In the facial bones surrounding your nose, there are four pairs of hollow air spaces known as sinuses or sinus cavities. These sinuses all open into your nose, allowing air to move into and out of the sinus and mucous to drain into the nose and the back of your throat. If the passage between the nose and sinus becomes swollen and blocked, then air and mucous can become trapped in the sinus cavity causing inflammation of the sinus membranes or linings. This is known as sinusitis.

Sinusitis can be:

• acute - usually a bacterial (or sometimes viral) infection in the sinuses that follows a cold, or an allergic reaction.
• chronic - a long term condition that lasts for more than 3 weeks and may or may not be caused by an infection.

Sinusitis can be a recurrent condition which means it may occur every time you get a cold.

Symptoms of sinusitis include:

• facial pain or pressure
• nasal congestion (blocking)
• nasal discharge
• headaches
• fever.

Treatment for bacterial sinusitis is antibiotics and for non-infective sinusitis may include steroid nasal sprays and nasal washes.

If this treatment is unsuccessful, surgery may be considered. This is usually performed endoscopically; a tiny camera attached to a tube (endoscope) is inserted into your nose. Very small instruments can be passed through the endoscope and used to remove abnormal or obstructive tissue thus restoring movement of air and mucous between the nose and the sinus.

Rhinitis is the inflammation of the lining of the nose (nasal mucosa). The most common symptoms are a blocked, runny and itchy nose.

Rhinitis can be:

• Allergic – either seasonal (hay fever) caused by pollen allergies or perennial caused by e.g. house dust mite, pets.
• Infectious – e.g. the common cold
• Non-allergic, non-infectious – caused by irritants such as smoke, fumes, food additives

In the case of allergic rhinitis, the specific allergen (the thing that you are allergic to) may be identified by skin prick tests. This involves placing a drop of the allergen on your skin and then scratching your skin through the drop. If you are allergic, your skin will become red and swollen at the site.

Treatment of allergic rhinitis involves avoiding the allergen if possible, but if not possible then corticosteroid nasal sprays and antihistamines are the usual medications prescribed.

Nasal polyps are removed by inserting small instruments through your nostrils which can grasp and cut out the polyps.

This operation repositions the nasal septum and is performed entirely within your nose so that there are no external cuts made on your face.

A tiny camera attached to a tube (endoscope) is inserted into your nose. Very small instruments can be passed through the endoscope and used to remove small pieces of bone and soft tissue. This opens up the ventilation and drainage pathways in the outer wall of your nose.

Service types: Nose surgery.

This surgery is performed in association with an oculoplastic surgeon.

Growths, lumps, tumours or masses on the head and neck can be benign (non-cancerous) or cancerous and can form in the larynx, pharynx, thyroid gland, salivary gland, mouth, neck, face or skull.

Tests to diagnose a mass may include:

• Neurological examination – assesses eye movements, balance, hearing, sensation, coordination etc
• MRI – magnetic resonance imaging uses magnetic fields and radio waves to give images of internal organs and body structures
• CT Scan – computer tomography combines x-rays with computer technology to give cross-sectional images of the body
• Biopsy – a sample of tissue is taken for examination under a microscope.

Enlarged Lymph Nodes

Lymph nodes in the neck often become swollen when the body is fighting an infection.

Benign Lesions

Non-cancerous masses such as cysts are often removed surgically to prevent them from pressing on nerves and other structures in the head and neck.

Cancer

Cancerous masses spread to surrounding tissues and may be:

• Primary – they arise in the head or neck. Mostly caused by tobacco or alcohol use
• Secondary – they have spread from a primary tumour in another part of the body.

Cancers may be treated by a combination of radiotherapy, chemotherapy and surgery.