Medical treatment of the nose & sinuses
General Rhinology

Rhinology is a medical sub-speciality of otolaryngology concerned with treating disorders related to the nose, sinuses and skull base regions. This area of medicine is the focal point of an otolaryngologist, an ENT doctor.

Numerous medical concerns can be addressed through rhinology. They may include sinusitis, nasal polyps, sinus and nose (rhinoplasty) surgery, allergies, certain cancers, problems with smelling and issues with the various small pipework behind the face, including the tear ducts and eustachian tubes (that help with equalising pressure in the ears).

Florian Bast is a leading expert in diagnosing and treating these disorders across some of London’s most prestigious hospitals.

Eustachian Tube Dysfunction

Eustachian tubes are small tubes that run between the middle ears and the post nasal space. They are responsible for equalising ear pressure along with draining and protecting the middle ear. The eustachian tubes are usually closed except when chewing, swallowing, or yawning.

These passageways are tiny in size and can become plugged for various reasons. Blocked eustachian tubes can cause pain, hearing difficulties, a feeling of fullness in the ears, dizziness, popping sounds and tinnitus. Such a phenomenon is referred to as Eustachian Tube Dysfunction (ETD).

ETD is a relatively common condition. Depending on the cause, it may resolve independently or through simple at-home treatment measures. Severe, recurring and chronic cases may require a visit to the doctor.

The length of time that ETD symptoms last depends on the initial cause. Symptoms from altitude changes, for example, may resolve once you return to the altitude with which you are acclimatised. In contrast, illness and other causes of ETD may result in longer-lasting symptoms.

The most common causes of ETD are allergies, chronic rhinosinusitis and the common cold. These conditions may cause your Eustachian tubes to be inflamed or clogged with mucous.

Activities such as travelling at high altitude, flying on a plane, scuba diving, and simply taking an elevator or riding the underground train, all of which involve a change in altitude, may elicit symptoms of ETD.

Endoscopic balloon dilation for ETD is the first technique that truly treats the cause of the symptoms experienced, and recent studies have demonstrated superior symptom improvement compared with medical treatment (0% complication rate).


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Sinus Concerns


Balloon sinus dilation is a minimally invasive technique for selected patients with chronic rhinosinusitis and barosinusitis.

The aims of balloon sinus dilation are:
• To provide relief from uncomfortable and painful sinusitis symptoms
• To unblock sinuses without invasive surgery

The treatment may be performed under general anaesthetic, or local anaesthetic +/- sedation.
Tiny balloons are carefully directed into the blocked sinus openings.
Once the correct position is confirmed, the balloon is inflated to high pressures to stretch the narrow channels. The whole procedure takes only a few minutes. When performed under local anaesthesia patients should only feel slight discomfort when the balloon is inflated.

What is barosinusitis?

Barotrauma of the paranasal sinuses is a risk factor for anyone exposed to ambient pressure changes. These pressure changes most often result from travel through mountainous regions, flying, or diving. Barosinusitis is characterised by inflammation of one or more of the paranasal sinuses. Inflammation is caused by a pressure gradient, almost always negative, between the sinus cavity and the surrounding ambient environment.


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