Nose

The nose is a vital organ that processes the air you breathe before it enters your lungs. In an adult, 18 – 20 000 litres of air pass through the nose each day. Because the connection between the nose and lungs is so important, paying attention to problems in the nose can reduce or avoid problems in the lungs.

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ENT boy smelling flower

Overview

Problems of the nose are often caused by recurrent infections, such as colds, adenoidal problems, an allergic lining of the nose (called rhinitis), or allergies such as hay fever. Mr Patel will see patients from 4 years and above for allergy testing. Recurrent nosebleeds and sinus difficulties are frequently seen in adults and children.

Your first consultation with Mr Patel will include a thorough discussion around your medical history and may involve an investigative examination of your nose using a rigid or flexible nasal endoscopy. A local anaesthetic is often used in preparation for one of these examinations and all examinations are undertaken by Mr Patel himself. He is highly skilled in using these methods and particularly able at ensuring children feel at ease.

All cases are discussed with you in detail before any decision regarding a procedure is made.

For patients needing MRI or CT Scans as part of their investigations, these be carried out on site.

 

Conditions treated include

Nasal congestion / discharge

Nasal congestion or discharge can be caused by anything that irritates or inflames the nasal tissues. Infections, such as colds, influenza or sinusitis or allergies and various irritants, such as tobacco smoke, may all cause a runny nose. Some people have a chronically runny nose for no apparent reason, a condition called nonallergic rhinitis or vasomotor rhinitis (VMR). Less commonly, nasal congestion can be caused by polyps or a tumour.

Catarrh

Catarrh is an excessive build-up of thick phlegm or mucus in an airway or cavity of the body. It is usually found in the sinuses (air-filled cavities in the bones of the face that drain into the nose), but it can also occur in the throat, ears or chest.

This can lead to; a blocked and stuffy nose, a runny nose or mucus that runs down the back of your throat, facial pain caused by a blocked nose and blocked sinuses, a loss of smell and taste or temporary, partial hearing loss and a crackling sensation in the middle ear. In some cases, people can experience chronic catarrh, which is not caused by an allergy or infection and lasts for a long time. The cause of chronic catarrh is unknown but it may be related to an abnormality in the lining of the throat.

Loss of the senses of smell (anosmia) and taste (ageusia)

The loss of the senses of smell (anosmia) and taste (ageusia) are the most common chemosensory disorders. The reduced ability to smell (hyposmia) or to taste sweet, sour, bitter, or salty substances (hypogeusia) are also common. In other disorders of the chemosenses, odors, tastes, or flavors may be misread or distorted, causing a person to detect an unpleasant odor or taste from something that is normally pleasant to taste or smell. These disorders are important because they can have a significant impact on quality of life and be a sign of underlying disease.

Nosebleed

Having a nosebleed (epistaxis) is common in children. Nosebleeds are usually mild and easily treated. Sometimes bleeding can be more severe. This is usually in older people, or in people with other medical problems such as blood disorders. Get medical help quickly if the bleeding is severe, or if it does not stop within 20-30 minutes. Some people have recurring nosebleeds. They may not be heavy, and soon stop, but can become distressing. It is often possible to ‘burn’ (cauterise) the bleeding point. This is normally a minor procedure which is usually successful in stopping recurrent bleeds.

Facial Pain

See sinusitis below.

Sinusitis

Sinusitis is inflammation of the lining of the sinuses, caused by a viral or bacterial infection. The sinuses are small, air-filled cavities behind the cheekbones and forehead. The main symptoms of sinusitis are; a blocked or runny nose, facial pain and tenderness, a high temperature (fever) of 38°C (100.4°F), a sinus headache. For severe or chronic (persistent) sinusitis, treatment options will include, antibiotics, steroid sprays or drops or surgery. Chronic sinusitis may last for several months and Functional Endoscopic Sinus Surgery (FESS) may be recommended.

Sinus headaches

Sinus headaches are an uncommon type of headache caused by inflamed sinuses (sinusitis). They are felt as a dull, throbbing pain in the upper face. A sinus headache is a constant, throbbing pain felt in the face (around the eyes, cheeks and forehead), usually only on one side. It tends to be at its worst first thing in the morning and may get better by the afternoon.

The pain may get worse with movement of the head, strain, bending down, or experiencing extreme changes in temperature (such as going from a warm room into freezing air outside). It can also spread to the teeth, upper jaw and other parts of the head.

Non-allergic rhinitis

Non-allergic rhinitis is inflammation of the inside of the nose that is not caused by an allergy. Non-allergic rhinitis, carries a risk of developing further problems. These can include problems caused by having a blocked or runny nose, such as difficulty sleeping, drowsiness during the daytime, irritability and problems concentrating. The inflammation associated with non-allergic rhinitis can also lead to further conditions, such as nasal polyps, sinusitis and middle ear infections

Rhinitis

Rhinitis is inflammation of the inside of the nose caused by an allergen, such as pollen, dust, mould or flakes of skin from certain animals. Symptoms of allergic rhinitis can include; a runny or blocked nose, sneezing mild irritation or discomfort in and around your nose or reduced sense of smell.

These symptoms usually start soon after being exposed to an allergen. Some people only get allergic rhinitis for a few months at a time because they are sensitive to seasonal allergens, such as tree or grass pollen. Other people get allergic rhinitis all year round. In some cases, it may be necessary to have further tests to check for any complications, such as nasal polyps or sinusitis.

These tests may include; a nasal endoscopy, where a thin tube with a light source and video camera at one end is inserted up the nose to view the internal part of the nose, a nasal inspiratory flow test, where a small device placed over the mouth and nose is used to measure the air flow or a computerised tomography (CT) scan to create detailed images of the inside of the body.

Vasomotor rhinitis

Vasomotor rhinitis a (type of nonallergic rhinitis) is not caused by an infection or allergy. The exact cause is unknown. Symptoms are triggered by something that irritates the nose, such as; a dry atmosphere, air pollution or the tissues lining the nose are swollen due to inflamed blood vessels.

Operations performed include

  • Septoplasty surgery
  • Sinus surgery both endoscopic minimally invasive and open
  • Turbinoplasty and turbinectomy
  • Transnasal repair of CSF leak
  • Anterior skull base surgery for pituitary tumours
  • Clival tumours and sphenoid bone tumours

Associates

Mr Patel works with Consultant Anaesthetists Dr Richard Waddington and Dr Bernard Norman. Dr Richard and Dr Bernard both have sub speciality expertise in paediatric anaesthetics and also serve as lead paediatric / Obstetric anaesthetists in two NHS trusts in London.

Ear

Mr Patel treats both adults and children with problems of the ear and specialises in areas of allergy and otology including balance and tinnitus.

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Throat

Children often experience problems with their tonsils, adenoids and snoring where the breathing becomes obstructed. Mr Patel treats both adults and children with problems of the throat.

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Woman suffered with sinusitis

Case Study: Blocked sinuses hindered young woman for many years

Georgia suffered with sinusitis regularly leaving her with pain and headaches. Georgia wondered if there were alternative treatments to the ineffective medication she had been taking.

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“I wanted to thank Mr Patel and all the team for your knowledge, skill, time and above all, the kindness shown to me on the day of my operation.”

Mrs Halloway, London