Sinus and Nasal Disorders-Rhinology

Deviated Nasal Septum

The nasal septum is the midline wall that separates the two sides of the nose. This partition is composed of both cartilage and bone and covered by a thin layer of mucosa (or skin that has a rich network of blood vessels running through it).

A deviated nasal septum occurs when this midline wall protrudes more into one side of the nose than the other. Causes for this disorder include:

  • Nose trauma
  • Passing through a narrow birth canal
  • Abnormal growth during childhood and adolescence

Many people with slightly deviated or off-center nasal septums do not show symptoms. Symptoms occur when the deviated septum shifts away from the midline enough to block airflow.

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Nasal Obstruction

Nasal obstruction or congestion has various causes, including:

  • Allergies
  • Environmental irritants
  • Nasal turbinate enlargement
  • Deviated nasal septum
  • Viral infection or “cold”
  • Chronic rhinosinusitis
  • Nasal polyps
  • Adenoid enlargement
  • Foreign bodies
  • Benign and malignant nasal tumors

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Sinusitis

Sinusitis encompasses a large group of diseases. It occurs when the lining of the nose and paranasal sinuses (mucosa) become inflamed or irritated. When severe enough, this inflammation can block the small openings of the sinuses or sinus ostium, trapping the mucus inside.

When filled with wet mucous, the sinuses create ideal conditions for organisms to grow. Infectious bacteria and fungal organisms can cause additional tissue inflammation and swelling. This can slow normal mucous clearance within the sinus, further propagating the cycle of inflammation and infection. Infected and/or swollen sinus cavities cause the major symptoms of what most people call sinusitis.

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Pediatric Sinusitis

In children, sinusitis most commonly develops from a common cold or viral infection. However, a foreign body such as a peanut, raisin or bead pushed into the nose may cause a nasal or sinus infection as well.

When an infection begins, the lining of the sinuses may become swollen and block the passage where normal sinus mucus drains. When this mucous remains in the sinus too long, it can become infected.

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Smell/Taste Problems

Problems with smell and taste can have a big impact on our lives. These senses contribute to our enjoyment of life by stimulating a desire to eat, which nourishes our bodies and enhances our social activities. When smell and taste become impaired, we eat poorly, socialize less and feel worse. Smell and taste also warn us of potential dangers such as fire, toxic fumes, and rotten food. Loss of the sense of smell may indicate sinus disease, growths in the nasal passages, or, in rare cases, brain tumors.

Most patients who complain about a loss of taste actually suffer from a loss of smell. The majority of a food’s flavor comes from our ability to smell it. The tongue can only sense salt, sweet, sour, bitter, and umami (or savory). Because of this, a cold or stuffy nose can make it difficult to taste food.

True disorders of only taste are rare. Disorders of smell and taste, on the other hand, affect approximately 2 million people in the United States.

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Functional Endoscopic Sinus Surgery (FESS)

Functional endoscopic sinus surgery (FESS) was developed about 25 years ago. It removes or corrects diseased pieces of sinus tissue, allowing mucous to drain normally. A surgeon inserts small, rigid telescopes (also called endoscopes) into the nose uses fine instruments to open the sinuses.

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