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San Jorge Children's Medical Office Building 252 Calle San Jorge Suite 501 San Juan, PR 00912
Tel: 787-268-2300
Nose
Endoscopic Sinus Surgery
Endoscopic sinus surgery, also known as sinoscopy, is a minimally invasive procedure used to remove blockages in the sinuses for patients with recurring or non-responsive sinus infections. This procedure opens the natural pathways of the sinuses to restore proper function and relieve symptoms such as nasal congestion, headaches and more.
During the endoscopic sinus surgery procedure, a thin lighted tube with a camera on the end is inserted into the nose to let the doctor visually examine the area. Tiny surgical instruments are inserted as well to remove the obstruction within the nose and restore proper breathing. There is no incision required during this procedure, as it is performed entirely through the nostrils. This procedure is usually performed under general anesthesia, although some patients may only need a local anesthetic with sedation.
After this procedure, most patients experience significant relief in symptoms such as facial pain and swelling, difficulty breathing and headaches. In addition to treating chronic sinus infections, this procedure can also be used to treat a deviated septum, nasal polyps or tumors.
While this procedure is considered safe for almost all patients, there are certain risks associated with any type of surgery. Some of these risks may include bleeding, recurring sinus infections, spinal fluid leak and vision problems.
Epistaxis (Nosebleeds)
Nosebleeds are fairly common given the prominence of the nose on the face as well as the rich network of capillaries contained within it. These both make the nose susceptible to trauma and injury, which may result in nosebleeds. Other factors include: changes in weather, dry air, allergies, repeated nose blowing, or sinus infections.
The two types of nosebleeds are anterior and posterior. Anterior nosebleeds comprise 90% of all nosebleeds. The bleeding usually occurs in the anterior (front) of the nose and flows outward. Posterior nosebleeds are less common and usually occur in the elderly, people with high blood pressure, or those who suffer a facial or nose injury. The bleeding usually occurs in the posterior (back) of the nose and flows down the throat. These nosebleeds are generally more complicated and often require medical assistance.
Laryngoscopy and Nasopharyngoscopy
Laryngoscopy and nasopharyngoscopy are diagnostic procedures that examine the voice box (larynx) and the internal structures of the nose and throat (nasopharynx). These procedures are often effective in diagnosing conditions such as hoarseness, sore throat, nosebleeds, snoring and more by detecting abnormal growths and any obstructions within the airway. If necessary, a tissue sample, known as a biopsy, can be obtained during this procedure as well.
Depending on the type of procedure being performed, a long, thin, flexible tube will be inserted down the nose or throat so that your child’s doctor can thoroughly examine the affected area. This procedure does not usually cause any pain, but may be uncomfortable, so local anesthesia is often administered. The results of the laryngoscopy or nasopharyngoscopy procedures are available right away to be reviewed with you after the procedure.
Nasal Fracture
A nasal fracture, or broken nose, is a common injury that may occur from playing sports, an accident, fighting or a fall. Children with a nasal fracture usually experience pain and swelling of the nose, bruising around the eyes, a nosebleed, blocked nasal passage and more. The nose usually has a bent or crooked appearance. If a nasal fracture is suspected, your child’s doctor will perform an X-ray exam to confirm the diagnosis. If left untreated, this condition can lead to chronic nasal obstruction or a predisposition to sinusitis and infection.
Treatment for a broken nose depends on the severity of the fracture, but may include straightening the bone with a splint or surgery to realign bones back into their normal position. For many patients, no treatment is necessary for proper healing other than managing pain and other symptoms.
Nasal Obstruction
Nasal obstruction involves a partial or complete blockage of the nasal passages, causing difficulty breathing, raspy voice, snoring and more. This condition can be caused by several different factors, including structural conditions such as a deviated septum, nasal polyps or bone deformities, as well as bacterial infections or other types of illness.
Correction of nasal obstruction is usually done through surgery. The type of procedure performed depends on the cause of the obstruction, but may involve removing polyps and other abnormal growths, aligning a deviated septum or reducing the size of enlarged turbinates. Treating the underlying cause is often effective in relieving a nasal obstruction and restoring proper breathing function to your child’s nose.
Obstructive Sleep Apnea Surgery
Obstructive sleep apnea is a common condition that involves breathing problems during sleep, as the muscles relax and block the airway. Children with this condition may experience loud snoring, headaches, insomnia and waking up with a sore throat. While there are some nonsurgical treatments available for obstructive sleep apnea, many patients require surgery for effective symptom relief.
There are several different surgical procedures available to treat sleep apnea. All of these procedures aim to remove excess tissue from the nose or throat in order to unblock the airways and promote healthy breathing. Surgery for obstructive sleep apnea may include:
• Surgical removal of tissue (uvulopalatopharyngoplasty) – removes tissue from the throat, tonsils and adenoids.
• Jaw correction – moves the upper and lower parts of the jaw forward to create a larger space behind the tongue.
• Implants (Pillar procedure) – places three small rods in the soft palate to support the tissue and prevent the airway from collapsing during sleep.
Septoplasty and Turbinate Reduction
Septoplasty is a surgical procedure performed to straighten or align the nasal septum, the partition between the nostrils that separates one side from the other; while turbinate reduction reduces the size of the turbinates, which are the small curved bones that extend horizontally along the wall of the nasal passage.
Up to 80% of the population has a septum that is slightly crooked, or deviated, a condition that can cause chronic nasal congestion and other related symptoms. Abnormal turbinates have become a common condition as well, as allergic reactions or infections cause them to swell up and block the lower portion of the nasal airway.
These procedures are often combined in order to fully restore normal function to the nasal airway and allow patients to perform their daily activities without chronic nasal congestion. Many patients report a significant improvement in their quality of life after these procedures.
Septoplasty and turbinate reduction are performed in an operating room under general or local anesthesia with sedation. Most patients can return home after three to four hours, after the nose has been packed and dressed to reduce swelling and promote proper healing.
While septoplasty and turbinate reduction are considered safe for most patients, there are certain risks associated with any surgical procedure. Some of these risks may include swelling, septal perforation, numbness, infection and bleeding. It is also possible that the nasal airway will not be cleared after these procedures. Your doctor will determine the best treatment for you after a thorough evaluation of your individual condition.