Patient Resources


About Your Visit

Please arrive 15 minutes prior to your scheduled appointment to register for your visit.

What should you bring to your appointment at The Nasal & Sinus Center

Please prepare for this by bringing:

  • A picture I.D. and your health insurance card/information.
  • The co-pay required by your insurance carrier.
  • Please check with your insurance carrier to determine if a referral is required for a clinic visit with us.
  • If you have HMO insurance, you must have a referral for this visit.
  • If you have HMO insurance, you must also obtain a referral for nasal endoscopy (CPT code 31231/31237)
  • Your referring physician’s or primary care physician’s name and contact information.
  • A copy of your XRAYS / CT scans (not the reports - please bring the actual films)
  • Copies of records from doctors related to your sinuses/nose/allergies/lungs.
  • A list of all medications you are taking
  • Completed forms

You may also want to have:

  • A list of your questions /concerns
  • A friend or family member to take notes/help with questions

If you are 30 minutes late for your appointment, it will be rescheduled.
If you are unable to keep this appointment, please provide 24 hours notice.


Office Forms (Downloadable PDF's)

Forms Require Adobe Reader, if needed click here to download for free


Frequently Asked Allergy Questions

What can I do at home to improve my sinus and allergy problems?

  • Over-the-counter nasal saline sprays used several times during the day along with nasal saline irrigations are beneficial for nasal hygiene.
  • Nasal saline irrigations can be done anywhere from 3 times a week to twice daily for benefits in hydrating and clearing the nose of irritants and thick nasal secretions. You can purchase various preparations from the drugstore.
  • You should actively institute environmental controls for allergens.
  • Staying well hydrated with water has a multitude of benefits as does staying healthy and getting plenty of rest.
  • Try to avoid contact with sick people as additional illnesses aggravate nasal and sinus problems.
  • Please take the medications as recommended by your doctor.

What do you mean by environmental controls?

Environmental Controls are things in your home and measures you can take to decrease exposure to allergy irritants. You may want to:

  • Housecleaning to keep the allergy particle loads low
  • Minimizing upholstery, carpet, curtains, rugs, stuffed animals – things that trap allergens
  • Use hypoallergenic bedding
  • Wash bed linens every 2 weeks in hot water
  • Add air filtration systems to your home
  • Commercially clean ventilation systems and duct work in the home
  • Keep windows and doors closed during your allergy season
  • Keep animals out of bedroom
  • Stay indoors during your peak allergy season if you are sensitive to outdoor allergens (e.g., grass, trees, ragweed)
  • Wear a mask while doing housework or during gardening or yard work
  • Prevent mold from growing in your home. Mold grows anywhere there is moisture – drain pans, under sinks, around air conditioner condensers, plants, bird cages. Keep these areas clean if you have allergies to mold.

What kinds of air filters are available?

  • Electrostatic filter – It is simple to use and practical to install. Electrostatic filters fit in the same space as a regular fiberglass filter found in most air conditioning systems and thus are advantageous in that there are no special or extra parts needed. There are also standalone, portable electrostatic filter systems available for small rooms which have been popular in recent years. It works by simply removing particles and allergens from the air by electrostatic attraction. The filter itself is easily cleaned by wiping or running it under water. Regular cleaning is required to maintain filtration efficiency. It is a convenient system and the purchase of extra filters is not required. Overall, however, it is less efficient than the two other forms of air filtration listed here.

  • HEPA (high-efficiency particulate arresting) filter – This is the most efficient type of filter. It captures particles as small as 0.3 micrometers and filters out many of the airborne pollens and allergens. Frequent filter changes are necessary as trapped particles build up rapidly and can strain the mechanics of the system. HEPA filtration can be placed in the home’s air conditioning system, but careful planning is required for its installation. Portable filtration systems are convenient to use with potential coverage of large areas in the home and filter changes are easy.

  • Electronic precipitators – These filters work by the passage of air current over several electronically charges grids. As with all filtration systems, frequent cleaning is required for maximum efficiency. In the case of uncleaned filters, the air passing through the filter contains an increasing load of uncaptured particles which will cling to the home’s walls and upholstery with accumulation of noticeable deposits.

  • Whatever type you choose, any additional filtration system is a great advantage over fiberglass filters in most air conditioning systems.

Which over-the-counter medications should I pick?

  • Mucolytics (e.g., guaifenesin) – might help thin very thick, hard to clear secretions
  • Nasal saline – regular use helps with nasal hygiene, clearing nasal irritants, and relieving nasal dryness; contains no medication and can be used as often as you like
  • Nasal decongestants – provide temporary relief. These contain a medication that will shrink the blood vessels in the lining of your nose. The lining of your nose then becomes thinner and you are able to breath more easily through your nose for 4 – 12 hours between uses. Recommended usage is no longer than 3 days in a row.
  • Oral decongestants – a pill taken by mouth that works the same way as topical decongestants. Caution is recommended in people with high blood pressure.
  • Antihistamines - stops the chemical reactions in the body that lead to such symptoms as sneezing, and runny nose, and itchiness.
  • Oral allergy and sinus medications – provide temporary relief; usually consist of a combination of the decongestant and an antihistamine.
  • Nasal emollients (e.g., Pretz, Ponaris, Better Nose) can help with nasal dryness

Tell me about treatment for my allergies.

The most straightforward way to help you allergies is to practice AVOIDANCE and limit exposure to offending agents that stir up your allergy symptoms. Medications can further help control symptoms. You can begin with a trial of over-the-counter medications. Your doctor can also recommend prescription medications. Avoidance and medications provide reasonable relief for most people.

Oftentimes, people are unable to stay away from offending agents and must live and work around their allergens. This is when allergy testing and allergy shots may be useful.

What happens during allergy testing?

Skin testing is performed in our office. Alternatively or in addition to skin testing, blood tests are available to test for sensitivity to certain allergens. We can describe these tests in more detail when you visit with us.

What are allergy shots?

Allergy shots, or immunotherapy, consist of injections containing very dilute amounts of the allergens to which you have sensitivities. This “primes” your immune system and blocks the reactions that lead to allergy problems – nasal congestion, runny nose, sneezing, itchy, irritated eyes, etc.

Over several months, you will receive injections containing increasing amounts of allergens to which you are sensitive. During this time, your symptoms will likely worsen, and you will need to stay on allergy medications. Once you begin to feel relief from your symptoms, we make that concentration of allergen you received the maintenance dose injection.



Glossary of Terms

Rhinitis- Irritation and inflammation of the lining of the nasal cavities. A cold is a form of rhinitis, viral rhinitis. Allergies are another form of rhinitis. Rhinitis is associated with symptoms such as alternating nasal congestion, runny nose, and postnasal drip.

Allergens – Particles that effect the immune system in sensitive patients and lead to allergy symptoms, e.g., grass pollens, dust, cat dander.

Allergy symptoms – Itchy Symptoms such as, itchiness, watery eyes, runny nose, nasal congestion, and sneezing.

Allergic rhinitis- The development of inflammation of the lining of the nasal cavities due to sensitivity of the immune system to particular allergen(s).

Nonallergic rhinitis, vasomotor rhinitis – A reaction to particles or compounds without a change in your immune system. Common causes of Nonallergic rhinitis are: cigarette smoke, perfumes, cleaning chemicals.

Sinusitis, Rhinosinusitis – Inflammation of the lining of the sinus cavities. Often referred to as rhinosinusitis because inflammation of the sinus cavities rarely occurs without inflammation and swelling of the nasal cavities at the same time. You can suffer from sinusitis without having an infection.

Septum – An anatomic structure in the nose which divides the nose into left and right sides.

Septoplasty – A procedure that removed the misaligned portion of the septum to improve nasal airway breathing.

Functional endoscopic sinus surgery- The use of telescopes and instruments through the nose to reach and open the sinus cavities and remove diseased tissue.

Nasal and sinus polyps- Outgrowths of the natural lining of the nose and sinus cavities that occur as a result of chronic sinus problems and inflammation.

Rhinoplasty surgery- This surgery is performed to change the appearance of your nose. Oftentimes, such surgery is done to improve nasal breathing.

Paranasal sinuses – Air-filled cavities in the bones of your face that surround and drain into the nasal cavities. There are up to four sinuses per side of the head, with a possible total of eight sinuses. Some people have fewer than eight sinuses.

Nasal endoscopy - A telescope and camera are used to look into your nose to examination of the nasal structures and see the spaces where the sinuses drain into the nose.

  • Frontal sinuses are just over your eyebrows at the lower forehead
  • Maxillary sinuses are under your cheeks
  • Ethmoid sinuses are between your eyes
  • Sphenoid sinuses are located behind your eyes, in the middle of your head



Anatomy Lesson

YOUR NOSE

Your nose is a central feature of your face.

It is a dynamic organ and has multiple functions – smelling, breathing, humidification, filtration, temperature regulation, mucous production and lubrication.

The lining of the nose is called mucosa which normally swells and decongests in what’s called the normal nasal cycle. The mucosa will stay swollen when irritated. This swelling may occur when you have a cold, allergies, or sinus infection.

Nasal cavities

Your internal nose is divided into left and right sides by the septum.

The nasal passages or cavities make up your nasal airway.

Within the nasal cavities reside the turbinates, scroll-shaped bones found on the walls of the nasal passages. The sinuses drain into the nose under the middle and superior turbinates.

The upper part of the the throat, called the nasopharynx, is behind the nasal cavities.

Turbinates

These are mucosa lined bony structures that extend from the (lateral) wall of the nasal cavity. There is a set of inferior, middle, and superior turbinates in each nasal cavity.

Like the nose, the turbinates are lined with mucosa which will swell and decongest during the nasal cycle.

Sometimes, the turbinates remain swollen despite normal physiology and the trial of medications. If this is the case for you, we may suggest trimming them to improve nasal breathing.

The Nasal Skeleton

The nasal skeleton forms your nasal cavity. There are three parts:

  • Upper third – nasal bones
  • Middle third – upper lateral cartilages
  • Lower third – lower lateral cartilages which form your nostrils

The nasal skeleton also consists of the septum which is composed of cartilage in the front and bone more deeply in the nose. The septum spans all three parts of the nasal skeleton in the midline. It is the structure that divides your nose into left and right nasal cavities on the inside.

Nasal breathing can be disturbed when any part of the nasal skeleton is out of alignment or protruding into your nasal cavity, such as with a deviated septum or with a broken nose.

Surgery can be done to reconstruct the nasal skeleton and improve nasal breathing.

However, if you have nasal mucosal problems, such as allergies or sinusitis, you will likely need to continue to take medications as surgery won’t change these conditions.

YOUR SINUSES

Sinuses are hollow spaces lined with mucosa, and these are filled with air when healthy. As an adult, we generally have 4 pairs of sinuses, one set for each side of the nose and face. The size, shape, and development vary from person to person.

Frontal – The frontal sinuses are in your forehead just above your nose.

Maxillary – These are located under your eyes beneath your cheeks.

Ethmoid – The ethmoid sinuses occupy space between your eyes and are made of many cells like a honeycomb.

Sphenoid – These are located behind your eyes in the middle of your head.

Sinusitis refers to inflammation and oftentimes infection of the sinus cavities. Associated signs and symptoms include, discolored nasal drainage, nasal congestion, nasal obstruction, facial pain or pressure, and decreased sense of smell.

Medicines often help relieve sinusitis. Chronic sinusitis is sinusitis that lasts for longer than 3 month. In some patients, surgery in addition to medications may help improve your condition. Speak to an Otolaryngology (ear, nose and throat doctor) who specializes in rhinology.

What’s next to my sinuses?

  • Nasal cavity
  • Eyes
  • Brain
  • Roof of mouth
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