Rhinology: Nasal and Sinus Care

Here at CHI, we are the only center in Nebraska to offer the full range of treatments for anterior and posterior sinus and nasal drip.

At this time there are 4 different types of procedures for sinus and nasal drip.  Each of these therapies are directed towards the posterior nasal nerves.  The posterior nasal nerves are small nerve endings at the back of each nostril that signal for your nose to run.  Each of these procedures have varying degrees of efficacy, and not all of these procedures are right for everyone.

Cryotherapy

Cryotherapy for the posterior nasal nerves has been offered for multiple decades.  Commercially available treatment options for this have been available for about 10 years.  With this therapy, the nerve fibers that tell your nose to run are atraumatically frozen using a freezing wand.  The procedure usually takes about 10 minutes per side, allowing time for numbing to take place when performed in the office.

Radiofrequency ablation of the posterior nasal nerves

Radiofrequency treatments for nasal congestion and removal of nasal lesions has been used for decades.  Over the past 10 years, this treatment has been applied to the posterior nasal nerves to similarly treat anterior and postnasal drainage.  The radiofrequency wand currently used can also be used to treat nasal congestion and improve nasal breathing.

Operative posterior nasal neurectomy

In individuals who are not a candidate for in office therapy, have had an adequate response to in office therapy, or simply do not want to undergo an in office procedure, there are surgical treatments.  Of these therapies for chronic nasal drip, the most common is operative posterior nasal neurectomy.  Like in office treatments, this treatment targets the posterior nasal nerves.  In this procedure, the nerve endings are divided in the operating room and a piece of artificial tissue placed to prevent regrowth.  This is usually a day procedure, performed at the ambulatory surgery center.  The procedure takes about 90 minutes to treat both sides, and is usually very well-tolerated.

Vidian neurectomy

The posterior nasal nerves originate from a larger structure called the vidian nerve.  In this procedure the larger nerve is divided, and the opening from which it exits is packed to prevent regrowth.  This procedure is reserved for individuals with severe, refractory anterior and/or nasal drainage.  This is also a day procedure usually performed in the amatory surgery center.

If you have a frequent runny nose, post-nasal drip or congestion extend beyond seasonal allergies, chronic rhinitis may be to blame. Millions suffer from this often undiagnosed condition, which is caused by abnormal nerve signals and inflamed soft tissues. 

Symptoms 

• Constant runny nose 
• Throat clearing, coughing, or itchy throat from persistent post-nasal drip 
• Feeling stuffed up frequently 
• Excessive sneezing 
• Nasal itching 

Treatment 

After numbing the nose, a small wand applies low-temperature radiofrequency energy to precisely target overactive nerves and shrink inflamed soft tissues. 88% of participants experienced significant reduction in symptoms.

When it’s difficult/nearly impossible to breathe through the nose, nasal airway obstruction (NAO) may be to blame. More than 20 million Americans have NAO, which is caused by an anatomical narrowing or blockage in the nasal airway. 

Symptoms 

• Difficulty breathing through nose 
• Blocked feeling in nose 
• Nasal congestion 
• Difficulty sleeping and fatigue 
• Struggling while exercising to breathe through nose 
• Frequent mouth breathing 

Treatment 

After numbing the nose, a small wand applies low-temperature radio-frequency energy to gently remodel the nasal passage to improve airflow. 97% of study participants experienced significant improvement.