Nose and Sinus

Rhinoseptoplasty for the Northern Beaches

Nasal Septum and Surgery to reduce enlarged turbinates

The cartilage and bone partition that divides the nostrils is the nasal septum. It sometimes bends more to one side during growth or because of injury. A Septoplasty or Nasal Septal Reconstruction operation is done to straighten the septum to improve airflow through the nostrils.

 - It is sometimes done to improve access to the small high ethmoid sinuses during sinus surgery. - It is often done together with a Rhinoplasty - It is often an essential part of Snoring surgery

The Turbinates are mucous membrane covering bone that juts out from the side wall of the nose. Their normal job is to humidify the air that we breathe. The turbinates (usually the inferior turbinates ) can swell and cause nasal blockage due to ...Allergy.., Persistent Sinus Infection... Excessive use of over the counter nasal decongestant sprays ... Other irritants such as smog, chemicals or cigrette smoke

Diagnosis and Treatment .

 A full diagnostic work up for nasal obstruction problems will include a Sinus CT Scan and skin allergy tests.                  

Operation  

The operation is usually done inside the nose with no or little change to the external nasal shape. I normally use packing to prevent post operative bleeding, and splints inside the nose. The packs are removed the next morning prior to discharge from hospital, and the splints are removed a few days after surgery. Most patients take 7 - 10 days off work or school to recover from this surgery

Functional Endoscopic Sinus Surgery 

FESS ... The use of small instruments inside the nose , with fibreoptic telescopes has improved sinus surgery a great deal over the last 20 years. The surgery is much less radical than it used to be and the results are better.The sinuses are air filled cavities in the skull surrounding the nose.

Maxillary Sinuses are the big sinuses in your cheeks under the eyes.

Ethmoid Sinuses are a group of small air cells between the eyes and under the nasal bones.

Frontal Sinuses are in the forehead above the eyes. They are very variable in size and are sometimes even absent in some people.

Sphenoid Sinus. Is deep behind the nose in the centre of the skull

The drainage and ventilation pathways of the sinuses can become blocked from inflammatory conditions or obstructedby polyps, bent septum, thickened lining mucosa subsequent to frequent infections.

The accurate assessment of sinusitis requires a Sinus CT scan and allergy tests... Dr Forrest can arrange these for you if your GP has not already done so. The aim of FESS is to unblock the tiny openings into the sinuses and remove diseased mucosa. When the sinuses heal they should then drain and ventilate better.

The extent of FESS required will depend on the amount of sinus disease present and consider other underlying conditions such as Nasal Polyps. The surgery takes between 1 and 3 hours depending on the complexity. Patients normally stay in hospital one night and go home the next morning.

Aftercare is important and will normally include antibiotics and frequent wash outs of the nose with saline solutions, and topical steroid nasal sprays. The aftecare will be carefully explained to you by Dr Forrest.He will give you a more detailed information sheet covering all aspects of Functional Endoscopic Sinus Surgery.

Rhinoplasty...

Commonly known as "a nose job" Rhinoplasty surgery will change the external appearance of your nose. Dr Forrest normally does this when needed to augment a septal operation to improve breathing. It can be done for purely cosmetic reasons but the lack of any Medicare rebate for cosmetic Rhinoplasty tends to make it an expensive procedure. Dr Forrest is always conscious of the expense of surgical care so please do not be afraid to ask about rhinoplasty surgery if you wish your nasal appearance to be improved.
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