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Conditions Treated

Gwinnett Medical Center’s physicians, surgeons and nurses are committed to providing the most advanced treatment for the full range of conditions affecting the nose. Here are some of the most common conditions we treat:

Sinusitis
Sinusitis is a term that covers both acute and chronic conditions that result from allergies or nonallergic sources, such as bacteria or viruses.

Allergic sinusitis is a reaction to inhalants such as pollen, dust, smoke and animal dander. Allergic sinusitis can be acute, lasting less than four weeks, or chronic, lasting longer than eight weeks.

Allergic sinusitis symptoms may vary with the seasons and has similar symptoms to nonallergic sinusitis; however, nonallergic sinusitis doesn’t usually cause an itchy nose, eyes or throat.

Sinusitis symptoms may include:

  • Nasal congestion, along with sneezing, runny nose and post nasal drip
  • Headache, pain, tenderness, swelling and pressure in the forehead, cheeks, nose and around the eyes
  • Irritability, inability to focus, fatigue
  • Sleep problems, such as insomnia and sleepwalking
  • Reduced or altered sense of smell and taste
  • Itchy eyes, nose and throat (for allergic sinusitis)
  • Post-nasal drip
  • Persistent cough
  • Fever

A physician diagnoses sinusitis by taking a detailed medical history and performing a physical examination. If appropriate, the physician may order allergy skin tests to identify the allergen causing the nasal flare-up, nasal endoscopy (inserting a flexible tube and fiber optic light into the nasal passages to allow the doctor to see abnormalities clearly) or a computed tomography (CT) scan to help assess any injury, infection or other problems.

Self-Help treatments
For mild seasonal sinusitis, avoidance of the allergen is often an effective course of action. Some other self-help and medicinal remedies are:

  • Saline nasal sprays to rinse the nasal passages
  • Inhaling steam may reduce nasal congestion
  • Decongestants, over-the-counter products
  • Corticosteroid nasal sprays (by prescription)
  • Desensitization through allergy shots
  • Over-the-counter pain relievers, such as ibuprofen and acetaminophen
  • Antibiotics for severe bacterial infections

When self-help and medicinal measures are insufficient, sinusitis may be treated with balloon sinuplasty or endoscopic sinus surgery.

Allergic fungal sinusitis
Allergic fungal sinusitis (AFS) is a fungal infection in the sinuses. These infecting fungi, such as mold, are found in the environment and, in some people, create an allergic reaction which results in thick fungal debris, sticky mucus and sinus blockage. Patients with AFS may also have other allergies, nasal polyps and/or asthma. The patient’s sense of smell may be affected. Left untreated, this condition may lead to vision loss through displacement of the eyeball.

AFS is diagnosed through laboratory testing of secretions or tissue. Treatment includes surgical removal of the thick fungal debris and mucus in the infected sinuses. Steroids may also be given. Immunotherapy and anti-inflammatory therapy may also be helpful. Recurrence of AFS is not uncommon.

Nonallergic sinusitis
Nonallergic sinusitis may be triggered by dust, smog, smoke, temperature or humidity changes, strong odors and chemicals, alcoholic beverages, spicy foods or stress. Other causes include viral infections, such as a cold or flu, hormonal changes, such as during pregnancy, and certain medications.

Bacterial infections
Bacteria in the sinuses can cause sinusitis, which is usually more severe and with longer-lasting symptoms than sinusitis caused by a virus. The most common cause of acute bacterial sinusitis is the bacteria streptococcus pneumoniae, which can be resistant to the most common antibiotics, given at standard dosages. There are other antibiotics, however, which can be given to treat the infection. Patients who have repeated bacterial sinus infections are advised to have the pneumococcal vaccine, as it often prevents most infections caused by streptococcus pneumoniae.

Deviated septum
The wall which separates the nose into two nasal cavities is called the septum. It is made of cartilage and bone. Ideally it should run down the center of the nose, equally separating the nasal passages. In many people the septum is not straight, so that one nasal passage is smaller than the other. If the septum is significantly off center, airflow in one side of the nose may be reduced and breathing may be difficult. This is called a deviated septum.

A deviated septum is typically only treated when it causes sleep apnea, snoring, nasal congestion, sinus infections and/or nosebleeds. If symptoms are not adequately managed with medications, a septoplasty surgery may be performed.

Septoplasty usually takes about 90 minutes and can be performed under local or general anesthesia. Working through the nose, a surgeon will make an incision into the septum and remove the excess cartilage or bone that causes the deviation. Then small splints, sutures or plastic tubes may be used to stabilize the septum. If indicated, this surgery may also be used to reduce the size of an enlarged turbinate. Recovery from septoplasty usually takes about a week, with full recovery after a month.

Nasal obstructions
Anything that impedes the flow of air into and out of one or both of the nasal passages is called a nasal obstruction. While most cases of nasal obstruction are temporary, caused by sinusitis, allergies, etc., the blockage may also be caused by an anatomical factor. Anatomical blockages can include a deviated septum, enlarged adenoids, nasal polyps, turbinate bones or foreign objects. Snoring is often a symptom of an anatomical cause for a nasal obstruction.

If the obstruction is temporary, avoidance of the allergen, saline rinses and/or medications can help. If the obstruction is anatomical, surgery is usually required.

Nasal polyps
Nasal polyps are small noncancerous growths of inflamed tissue that develop on the lining of the nose or sinuses. Large nasal polyps can make breathing difficult and may lead to a decreased sense of smell and taste. Nasal polyps can be caused by infections (viral or bacterial), allergies or as an immune system response.

Nasal polyp symptoms include:

  • Breathing through the mouth instead of through the nose
  • Sinus pressure
  • Chronic sinus infections
  • Runny nose
  • Persistent stuffiness
  • Headaches
  • Loss or diminished sense of smell and taste
  • Snoring

Chronic inflammation in the nose or sinuses is the biggest risk factor for nasal polyps. Nasal polyps are more common in adults and children with cystic fibrosis, asthma, rhinitis or chronic sinusitis. They are also more common in adults over the age of 40.

Testing for nasal polyps may include

  • Computed tomography (CT) scan
  • Nasal endoscopy (inserting a flexible tube and fiber optic light into the nasal passages to allow the doctor to see abnormalities clearly)
  • Allergy skin testing
  • Laboratory tests to identify chronic conditions such as cystic fibrosis

Small nasal polyps may be treated with corticosteroid nasal sprays to reduce inflammation and the size of the polyps. If medications aren’t effective, and for larger polyps, endoscopic sinus surgery may be recommended to remove the nasal polyps.

Rhinitis
Rhinitis is an inflammation of the lining of the nose. It can be perennial (chronic) or seasonal (allergic). Seasonal rhinitis, also called hay fever, is a reaction to environmental allergens. The most common treatment is to avoid the allergen. Rinsing our nasal passages with saline can also help.

People with perennial (chronic) rhinitis may believe they catch frequent colds. Diagnosis of perennial rhinitis can be difficult, as a cold is also a form of rhinitis (viral rhinitis), and presents the same symptoms.

Rhinitis symptoms include:

  • Runny nose
  • Blocked or clogged nose
  • Sneezing
  • Itchy nose
  • Post-nasal drip or phlegm