Nasal problems may be minimal or they may seriously interfere with the quality of one’s life. Symptoms may include obstruction, discharge, facial pain and or loss of smell. The earlier one deals with these, the easier they are to treat and the more likely on is to avoid surgery. The commonest cause of nasal obstruction is Rhinitis. This is a condition which is often but not always due to allergy. The lining of the nose becomes inflamed and swollen. Adequate medical management should resolve this. Occasionally however surgery may be required.
Other causes of nasal obstruction are septal deviation and polyps. Septal deviation does not always require correction but to correct it requires a thirty minute procedure (Septoplasty)
Polyps should first be treated medically. Only if you remain symptomatic after adequate
medical management will surgery be considered. Contrary to common mythology, polyps do not often return following adequate modern surgery. (Endoscopic sinus surgery) They commonly did following simple polypectomy
Up to twenty-five years ago E.N.T Surgeons would perform surgery on the individual sinuses that had become infected using procedures such as wash-outs, antrostomies and operations with cheek incisions.
Those procedures either resulted in a lot of facial swelling or were very uncomfortable as well as associated with nasal packs. We no longer carry out such procedures except in rare circumstances. They are now obsolete as are plain sinus films (in chronic disease.) The development of Functional Endoscopic Sinus Surgery (FESS) and the advent of the CT scan has ushered in a new philosophy allowing the surgeon to target an area in the anterior Ethmoidal sinus region. Called the ostio-meatal complex (OMC) Obstruction in the OMC can lead to subsequent infection of the maxillary, ethmoidal and frontal sinuses. Accordingly endoscopic sinus surgery through the nose, removes thickened and diseased tissue that blocks the OMC. Most of the healthy tissue in the sinuses is undisturbed allowing for rapid recovery.
The endoscopic approach is a much better and more effective way of removing nasal
polyps, (compared to simple polypectomy) allowing for more complete removal and much better subsequent medical control if indicated.
The endoscopic approach is also the modern way of dealing with severe nose bleeds and some tear-duct problems as well as some neurosurgical diseases in collaboration with neurosurgeons.