Nasal & Sinus


Our Services

  • Endoscopic Sinus Surgery
  • Septoplasty
  • Balloon Sinuplasty
  • Turbinate Reduction
  • Nasal Cautery for Nose Bleeds

Conditions We Treat

  • Sinusitis
  • Rhinitis
  • Nasal Congestion
  • Post Nasal Drip
  • Sinus Headaches
  • Deviated Septum
  • Nose Bleeds

The nose is a complex organ that serves to warm, humidify and filter the air that reaches our lungs. Airflow through the nose is also important for the sense of smell since the smell receptors are in the roof of the nasal cavity. The common complaints related to the nose include nasal congestion, runny nose, post nasal drip, and nose bleeds.

What causes nasal congestion?

Nasal congestion is usually caused by underlying anatomic abnormalities of the nose and/or inflammation and swelling of the lining of the nose called the “mucosa.”

The inside of the nose contains the septum that divides the left and the right side. This is made of bone and cartilage and covered by mucosa. Most people have some degree of “septal deviation.” This means that the septum is crooked to one side or the other. It can sometimes be deviated to both sides in different places. When there is a significant deviation, there can be blockage on one side of the nose and sometimes both. You can be born with the deviation or this could have been acquired through trauma to the nose.

On each side of the nasal cavities you have turbinates. These bony protuberances project into the airway to help the flow of air. They increase the surface area to allow for warming, humidification, and filtration of the air we breathe.

The mucosa lines the septum and turbinates and produces mucous that coats all of the internal nasal surfaces. The mucous helps to trap and filter particles we breathe in. It also provides moisture and humidity. The mucosa contain tiny specialized cells that have microscopic hairs that sweep mucous to the back of the nose and eventually down into the throat where it is swallowed. This is a process that normally you don’t notice. When there is increased mucous, you may notice this as postnasal drip.

Underneath the mucosa, vascular tissue called submucosa help with warming the air we breathe. When there is increased inflammation due to infections such as the common cold or allergy, the mucosa and submucosa swell causing the nose to feel blocked. There is also increased mucous production resulting in a runny nose or postnasal drip. If there are severe allergies the mucosa and submucosa can swell significantly over time and form polyps that can lead to even more nasal congestion.

How can nasal congestion be treated?

If allergies are a major cause of nasal congestion, treating for allergies including nasal sprays and oral antihistamines are helpful to decrease the swelling inside the nose. It is also helpful to wash the nasal cavity with saline to help clear away the allergens that we breathe in.

Click here to learn more about Allergies

If management of allergies does not suffice, treatment of underlying anatomic abnormalities may be beneficial. These procedures include septoplasty to straighten the septum and turbinate reduction to remove excess bone and/or to reduce the submucosa so that the turbinates do not swell as much.

If you have nasal congestion and allergies call today for an evaluation with the physicians at Potomac Ear, Nose and Throat at 703-499-8787

What about the Sinuses?

We don’t really know why we have sinuses. There are theories that evolutionarily, the sinuses helped to lighten the head so we could stand upright. They also act like crumple zones in a car that protect the brain from trauma. The sinuses also help modulate the sound of our voice.

The sinuses in your cheeks are called the maxillary sinuses. The sinuses in your forehead are called the frontal sinuses. The sinuses between the eyes are actually composed of numerous air cells and we call these the ethmoid sinuses. In the back of the nose and in the middle of the skull, there is the sphenoid sinus.

The sinuses are normally filled with air and are lined with mucosa that produces mucous. They are connected to the nasal cavity through openings called ostia. Normally mucous is easily swept out of the ostia, however if the ostia become blocked due to inflammation from allergies or the common cold, mucous can accumulate in the sinuses and air cannot enter into the sinuses. This results with sinus pressure and facial pain. If the blockage occurs long enough, the stagnant mucous can be a breeding ground for bacteria and a bacterial sinus infection “sinusitis” can occur. Because the nose and sinuses are interconnected, otolaryngologists now use the term “Rhinosinusitis.”

How is rhinosinusitis treated?

For viral rhinosinusitis, supportive therapy including analgesics, nasal saline, decongestants, and nasal steroid sprays can be beneficial. Viral infections are self limited and usually resolve within 10 days. If symptoms get worse after 10 days, you may have a bacterial infection. Sometimes, a bacterial infection may be present if you improve within 10 days, but suddenly worsen again. Bacterial rhinosinusitis is treated with oral antibiotics. Occasionally oral steroids may be needed to help decrease the swelling inside the nose. Treatment of allergies may help to decrease the number of sinus infections.

Surgical intervention can be considered for patients who have recurrent infections (more than 4 per year) or if there are symptoms lasting more than 12 weeks or greater (chronic rhinosinusitis) AND if medications have not been sufficient to improve symptoms. Surgeries for the sinuses are done endoscopically (with a thin telescope connected to a camera). The goal is to enlarge the openings into the sinuses so that they are less likely to be blocked by inflammation. This can be done via a minimal invasive approach in the office called balloon sinuplasty for certain cases or in the operating room called functional endoscopic sinus surgery for more complex cases.

If you have sinus related symptoms, call today for an evaluation with the physicians at Potomac Ear Nose, and Throat at 703-499-8787

What to expect during your visit for evaluation of nasal and sinus symptoms:

A comprehensive medical history will be obtained and a physical examination of the head and neck will be completed. It may be necessary to perform a nasal endoscopy for further evaluation. The nose is sprayed with a decongestant and topical anesthetic to numb the nose so that you are comfortable during the procedure. An endoscope is then passed into each nasal cavity to evaluate. The anesthetic often numbs the throat and therefore we ask our patients not to eat or drink for an hour after the procedure.

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