Most sinus problems are treated medically, with surgery being reserved for cases that fail to settle on medical management. Surgery for the sinuses is typically in the form of FESS (Functional Endoscopic Sinus Surgery). The Bon Secours has a state of the art 3-D navigation system that allows accurate determination of intraoperative instrument position to help maximise the safety and efficacy of sinus surgery.
30% of the population suffer from allergic rhinitis, with symptoms of nasal congestion and often clear nasal discharge. Accurate diagnosis is facilitated by telescopic examination of the internal nose, allergy tests and CT scan in selected cases. The treatment is typically medical with a combination of steroid nasal sprays, antihistamines, leukotriene antagonists, saline sprays and allergy avoidance. Surgery in the form of a turbinoplasty/turbinate diathermy (in kids) can be performed in occasional selected cases.
Kids with large adenoids, have constant mouth breathing, or mucky nasal discharge (often more than 50% of the time) or heavy snoring. Adenoidectomy is often performed in these kids, though natural shrinkage of the adenoids with time has to be also taken into account.
Facial pain is often non-sinogenic. It is a very frequent patient that attends an ENT clinic with facial pain that has been treated with 20 or more courses of antibiotics to discover after a nasal endoscopic examination and a CT that the pain is a migraine variant (mid facial pain / atypical facial pain). This diagnosis is important, because it allows the patient to stop treating their facial pain with antibiotics and to look at different and effective treatment strategies.
Septoplasty changes the shape of the nasal septum to allow an improvement in breathing; rhinoplasty changes the external shape of the nose that can be for breathing purposes (functional rhinoplasty) or cosmesis (cosmetic rhinoplasty), or most commonly, for both reasons. Septoplasty surgery is often performed in conjunction with rhinoplasty surgery as a septorhinoplasty. Both surgeries can be performed using an open (external) approach or a closed (endonasal approach). The closed (endonasal) approach (no scars) is used in Mr Harneys practice for most (>er 90%) of septoplasties, and for the basic rhinoplasty surgeries (approximately 20%). Most complex rhinoplasties require an open approach, as Mr Harney believes it gives superior control for the repair of difficult abnormalities.