Sinus Center Treatments and Services

We provide comprehensive treatments and services for sinus conditions. We can provide many treatments in the office or on an outpatient basis.

Our treatments and services include:

• Absorbable nasal implants: This minimally invasive in-office treatment supports the upper and lower cartilage inside your nose's lateral (side) wall. We use this treatment to prevent the dynamic collapse of the nostril.

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  Cerebrospinal fluid (CSF) leak and encephaloceles repair: Spinal fluid leaks into the nose may occur spontaneously or as a result of craniofacial trauma. These leaks can usually be repaired endoscopically through the nose to prevent the development of meningitis. We perform these endoscopic repairs by inserting a thin instrument into the nose.
• Chemical cautery or electrosurgery: We use this in-office to treat recurrent or severe nosebleeds. In this procedure, the doctor uses a chemical swab or electric current to seal blood vessels and create scar tissue, which will help prevent nosebleeds.
• Cryotherapy ablation: This in-office procedure treats chronic nasal drainage and vasomotor rhinitis (non-allergic runny nose). Cryogenic ablation uses extreme cold to freeze and destroy tissue.
• Culture-directed antibiotic therapy: This therapy involves delivering a high dose of topical antibiotics to an area in the nose. To ensure that the correct antibiotic is used, the doctor will first take a culture (sample) from the nose. This therapy can be used to treat sinusitis when there are issues with antibiotic resistance.
• Endoscopic dacryocystorhinostomy (DCR): Endoscopic DCR is a treatment for watery eyes (epiphora) caused by a blockage in the lacrimal system. This minimally invasive procedure involves creating a small opening to provide a new path for tears to drain between your eyes and nose.
• Endoscopic orbital decompression: This is a surgical treatment for thyroid eye disease, also known as Graves' ophthalmopathy. This disease can occur before or with other signs of hyperthyroidism. The surgery removes small amounts of bone that surrounds the eye to help reduce the bulging appearance of the eye.
• Endoscopic septoplasty: This procedure can relieve symptoms of nasal obstruction caused by a severely deviated septum. The minimally invasive surgery involves removing the deviated part of the nasal septum. This procedure generally avoids having to use nasal splints and packing after surgery.
• Endoscopic skull base surgery: We use this minimally invasive surgery to remove pituitary tumors or other growths from the bottom (base) of the skull. Patients who have endoscopic skull base surgery recover more quickly than those who have traditional surgery through an open incision. They also have a lower risk of complications and a similar success rate. This multidisciplinary surgery involves a rhinologist (sinus surgeon), who works through one nostril to open the sinuses, and a neurosurgeon, who works through the other nostril to remove the portion of the tumor involving the skull base. This approach offers the advantage of having 2 surgeons and 4 hands performing the surgery.
• Endoscopic sphenopalatine artery ligation: This is an effective treatment for some cases of hard-to-cure posterior nosebleeds that are not related to an underlying systemic disease or bleeding disorder. The sphenopalatine artery is a blood vessel at the back of the nose. Ligation is the process of closing off a blood vessel.

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  Functional endoscopic sinus surgery: The goal of this minimally invasive surgery is to restore the natural drainage to the sinuses. It also allows the application of topical medications to treat the sinuses.
• Monoclonal antibody treatment for polyps: These novel, non-steroidal medical therapies approved by the Food and Drug Administration (FDA) are a non-surgical option to reduce nasal polyps.
• Nasal valve repair and functional rhinoplasty: Nasal valve repair and functional rhinoplasty are surgical approaches to optimize airflow through the nose and alleviate nasal obstruction.
• Olfactory testing: Olfactory testing can assess your ability to sense common odors. A nationally recognized and standardized scratch-and-sniff test evaluates your sense of smell identification for 40 common odors. This testing may help determine the presence and severity of your loss of smell, based on data from people your age that have a normal smelling ability.

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  Polypectomy: This in-office treatment is used to remove nasal polyps.
• Radiofrequency ablation of the inferior turbinates: Turbinates are tiny structures in the nose that moisten, heat, and filter air as it passes through your nose and into your lungs. The inferior turbinate is the largest turbinate. This in-office treatment is used to treat nasal obstruction caused by an inflamed or swollen inferior turbinate. The treatment involves using a needle-like instrument to apply heat-producing radio waves to the turbinate.
• Stereotactic computer-assisted (navigational) surgery: Computer-assisted surgical navigation is a tool we use in special cases. These devices provide precise information about the location of surgical instruments within the sinuses during surgery. They can also be used to create 3D reconstructions to help your surgeon. We typically use stereotactic computer-assisted surgery during procedures to correct a previous operation, treat nasal polyps, or remove skull base tumors where normal surgical landmarks have been removed or altered. Surgeons combine the information from the computer along with their training.
• Vasomotor rhinitis surgery: This surgical treatment may be an option for patients with chronic vasomotor rhinitis (non-allergic runny nose) and vasomotor rhinitis that responds to topical medications.

Treatments for benign and malignant tumors

Benign tumors

An inverted papilloma is the most common benign soft tissue tumor of the sinuses. Other types of benign tumors include:

• Adenoma
• Hemangioma
• Juvenile nasopharyngeal angiofibroma (JNA)
• Schwannoma
• Squamous papilloma

These benign tumors are generally removed endoscopically without any incisions. More extensive tumors may require a small incision hidden in the eyebrow.

Recurrent left frontal sinus inverted papilloma

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Juvenile nasopharyngeal angiofibroma (JNA)

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Malignant tumors

Malignant sinus tumors are uncommon. There are many types of malignant sinus tumors, including:

• Adenoid cystic carcinoma
• Adenocarcinoma
• Mucosal melanoma
• Nasopharyngeal carcinoma
• Neuroendocrine tumors
• Olfactory neuroblastoma (esthesioneuroblastoma)
• Squamous cell carcinoma

For these tumors, we often recommend surgery as an initial management approach. We can often do this surgery endoscopically. Further postoperative treatment may involve radiation, chemotherapy, or both, depending upon the type of tumor and the recommendations of our multidisciplinary Head and Neck Cancer Program team.

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