Allergies

When an allergen enters the body, the immune system kicks in to counter to the effects. In most cases, the immune systems produces histamine, which causes the symptoms typically associated with allergies and hay fever: headaches, sneezing, watery or itchy eyes, nasal congestion and scratchy throat. Allergic substances range from pollens to environmental and chemical pollutants. Smoking can also contribute to nasal congestion. To treat allergies, most people need to reduce exposure to the allergen and take medication, often antihistamines and nasal decongestants. For more severe cases, allergy shots or allergy drops may be needed to build up the body’s immune response to the allergen over time.

Deviated Septum

The septum is the vertical structure that divides the two nasal passages in the nose. When the septum is crooked or bent, it is called a deviated septum, which can block the flow of air through the nose. If the constriction is serious, an outpatient surgical procedure can straighten out the septum and open the nasal airways.

Environmental Factors

Molds, dust and dry air are the most common culprits of environmentally induced allergies. These can be assessed by your doctor through physical examination and skin tests. If the allergic response is severe, your doctor may recommend allergy shots or allergy drops to build up an immunity to the allergens and alleviate your symptoms.

Sinusitis

Sinusitis is an inflammation of the sinus tissue behind the upper cheeks on both sides of the nose, between the eyes and above the eyes. It is characterized by congestion and a feeling of pressure, sometimes in response to moving up and down. Sinus pressure can also cause watery eyes. Many over-the-counter medications suffice in treating mild sinusitis. For more serious cases, prescription medications may be required to alleviate the pain and pressure and open up the nasal passages. Occasionally, surgery is required to remove chronically inflamed sinus tissue.

If you’re experiencing persistent breathing problems, please contact our office and schedule an appointment with one of our Otolaryngologists.

Sinusitis

Chronic sinusitisis an inflammation of the sinus lining lasting three months or more, and is one of the most commonly diagnosed chronic illnesses. It is most commonly caused by bacterial, viral, and/or microbial infections. Structural issues such as blockage of the sinus opening can also lead to chronic sinusitis. If the opening is closed, normal mucus drainage may not occur. This condition may lead to infection and inflammation of the sinuses.

Sinusitis Diagram

The painful symptoms associated with chronic sinusitis can be overwhelming. If symptoms are difficult to control with medications alone, your primary doctor may refer you to an Ear, Nose and Throat (ENT) specialist, who can determine the best course of treatment, including further medication therapy or surgery to open the sinus passage ways.

Common Signs and Symptoms

  • Facial pain, pressure, 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

If you are experiencing some of these symptoms you may be suffering from chronic sinusitis. Sinuses are air-filled pockets that surround the nose. Each sinus has an opening through which mucus drains. Chronic sinusitis sufferers do not experience the normal drainage which keeps the sinus healthy. Medications, allergy testing, In-Office Balloon Sinuplasty and/or conventional sinus surgery may help improve your symptoms.

Please refer to In-Office Balloon Sinuplasty and Sinus Surgery sections below for more information on the procedures.


In-Office CT Scan


In-Office Balloon Sinuplasty

In the past few years, a new minimally invasive treatment for Chronic Sinusitis sufferers has been introduced and has proven to be safe, effective, and is performed in the office.

We would like to introduce you to In-Office Balloon Sinuplasty. These products are endoscopic, balloon-based devices. This balloon procedure is used to dilate blocked sinuses and the sinuses can be directly cleaned with topical antibiotics. The sinuses are better able to drain and the bacteria are directly sterilized.

What is the Balloon Sinuplasty™ Technology?

Now, there is an additional surgical option for treatment of blocked sinuses called Balloon Sinuplasty™ Technology. If you have been diagnosed with chronic sinusitis and are not responding well to antibiotics, you may be a candidate for surgery. Your surgeon now has a less invasive option that is clinically proven to be safe, effective and improve the quality of your life.

Balloon Sinuplasty™ Technology is an endoscopic, catheter-based system for patients suffering from sinusitis. The FDA-cleared technology uses a small, flexible, sinus balloon catheter to open up blocked sinus passageways, restoring normal sinus drainage. When the sinus balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.

The Benefits of Balloon Sinuplasty™ Technology

Safe and Effective

While use of any surgical instrument involves some risk, clinical research has indicated the Balloon Sinuplasty™ System to be safe and effective in improving symptoms of sinusitis.

Minimally Invasive

The technology uses small, soft, flexible devices that enter entirely through the nostrils. These devices gently open blocked sinus openings, and in many cases, without tissue or bone removal.

Minimal Bleeding

Because in many instances no tissue or bone is removed when using this technology, there may be little bleeding associated with the procedure.

Quick Recovery Time

While recovery time varies with each patient, many people can quickly return to normal activities.

Does Not Limit Treatment Options

This technology is an endoscopic tool and may be used with other medical therapies or sinus surgery techniques. It does not limit future treatment options if you have progressive disease.

How does the technology work?

Step 1. Gain Access to the Sinus. To gain initial sinus access, the sinus guide catheter is introduced into the nasal cavity to target the sinus ostia under endoscopic visualization. The sinus guidewire or the sinus illumination system is introduced through the sinus guide catheter and gently advanced into the target sinus.

Step 2. Inflate Balloon Across Ostium. The sinus balloon catheter is introduced over the sinus guidewire or sinus illumination system and positioned across the blocked ostium. The position of the sinus balloon catheter is confirmed and the balloon is gradually inflated to open and remodel the narrowed or blocked ostium.

Step 3. Remove Balloon and Irrigate Sinus. The sinus balloon catheter is then deflated and removed. The irrigation catheter is advanced over the sinus guidewire or sinus illumination system into the target sinus. The sinus is then irrigated, flushing tenacious sinus contents – like pus and mucus.

Step 4. Remove System. The irrigation catheter is removed, leaving the ostium open and the sinus cleared of mucus allowing the return of sinus drainage. There is little to no disruption to mucosal lining.

Ask your ENT doctor if you are a candidate for In-Office Balloon Sinuplasty.


Sinus Surgery

Sinus Surgery is one of the most common operations performed. Our ENT Doctors will review with you whether this procedure is the appropriate procedure to open possible sinus obstructions. Removal of such obstructions may require eliminating polyps that are blocking sinus openings or possibly enlarging the hole that sinuses drain through.

Sinuses are the empty pockets that are filled with air in the head. There are actually four pairs of sinuses within your skull. These circulate air while lubricating the nose. This keeps the sinuses free of bacteria, dirt, and other particles. Mucosa lines the sinuses and secretes mucus which traps particles from incoming air. These dust particles are then expelled via cilia, small hair like fibers. Sinuses that are in good health are not obstructed or clogged. Mucus is able to pass through into the nose and then the throat without problems.

Colds, allergies, infections or other obstructions of the sinuses (i.e. deviated septum) can cause inflammation of the mucosa and block the drainage of the sinus cavities. If the sinuses become inflamed, Sinusitis can occur. The mucosa becomes thicker and cannot pass through the openings and end up accumulating in the sinuses. Many symptoms can arise including fever, headaches, and pain over and underneath the eyes. Polyps form when mucosa becomes swollen by repeated infections.

Our Doctors will determine if you have sinusitis during your examination. Your doctor will examine your ear, nose and throat and determine the cause of your sinusitis. Diagnosis can occur with the help of a CT scan in order to see the sinuses within your skull. Blood or allergy tests may also be performed. Treatment may be based upon the cause of your infection. Obstructions caused by allergies can be minimize or eliminated by treating the allergy. Sometimes humidifiers, warm compress over your sinuses, or drinking lots of fluids (which thins out your mucus) can also alleviate symptoms. Medications including antibiotics can treat an infection in the sinuses and control the condition. Repeated sinusitis may be caused by an obstruction and will be most responsive to surgery.

Surgery can be performed in a number of ways. It’s possible that the walls between sinuses are removed to make the sinuses larger. When the sinuses are larger, there is less of chance for obstruction to occur. Sometimes new openings are created in the sinuses for better drainage in the operating room under general anesthesia. If an obstruction is caused by a deviated septum, surgery can help straighten it out. Many of these options are performed endoscopically and under general anesthesia. Patients usually are treated and go home the same day.

Sinus surgery is a very common procedure and helps treat sinus disorders. There are some rare risks, which should be discussed during your visit with the doctors. Your doctor will explain possible complications to help you better understand your treatment options.

Please refer to After Nasal/Sinus Surgery for post-operative instructions.