Septoplasty, Turbinoplasty and Sinus Surgery in New York
Patients with a significant deviated nasal septum (the wall that separates the right and left nasal chambers) often suffer from breathing problems. In addition, people who suffer from allergies tend to develop enlarged nasal tissue (called turbinates) which block their airways. Polyps and other nasal conditions can contribute to breathing difficulties as well. Dr. Rizk will examine the possible factors that may be affecting your nasal breathing when you come in for your consultation.
Septoplasty, turbinoplasty, and sinus surgery in NYC can help relieve these symptoms. Patients can also choose to combine septoplasty with rhinoplasty if they are interested in improving their nose’s appearance as well. This is done in a combination procedure called septorhinoplasty.
Dr. Rizk, a double board-certified facial plastic surgeon, and cosmetic nose expert, provides septoplasty, turbinoplasty, and sinus surgeries to patients in New York and surrounding areas. If you want to learn more about working with Dr. Rizk, get in touch with his clinic and book a consultation today.
[Dr. Rizk works with most insurance companies for any medical issues in the nose as an out-of-network doctor. Call his office to find out more]
Septoplasty and Breathing Difficulties
During your consultation at Dr. Rizk’s New York office, he will determine if your septum is significantly deviated, whether your turbinates are considerably enlarged and how a reduction would improve your breathing. In addition, Dr. Rizk will use a 3D high-definition telescope to observe and evaluate other nasal conditions including polyps, which may affect your breathing. Dr. Rizk may recommend doing a CT scan in some cases to further analyze polyps or sinuses, as well as testing for allergies.
Initial treatment will include medications that are supposed to decrease the nasal tissue, such as antihistamines and nasal steroid sprays, or antibiotics if a sinus infection is detected. When this treatment fails, Dr. Rizk may recommend performing a septoplasty, sinus surgery and/or turbinate reduction.
Endoscopic septoplasty is a procedure done from inside the nose to correct the nasal septum and it does not involve breaking the nose. Dr. Rizk does not use packing, as was commonly used in the past. This considerably decreases swelling and recovery time. He sometimes uses nasal tissue glue in place of a pack.
Septoplasty with Turbinoplasty
In some cases, patients that have a deviated septum, where inside the nose one side is bigger than the other, can also experience large turbinates as they tend to adjust themselves by getting bigger as well. As a result, the blockage of airways worsens. In these situations, septoplasty surgery combined with turbinate reduction is required in order to improve your breathing as well as the level of sinus drainage.
Ethmoidectomy and Maxillary Antrostomy
The ethmoid sinuses are located between the upper eye toward the eyebrows and the bridge of the nose and drain into the nose. The maxillary sinuses are the cheek sinuses, which drain into the nose as well. These are the main places that need to be cleaned from all sinus infection and well-drained since all other sinuses drain through the ethmoid sinuses, using them as a passageway.
If this area is blocked, the infection can migrate/expand to other sinuses. Ethmoidectomy is a surgery in which Dr. Rizk removes the infected tissue and bone in the ethmoid areas that block natural drainage. Maxillary antrostomy is a surgery in which Dr. Rizk opens or widens and cleanses diseased tissue or polyps from the maxillary sinus opening. These procedures are done with telescopes from inside the nose. Occasionally the sinus infection may involve the frontal or sphenoid sinuses as well and they may require cleaning and opening.
What is a Deviated Nasal Septum?
A deviated nasal septum or “crooked” internal nose can occur at childbirth or as the result of an injury or other trauma. If the wall that functions as a separator of both sides of the nose is tilted towards one side at a degree greater than 50%, it might cause difficulty breathing.
Sinusitis and Sinus Surgery
1 in 10 Americans suffers from sinusitis, a chronic condition in which the sinuses are blocked and do not drain properly. Repeated infections develop and patients experience difficulty breathing, pressure, headaches, and excessive drainage from the front of the nose (rhinorrhea) or back of the nose into the throat (post-nasal drip).
If you catch a cold or have an allergy attack and it lingers for more than a week, it can often be related to sinusitis. The nose collects mucus, and within a few days, the sinus passages swell and block the airways. The mucus then starts to build up within the sinuses, causing the symptoms described above.
Other causes of sinusitis are polyps, a deviated nasal septum, or narrowing of nasal drainage pathways. When there is a specific anatomical blockage that does not respond to medicine, a CT scan is recommended. If it shows the etiology of sinusitis, surgical drainage may be the only effective alternative. Functional endoscopic sinus surgery (FESS) in combination with medications and allergy treatment can improve breathing and alleviate sinusitis symptoms.
Risks Associated with Septoplasty, Turbinoplasty and Sinus Surgery
Septoplasty, turbinoplasty, and sinus surgery can greatly improve patients’ quality of life. However, there are some potential side-effects and risks associated with these procedures. These include:
- Small chance of infection
- Bruising and swelling during the recovery
- Turbinate asymmetry
- Visible scarring
Dr. Rizk examines each patient individually and builds an aftercare plan tailored to your specific case. This will help minimize potential side-effects and increase your chances of a successful outcome.
Why Choose Dr. Rizk for Your Septoplasty, Turbinoplasty and Sinus Surgery in NYC?
Dr. Rizk specializes in nose surgery and sinus surgery, including treating various breathing problems with septoplasty. He is double board-certified in facial plastic surgery and otolaryngology, providing him a deep understanding of the nasal structure. Furthermore, his extensive skill allows him to treat medical conditions while keeping in mind the aesthetic implications of changes done inside the nose.
Interested in working with Dr. Rizk? Contact his office and book a consultation today.
What are the sinuses?
The sinuses are air pockets located within the bones of the skull and face. They are connected to your nasal passages by small tubes or channels (osteomeatal channels). These channels allow air to flow from the nose to the sinuses and allow drainage of mucus from each sinus into the nose. We have four sinuses on each side: the maxillary (cheek), ethmoid (nose), frontal (above nose in between the eyes), and sphenoid (in the back of the nose).
The osteomeatal channel or connection from the sinus into the nose can vary in length and width. This difference can impact one's ability to drain properly and can predispose to blockage if it is narrow. A cold or allergy attack can easily block this channel if it is already narrow (these passages are millimeters wide). Blockage of these channels, partial or complete, by structural conditions, polyps, a deviated septum or generalized swelling from a cold or allergies are the various causes of rhinosinusitis.
How is sinus surgery done?
Functional endoscopic sinus surgery is done by inserting small telescopes connected to a monitor with a high-definition camera system to visualize the narrowed or blocked sinus openings. Micro-instruments are used to enlarge the natural sinus openings into the nose. The word functional is used in the procedure name because the procedure enlarges the natural sinus openings and does not create new openings. Sometimes, a three-dimensional CT guided system is used to visualize all the sinuses and surrounding structures on a computer screen for additional precision.
Is sinus surgery covered by insurance?
If the sinus condition does not improve with medical therapy and if a CT scan documents the degree of blockage, sinus surgery may be covered by insurance. A rhinoplasty, however, is almost never covered by insurance.
Does sinusitis recur? Can polyps come back?
Sometimes, if an allergy is severe, polyps or sinusitis may recur. This is why it is important to control the allergy with medication or allergy shots in order to prevent or delay the recurrence of these conditions. A condition called the Aspirin triad is when the patient is allergic to Aspirin and has asthma and polyps. With this Aspirin triad condition, the polyps tend to recur more rapidly.
Is sinus surgery safe and can sinus surgery be combined with a rhinoplasty?
Today, sinus surgery is much more accurate than it was in the past, especially with advanced technology to visualize the sinuses. Complications may occur such as bleeding, but they are rare. Other uncommon complications may include cerebrospinal fluid leakage (brain fluid) which may necessitate further surgery to correct. Eye injury is also a possibility in rare cases.
Dr. Rizk wrote one of the earliest articles on rhinoplasty and sinus surgery combined, concluding that it is generally a safe procedure. It was published in Annals of Plastic Surgery in April 1997.
Do you use nasal packing after septoplasty or sinus surgery?
No, Dr. Rizk uses various tissue sealants but does not use packing after nasal or sinus surgery. Packing creates more swelling and is very uncomfortable for the patient. Also, removing the packing can be a stressful event for patients after surgery.
Dr. Rizk uses the latest technology, the 3D live fusion sinus surgery system, which allows visualization in all 3 dimensions while performing sinus surgery for improved access to sinuses safely. This navigation system is one of the latest advances in image-guided FESS surgery or endoscopic sinus surgery. It provides surgical access with precision to narrow areas of the sinuses to open them or to remove polyps.
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Written by Dr. Sam Rizk
Last Modified On: 01/20/2020