NOSE & SINUS PROBLEMS

General Information

Many people experience problems with their nasal passages or sinuses (the air cavities within the skull which open up into the nasal passages). These problems may occur temporarily or persist long term. Most problems are due to an allergy, an infection, or as a result of a foreign substance being inhaled up the nose.

Allergic rhinitis

Allergic rhinitis is when the lining of the nose becomes inflamed, due to an allergy. Allergic rhinitis can be either seasonal (known as hayfever or intermittent allergic rhinitis), occupational (from using certain chemicals at work that trigger symptoms) or persistent (perennial). In persistent allergic rhinitis, symptoms occur continuously throughout the year rather than during a particular season, but they may be worse during the pollen season. Allergic rhinitis is also classified according to the frequency and severity of symptoms. If troublesome symptoms that affect normal daily functioning occur more than four times a week, it is classified as persistent rhinitis.

Apart from the length of time symptoms persist, most other symptoms of intermittent and persistent allergic rhinitis are similar. Nasal congestion and sneezing, runny nose, sore throat, itchy roof of the mouth, tickly cough and husky voice are common to both.

People with seasonal allergic rhinitis are more likely to experience eye involvement (sore, red and itchy eyes), while people with persistent allergic rhinitis commonly develop sinusitis (painful swelling of the sinuses) and are less likely to have sneezing episodes.

People with persistent allergic rhinitis are typically allergic to allergens which are constantly present such as house dust mite faeces, mould spores, or animal dander.

Infective rhinitis

Infective rhinitis is often associated with the common cold or sometimes the ’flu, and is usually caused by a virus. Common symptoms can include coloured nasal discharge, cough and/or sore throat, but these usually clear up within a few days.

Vasomotor rhinitis

Symptoms of vasomotor rhinitis are similar to those of allergic rhinitis (though there is usually less sneezing or itching), and it often get worse with seasonal changes; allergy testing will, however, give a negative result. Certain odours (such as perfume, cigarette smoke and paint fumes), alcohol, spicy foods, emotions and environmental factors such as temperature, barometric pressure changes and bright lights may also exacerbate or trigger the symptoms.

The nose can be either very runny or dry and congested. Vasomotor rhinitis is believed to be caused by oversensitive blood vessels, or an overabundance of blood vessels, within the nose. Topical treatment products are usually effective at reducing the symptoms of vasomotor rhinitis.

Nasal foreign bodies

Anybody with an object trapped up their nose should see a doctor if the object cannot be dislodged easily. For parents, sometimes the first sign in young children is a smelly discharge leaking from one nostril. If you suspect that something may be up there that you are unaware of, always see a doctor rather than attempting to remove it yourself. Keep toys with small parts, or other items (such as beads) out of reach of young children at all times.

Other problems

In addition to the most common sinus and nasal problems listed above, pregnant women may also develop rhinitis (inflammation of the lining of the nose) due to hormonal changes, and persistent nasal congestion can occur due to over-use of topical decongestant medicines, e.g. nose sprays or eye drops. Certain medicines can also contribute to rhinitis, so it is important to let your medical professional know what medicines you take.

 

See Your Pharmacist or Medical Professional

  • if the person needing treatment is a child; some medicines may not be suitable

  • if it is possible an object could be trapped up the nose

  • if only one side of the nose or eye is affected

  • if the symptoms have persisted despite treatment

  • if the nasal symptoms have come on soon after beginning a new medicine

  • if you have shortness of breath, a cough or wheeze; this could be asthma, since allergic rhinitis and asthma frequently occur together

  • if you have other symptoms, e.g. swollen glands, fever and/or a persistent headache, you may have an infection

  • if there is any coloured or yellow discharge from the nose or eyes

  • if the ears or sinuses are painful

  • if there are recurrent nose bleeds or a reduced sense of smell

  • if you have ongoing medical conditions or take other medicines

  • if you are pregnant or breastfeeding; some medicines may not be suitable

About 35 million people develop sinus infections (sinusitis) each year, making it one of the most common health complaints in the US. Care of the nasal cavity and sinuses is one of the primary skills of ENTs. Other problems in the nasal area treated by ENTs include allergies, smell disorders, polyps, and nasal obstruction due to a deviated septum.

If you experience difficulty with allergies, smelling problems, structural problems, or sinus problems, an ENT specialist can diagnose the condition and help find the right treatment plan for you.

Common Nose Problems

Common nose-related issues that ENT’s see include: sinus infections, congestion, and airway blockage. Symptoms of sinus infections are a pain in your face, upper teeth or in your ear, and drainage that is obstructed or abnormal, or nasal congestion. Symptoms of congestion include feelings of pressure in your head, headaches, and dizziness. Airway blockage of the nose is not being able to breathe properly through the nose.

Reasons for these symptoms can range from allergies to viral or bacterial infections to a deviated septum. Polyps may also be the culprit in airway blockage. A visit to an ENT will help pinpoint the source of the problem and inform the treatment.