Khatwa Nasal Disorders
Patients with nose and sinus problems may present with many different types of symptoms. Some of these include:
- Blocked nose (Nasal obstruction)
- Runny nose (nasal discharge or postnasal drip)
- Facial pain
- Reduction/loss of sense of smell (hyposmia/anosmia)
- Nose bleeds (epistaxies)
- Broken/misshapen nose
- Watery eyes (epiphora)
- Nasal polyps are grape-like swellings of the lining of the sinonasal cavities. It is not clear why some people with chronic sinusitis develop polyps and others don’t.
- Polyps can cause a blocked nose and a reduction/loss of one’s sense of smell. A patient with polyps may constantly sound ‘bunged up’ when they speak. They may have to breathe through their mouth constantly, which can lead to a dry mouth, especially on waking up in the morning.
- Polyps are almost always related to inflammation of the sinuses, and can make the sinusitis worse by blocking the drainage of the sinuses. Therefore, patients with polyps often also have symptoms of sinusitis too.
- Occasionally, tumours of the nose and sinuses can look similar to nasal polyps. The presence of polyps on only one side of the nose raises suspicion, and should be investigated by a specialist endoscopic sinus surgeon. A biopsy may need to be taken, either in the clinic or in theatre, with a view to proceeding to further surgery if appropriate.
- If a patient’s only symptoms are a blocked nose, and this is because of the polyps, the polyps can be removed in the clinic setting. This avoids the need for courses of oral steroids and for a general anaesthetic.
- Sinusitis, or more accurately, rhinosinusitis, literally means inflammation of the nose and sinuses’. Specifically, this relates to the tissue that lines the inside of these structures. The lining of the nose (rhino) is continuous with the lining of the sinuses (sinus) and therefore should be regarded as a single entity – hence ‘rhino-sinus-itis’!
- Patients can present with symptoms such as a blocked nose, congestion, nasal discharge (runny nose), facial pain and headaches, or a change in their sense of smell.
CT Scan of chronic sinitus
Sinus surgery (FESS)
Surgery by a sinus specialist is most often performed to relieve the patient of a painful sinus infection, or the symptoms of chronic sinusitis. Endoscopic (keyhole) surgery is the most common method applied. An endoscope is used by the doctor to check the sinus and surrounding nasal passages and is used to remove any inflamed tissue which is the likely source of painand/or polyps. Polyps are areas of swollen mucosa (nasal lining) which are formed by chronic inflammation and can block the passage of air and in some instances, reduce the nose’s smelling function.
This type of surgery is called functional endoscopic sinus surgery (FESS).
- The nasal septum is the midline partition of the nose, that divides the nasal cavity into a right and a left side.
- It is constructed from a skeleton made of cartilage at the front, and bone at the back. This skeleton is covered by the same lining that covers the rest of the nose and sinuses.
- Deviations (twists) of the septum can be caused by injuries, but in many cases, patients do not recall any trauma and the septum may have simply become ‘buckled’ during a person’s growth.
- Septal deviations can cause a blocked nose and breathing difficulty. Conservative methods of treatment such as steroid sprays and nasal splints are always worth trying first but in many cases, if a patient is troubled by their symptoms, surgery to straighten the septum, or remove the twisted part, is required.
- The operation is known as a septoplasty.