NOSE & SINUSES


Nasal Obstruction

What is a nasal obstruction?

A nasal obstruction is anything that impedes the airflow in or out of the nose. For some, it may only be a nuisance; for others, nasal congestion can be a source of considerable discomfort.

What causes a nasal obstruction?

Most cases of nasal obstruction are temporary, caused by a sinus infection, overuse of nasal sprays or allergic/non-allergic rhinitis. The blockage can also be caused by a structural abnormality, such as a deviated septum, enlarged adenoids, nasal polyps or foreign objects. Patients often have a combination of these factors.

If the nasal obstruction appears to coincide with a certain time of year, it may be caused by an allergy, such as pollen. If the blockage appears to be on only one side of the nose, than an anatomical cause is more likely. Snoring is often a symptom of anatomical defect.

How is a nasal obstruction treated?

If the cause is an allergic in nature then avoidance of the offensive allergen or appropriate medications might alleviate the symptoms. A structural abnormality that is intolerable would usually require surgery.


Nasal Polyps

What are nasal polyps?

Nasal polyps are small non-cancerous growths of inflamed tissue that develop on the lining of the nose or sinuses. Small nasal polyps may not cause sense of smell and taste. Nasal polyps themselves aren’t a disease, but are the result of a viral or bacterial infection, allergies or an immune response.

What are the symptoms of nasal polyps?

  • Mouth breathing
  • Chronic sinus infections
  • Runny nose
  • Persistent nasal stuffiness
  • Diminished sense of smell and taste
  • Headaches
  • Snoring
  • Sinus pressure

How are nasal polyps diagnosed?

Having a condition that causes chronic inflammation is the biggest risk factor for nasal polyps. They are also more common in adults over 40 years old or in patients that have cystic fibrosis, asthma, hay fever or chronic sinusitis.

After a physical examination and review of medical history, Dr. Lieberman, may utilize any of the following to aid in the diagnosis:

  • CT scan
  • Nasal endoscopy (a flexible tube is inserted into the nose with a fiber optic light that allows Dr. Lieberman to examine the nasal passages)
  • Allergy skin testing

How are nasal polyps treated?

For small polyps, Dr. Lieberman may prescribe to relieve inflammation and reduce the size of the polyps. For larger polyps or when medications aren’t effective, functional endoscopic sinus surgery might be required to remove the polyps and any accompanying infection.

Functional endoscopic sinus surgery is typically preserves more of the surrounding tissue than traditional “open” surgeries. Dr. Lieberman inserts a thin, lighted tube (endoscope) into the nasal cavity or sinus rather opening the area with an incision. Micro instruments are used with the endoscope to remove diseased tissue and the polyps.


Nosebleeds

What are the causes of nosebleeds?

  • Medications that slow blood clotting (e.g. Wafarin, aspirin or anti-infammatories)
  • Low humidity conditions
  • Infections
  • Trauma
  • Rhinitis
  • Excessive use of alcohol
  • High blood pressure
  • Cancer

How are nosebleeds alleviated?

Home treatment:
Most nosebleeds can be controlled without Dr. Lieberman’s intervention. To stop a nosebleed, using the thumb and index finger, pinch the soft part of the nose closed and pressed firmly toward the face while leaning forward. If you lean back, blood is more likely to run through the sinuses and down the throat, causing gagging. Hold the nose for at least 10 minutes and sit with the head higher than the heart. If the bleeding continues, pinch the nose again for an additional 10 minutes.

Once the bleeding has stopped, do not blow your nose or put anything in it for 24 hours. Avoid straining during bowel movements, bending down to lift anything, smoking or drinking hot liquids, again for a day. Lubricating the nose with a nasal saline spray or Ponaris oil can help reduce the risk of another nosebleed.

Professional intervention:
Nosebleeds can be life threatening and should not be taken lightly. It is important to see Dr. Lieberman if the bleeding cannot be controlled or if you feel weak or faint. He will attempt to identify the source of the bleed and cauterize the area to end the problem. In certain cases, it is necessary to firmly pack the nose with gauze to maintain constant pressure. There are rare instances when surgery is required and endoscopically, the bleeding is stopped by electro cauterization.