NOSE & SINUS

Medical and Surgical
Treatment of Nasal Drainage

Chronic rhinitis is a nasal condition that refers to a persistent runny nose or post-nasal drip, and affects more than 24 million people in the United States! Until just a few years ago, we had no minimally invasive means of treating patients who did not respond to medical or allergic therapy. Thanks to some very effective new treatments, that is no longer the case. The posterior nasal nerve, a small nerve in the back of the nose found to be responsible for most cases of ‘runny nose’, is now treated in a quick, noninvasive fashion. This 15 minute office procedure has been done in thousands of patients across the country with great success. The physicians at the Nose and Sinus Institute of Boca Raton were proud to be Principal Investigators in some of the early research on posterior nasal nerve ablation.

Frequently Asked Questions

Drainage from the nose has almost as many causes as the ways that people describe it. The terms runny nose, excess mucous, and postnasal drainage all refer to disorders that cause patients to be bothered by excess nasal drainage. There are three general conditions that contribute to most of these issues: Allergic rhinitis, Nonallergic rhinitis, and Vasomotor rhinitis.

Allergic rhinitis, as its name implies, is caused by underlying allergies. Symptoms may include nasal drainage, postnasal drainage, and congestion. If left untreated, Allergic rhinitis can also lead to chronic sinusitis; blockage of the sinuses contributes to facial pressure, facial pain, headaches, and infection.

Nonallergic rhinitis, in many ways, mimics Allergic rhinitis, except that the allergy cells normally seen in the mucous of patients with Allergic rhinitis are absent. Irritants, such as those from occupational exposure, strong fumes, smoke, perfumes, etc., can cause a nonallergic reaction that manifests as nasal drainage.

Vasomotor rhinitis is a disorder resulting from an over-active nerve in the nose, specifically the posterior nasal nerve. This increased activity is often associated with eating, leading patients to complain of excess nasal drainage during and after meals.

As always, medical options are best determined after evaluating the patient for the underlying etiology. In inflammatory conditions, including Allergic and Nonallergic rhinitis, cortisone nasal sprays such as fluticasone, may be of benefit. In patients with strictly allergic rhinitis, antihistamines may also be useful. Antihistamines may either be taken as a pill (eg., Claritin™ or Allegra™) or as a nasal spray (azelastine). In the case of Vasomotor rhinitis, a different spray, ipratropium bromide, works to inhibit the overactive posterior nasal nerve. Patients are recommended to undergo allergy testing to try to differentiate the forms of rhinitis.

In patients not responding to conservative medical management, office procedures may be performed. These procedures are minimally or non-invasive and require no downtime. They typically involve placing some numbing medicine on cotton and inserting it into the nostrils. A special probe is then used to deliver energy to the region causing the congestion and/or drainage. The procedure takes minutes to perform but can result in a lifetime of relief.

Specific office procedures used to treat nasal drainage include the following:

Clarifix

Rhinaer

Your provider at the Nose and Sinus Institute of Boca Raton will evaluate you with a history and physical examination, as well as allergy testing and a CT (computed tomography) scan of the sinuses, if needed. The procedures to treat drainage and congestion are recommended in patients in whom medical management does not satisfactorily bring their symptoms under control.

The specific treatment for nasal drainage can be done as a separate procedure or in conjunction with procedures done for breathing or sinus issues. After your evaluation, your provider will review all of the findings and the treatment options.

Understanding the complexities of both the inside and the outside of the nose are imperative to providing long lasting relief of sinonasal symptoms. Dr. Nathan E. Nachlas and Dr. Melyssa Hancock have extensive training in both the functional and structural sinonasal issues and offer an individualized approach to maximize results for every patient.
Other nose and sinus procedures that may be performed at the same time as a surgical procedure to address nasal drainage include:

In addition, addressing any cosmetic concerns you have about your nose with a Rhinoplasty surgery can also be done during the same operative session. The Nose and Sinus Institute of Boca Raton pioneered the Total Nose Approach™ to sinonasal surgery where all of your functional sinonasal complaints and cosmetic concerns can be addressed during one surgery, with one anesthetic, and one recovery.

There is no downtime following the procedure for nasal drainage. There is no cutting involved in the procedure, so there is no wound that needs to heal. Patients resume all activities the next day.

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