Dr. Chau is a general otolaryngologist (ear, nose and throat specialist), therefore, during your initial consultation, all aspects of your breathing will be examined. Based on your anatomy, Dr. Chau may suggest starting medical therapy or discuss nasal procedure/surgery to treat your nasal issues. Various nasal treatments exist from non-surgical like medication and external nasal dilators to surgical procedures like septoplasty, nasal valve surgery, endoscopic sinus surgery, rhinoplasty and turbinate reduction.
Sinuses are effectively spaces in your skull. They serve many purposes, but nobody is sure exactly why we have them. There are four pairs of sinuses; 1. maxillary sinuses behind your cheekbones, 2. the frontal sinuses in your forehead, 3. the ethmoid sinuses that form a honeycomb-type structure in the area between your eyes and 4. the sphenoid sinuses towards the back of your nose, almost between your ears. Sinuses are connected to your nose through narrow passageways. The mucus made by the lining of the sinuses normally drains into the nose, however, when the lining of your nose is swollen, including swelling related to allergies or colds, these passageways can close off. This can cause the mucus to be trapped inside your sinuses, leaving it open to infection with the bacteria (and possibly fungus) in our noses.
Short-term sinus infections (acute sinusitis) are common, as they can be caused by colds or viruses. Typically they respond well to combinations of nasal sprays and, possibly, antibiotics. Sinus surgery is reserved for those who have many short-term infections or have infections that last a long-time (chronic sinusitis), without good control with medications alone. Chronic sinus issues or a deviated nasal septum may contribute to snoring and obstructive sleep apnea (OSA) as well so it is important to treat both airways when dealing with OSA.
The nasal septum separates one side of the nose from the other with bone, cartilage, and overlying soft tissues. Blockage in the nose occurs with issues like septal deviation or septal spurs. A septoplasty attempts to straighten the septum and restore its position and open up nasal airways. This will not change the outside look of the nose as it is only addressing your septum.
Endoscopic Sinus Surgery
Using small telescopes to look into the nose, Dr Chau will remove small pieces of bone and lining (including any abnormalities) in order to widen the passageways that connect the sinuses to the nose. This surgery is done to remove inflamed tissue and improve ventilation in the sinuses. Allowing for medications to reach the sinus cavity resulting in reduced severity of sinus infections and making them easier to treat.
In the nasal cavity of the nose, there are three pairs of turbinates on the lateral walls. The inferior turbinates can be enlarged due to allergies or nasal irritants and can cause nasal obstruction. By reducing the size of turbinates we are creating more space for nasal breathing, thus reducing nasal obstruction. This procedure can be performed under local or general anaesthetic.
General Anaesthetic Option – If you are having additional surgery, such as septoplasty or endoscopic sinus surgery, it is easiest to have the turbinate reduction under general anaesthetic. This procedure reduces tissue volume by making a small cut in the lining of the inferior turbinates and lifting the lining of the thin bone that forms the structural support of the inferior turbinate. By removing part of this bone and allowing the healing process to shrink the lining of the turbinate, the nasal passage increases in size.
Local Anaesthetic Option – This is performed at the Peter Lougheed Minor Surgery Clinic without general anaesthesia or sedation, instead a local anaesthetic is used (“freezing”). The tissues volume is reduced by inserting a heating probe into the inferior turbinate, energy is delivered to heat the tissues, acting as a catalyst to healing.
Rhinoplasty (Cosmetic Nasal Surgery)
Rhinoplasty is nose reshaping surgery performed for the external appearance of a nose. Rhinoplasty, as any surgery that alters the outside appearance of the nose, will affect nasal function as well. This is why it is very important for your surgery to be performed by a surgeon who specializes in nasal surgery, both inside and outside the nose. Most patients, and experienced plastic surgeons, often fail to realize that even simply taking a bump off of the nose can impair nasal breathing. It is an excellent procedure to reshape the nose to: