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Nose & Sinus Conditions

Of all our sense organs, our nose is perhaps the least appreciated. It’s a classic case of not knowing what we have, until we’ve lost it. Who can deny the unmistakable feeling of remembering something, even from decades ago, triggered by a scent? Of course, many people are aware of their nose for cosmetic reasons.

Sinus Problems

Your sinuses are cavities in the bones of your face surrounding your nose, whose main function is to make the skull lighter. These sinuses are lined with the same mucosa that lines the inside of your nose, and produces the same type of mucus as well. The mucus normally drains though small openings into your nose and is swallowed without us even knowing about it.

An upper respiratory tract infection, such as a ‘flu or cold, can cause the lining of the nose around these openings to swell, impairing the drainage of the mucus. The mucus can then become infected, resulting in a condition known as acute sinusitis. Treatment of sinusitis, in addition to antibiotics, requires medication that will reduce the congestion around the sinus openings, allowing the mucus to drain.

If you have a longstanding problem with your sinuses not draining properly it is called chronic sinusitis. Symptoms vary, but include a constant blocked or runny nose, post-nasal drip, sinus headaches and reduced sense of smell. The reason for the reduced draining of your sinuses can be because of allergies, longstanding infections or if the anatomy of your nose makes it difficult for the sinuses to drain normally. Treatment is aimed at the underlying cause, whether with medicines and nose sprays or with a sinus operation.


Nosebleeds, also called epistaxis, can affect patients in all age groups, but are most commonly found among children and elderly individuals. The most common cause for nosebleeds in children is nose picking, but there are many other causes. If you suffer from repeated nosebleeds, it may be a good idea to make an appointment with an ENT specialist to assess your specific issue.

If you have a nosebleed at home, sit down with your head tilted forward (NOT BACKWARD!!!) and pinch the bottom, soft part of your nose firmly for a few minutes. You may put an ice compress on your forehead or back of your neck. Resist the temptation to repeatedly let go and check if it’s still bleeding. Relax and breathe through your mouth, while spitting out any blood that runs into your mouth. Slowly release your pinch after a while. If the bleeding persists or starts again it is best to go to your nearest hospital or seek medical help.

Treatment of a nosebleed depends on the cause. The majority will respond to simple measures such as lubrication, but occasionally, patients may require surgery.

Nasal Polyps

Nasal polyps are small growths that can be found in the nose or sinuses, and represent the ultimate manifestation of inflammation of the nasal lining, usually as a result of chronic sinusitis. They are normally treated with medicines, but they usually block normal drainage from sinuses, leading to the sinuses becoming infected. In this case they need to be surgically removed with a sinus operation. Asthmatics are particularly prone to nasal polyps. It is important to realise that any treatment of nasal polyps, including surgery, seldom results in long-term cure, since the underlying cause (asthma, allergy etc) rarely goes away.

Some of the symptoms of chronic sinusitis and nasal polyps include:

  • Facial pain
  • Runny nose
  • Sneezing
  • Postnasal drip
  • loss of taste or smell
  • Nasal congestion


Allergic problems are common conditions that affect millions of people around the world, and fall under the generic term “atopy”. It is especially common in childhood and adolescence and can have a negative impact on the physical and social well-being of these individuals.

Allergies of the lung is called asthma, allergies of the skin is called eczema and allergies of the nose is called allergic rhinitis. There is a strong relationship between asthma and allergic rhinitis. Many asthmatics may have severe asthma symptoms if the rhinitis is not controlled. Asthma and allergic rhinitis may also occasionally be associated with aspirin allergy.

Allergies of the nose (allergic rhinitis) are caused by things that can be inhaled. House dust mite, grass or tree pollen and cat hair are the main causes. On the Highveld, grass pollen allergy is common. The symptoms of allergic nose conditions are caused by the body’s reaction to these particles and include:

  • Sneezing
  • Watery, runny nose
  • Blocked nose
  • Itchy eyes and nose

If you suffer from these symptoms, it is best to consult an ENT specialist who will do a thorough examination and possibly special tests to help diagnose your problem. Treatment is mostly medical, relying on topical steroid nose sprays and anti-histamines.


It is estimated that almost half of all adults snore at least occasionally, with about 25 percent being regular snorers. Whilst mild snoring may be nothing more than a nuisance to your spouse, snoring may be severe enough to cause significant obstruction in breathing. This is called apnoea, and it can have a negative impact on your work and quality of life. You will have symptoms like excessive sleepiness in the daytime, decreased energy levels, waking up tired and headaches, especially in the morning. Snoring and apnoea are closely linked to your weight, and the first step to treating any snoring is to make sure you are not overweight.

The is no real instant cure for snoring, but it is important to visit an ENT specialist who can assess your situation and see if anything can be done to improve it.

Chronic snoring in children should also be seen by an ENT specialist as it may indicate enlarged tonsils and adenoids, and can impact on the cardiovascular health of the child. This is the most common reason why children snore.

Deviated Nasal Septum

The nasal septum is the structure that divides your nose into left and right sides internally. Sometimes, it may deviate to one side or the other. Usually, this is a result of trauma. Even minor trauma can result in a deviated septum, and patients sometimes don’t even remember the incident.

Septal deviations can cause a sensation of a blocked nose, excessive mucus production and decreased sense of smell. Occasionally, there may also be a growth near the base, called a spur, which exacerbates the situation.

Septal deviations are easily corrected by doing a surgery called a septoplasty. It is important to note, however, that not all deviations are equal, and each patient is unique. Your ENT will assess you and advise you on the best solution.

Septal Perforation

A septal perforation, like an eardrum perforation, refers to a hole in the nasal septum. There are many causes of septal perforation, but one of the commonest is an untreated haematoma (bruise) of the septum following blunt trauma, such as a punch to the face. Septal perforations present with epistaxis, excessive crusting in the nose, and, if the perforation is small, as whistling sound on breathing.

You ENT will rule out other more serious causes of a perforation, and then discuss treatment options with you. This may include surgery, but not in all cases.