Nasal, Sinus & Allergy Disorders

What are Sinus & Allergy Disorders

Congestion, allergic rhinitis, a deviated septum, and mouth sores are just a few of the varied health problems that occur in this region of the body.  Information about ways you can relieve symptoms at home and when you should see a physician can be found in this section.

Dr. Rubinstein is a board certified ENT and facial plastic surgeon. If you are bothered by congestion, allergic rhinitis, a deviated septum or mouth sores, he can help.

Allergies and Hay Fever

Nasal allergies, also known as hay fever, are very common and there are a variety of substances that can lead to allergies. Common allergens include pollen, mold, food, feathers, drugs, environmental pollutants, and household allergens like dust, pet dander, and household chemicals.

An allergic reaction occurs when the immune system reacts to an allergic substance. This triggers a variety of reactions in the body including the production of histamine which causes common allergy symptoms like itchy or watery eyes, nasal congestion, sinus congestion, headaches, sneezing, shortness of breath, hives and a scratchy throat.

While rarely life-threatening, allergies can significantly detract from one’s quality of life. Dr. Rubinstein will take a complete medical history, examine your ears, nose, throat and head, evaluate your sinuses, and conduct allergy testing if necessary. There are a variety of steps that you can take to improve your allergies. These may include minimize your exposure to allergens or having allergy shorts or drops. There are also many medications which can help including antihistamines, nasal decongestant sprays, steroid sprays, saline sprays and cortisone-type preparations.

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Antihistamines, Decongestants and Cold Remedies

Antihistamines, decongestants and cold remedies do not cure allergies but they can provide relief from common symptoms associated with seasonal allergies and upper respiratory infections. Antihistamines are drugs which block the action of histamine, thus reducing allergic symptoms. They are good for treating sneezing, a runny nose and itchy eyes. Antihistamines may cause drowsiness, dry mouth and a dry nose. Decongestants work by shrinking the swollen blood vessels in the nasal membranes that cause congestion. This opens up the air passages, treating congestion or a stuffy nose. Decongestants can cause excitability or a nervous feeling, insomnia and a rapid heartbeat. They should not be taken by patients with an irregular heart rhythm, high blood pressure, heart disease or glaucoma. Decongestants come in pill form, liquid form, and as a nasal spray. Combination remedies are comprised of an antihistamine and decongestant. Cold remedies generally contain a decongestant and/or antihistamine but may also include aspirin, a cough suppressant and drying agents.

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Continuous Positive Airway Pressure (CPAP)

You may have sleep apnea if your snoring disturbs others, if you are sleepy during the day, if you wake often throughout the night, if you’ve experienced episodes of obstructed breathing while sleeping, or if you experience headaches or tiredness in the mornings. Continuous Positive Airway Pressure (CPAP) is the most common and effective non-surgical treatment for sleep apnea. While you sleep, a nasal or facial mask creates a strong flow of air pressure with each inhalation that keeps the airway passages open. This is the most effective treatment for snoring and sleep apnea, however the mask must be worn every night and some individuals find this uncomfortable. Alternative treatments for sleep apnea include weight loss, exercise and other lifestyle changes, sleep positioning, oral appliances, and surgery.

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Facial Plastic Surgery

Facial plastic surgery and otolaryngology are often closely related. Facial plastic surgery is a component of otolaryngology and it is comprised of both reconstructive surgery and cosmetic surgery. Many individuals seek cosmetic surgery to improve or enhance theirs appearance, while others seek reconstructive surgery to improve a congenital facial abnormality like a birth mark or  cleft lip or one that has been acquired through injury, trauma, burn, disease or previous surgery.

There are a variety of plastic surgery procedure including rhinoplasty, which is often combined with septoplasty, eyelid surgery, facelift, browlift, liposuction, cheek augmentation, chin augmentation, ear surgery, and facial reconstruction.

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Facial Sports Injuries

Facial injuries often occur as a result of sports. Facial fractures can occur around the sinuses, eye sockets, nasal bridge, cheek bones, jaw or lower face. Surgery may be needed to correct facial fractures. Soft tissue injuries like bruises, cuts and scrapes also occur quite frequently from sporting activities.  Some cuts may require sutures. Nasal injuries may also occur and lead to breathing difficulties and nasal deformity. Neck injuries may involve the larynx, esophagus, and major blood vessels and nerves, while throat injuries can lead to breathing problems and should be evaluated.

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Sinusitis

Sinusitis is a fairly common condition characterized by inflammation of the membrane lining of a sinus, particularly one of the paranasal sinuses. Sinusitis can be either acute or chronic. Acute sinusitis is often treated with antibiotics and decongestants. If an individual has at least four recurrences of acute sinusitis, they are then considered to have chronic sinusitis which can be treated with medication or surgery.

Acute sinusitis may cause facial pain and pressure, nasal discharge, nasal obstruction, and decreased sense of smell. Other less common symptoms my include fever, fatigue, bad breath, dental pain and cough. These symptoms may be accompanied by thick green or yellow nasal discharge. Symptoms may last four weeks or more.

With chronic sinusitis, patients may experience symptoms for twelve weeks or more, including the following: facial pain and pressure, facial congestion or fullness, nasal obstruction or blockage, thick nasal discharge, discolored post-nasal discharge, pus in the nasal cavity, fever, headache, bad breath, and fatigue.

The symptoms of sinusitis may be relieved with warm, moist air, saline nose drops, nasal sprays, nose drop, oral decongestants, and sinus surgery. Antibiotics are also prescribed. Surgical options include functional endoscopic sinus surgery (FESS), image guided surgery, and the Caldwell-Luc operation.

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Deviated Septum

The septum is the wall that separates the two nostrils and divides the inside of the nose into two cavities. An ideal septum is straight and centered in the middle of the nose with equal airways on either side. When the septum becomes off-center or crooked, it is considered a deviated septum. A deviated septum may occur due to nasal trauma, or it may even be congenital. Deviated septums can lead to a variety of symptoms and even chronic sinusitis. Common symptoms include nasal blockage, nasal congestion, breathing difficulty, frequent nosebleeds and frequent sinus infections. Other less common symptoms may include facial pain, headaches, postnasal drip, and noisy breathing during sleep in young children and infants.

Septoplasty is the surgery to correct a deviated septum. It is performed entirely through the nostrils so there is no visible scarring, bruising or other external signs of surgery unless combined with a rhinoplasty. Septoplasty can also be performed at the same time as sinus surgery if needed. During surgery, the septum is straightened by removing and/or readjusting portions of the septum.

Learn more about Fact Sheet: Deviated Septum

Post-Nasal Drip

Post-nasal drip is a condition in which naturally occurring mucus accumulates in the throat or drips from the back of the nose. Post-nasal drip may occur if you have very thick secretion or as a result throat muscle and swallowing disorders. Increased nasal secretions are often associated with colds and flu, allergies, pregnancy and other hormonal changes, cold temperatures, bright lights, and sinus or nose infections. Post-nasal drip can affect the throat and swallowing. Treatment of post-nasal drip will vary depending on the cause.

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Smell and Taste

Our sense of smell and our sense of taste greatly impacts or lives, especially our enjoyment of life. If these senses are impaired, our life may be negatively impacted. There are a number of things that can cause a loss of smell and taste, including upper respiratory infections, head injury, nasal or sinus cavity polyps, hormonal disturbances, dental problems, some medicines, smoking, radiation therapy, and prolonged exposure to insecticides and other chemicals. Treatment will depend on the cause.

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Nasal Congestion

Many individuals experience nasal congestion, or a stuffy nose. Obstructed nasal breathing is one of the most common complaints. The four main causes of nasal congestion: infection, structural abnormalities, allergic , and nonallergic rhinitis. Depending on the specific cause, treatment of nasal congestion may involve antibiotic treatment, surgery, antihistamines, decongestants, or allergy shots.

Learn more about Stuffy Nose

You can also read the fact sheets from the ENTNET.org website.

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