Deviated Septum

The diagnosis of a deviated septum is made by examination of the entire inside of the nose. Since the septum extends about 3 inches back, the entire nose must be examined. Curvatures of any portion of the septum may lead to symptoms. The nose is examined after decongesting the nose with a decongestant spray. Your doctor will spray the nose with oxymetazoline (Afrin) or neosyneprine spray. After a few minutes to allow the lining of the nose to shrink, the nose is re-examined. A nasal endoscopy exam may be needed to visualize the back part of the septum.

Turbinate Enlargement (Hypertrophy)

The diagnosis of turbinate enlargement is made by examination of the entire inside of the nose. Since there are 3 turbinates on each side (lower, middle and upper) and they extend about 3 inches back, the entire nose must be examined. Enlargement of any of the turbinates may lead to symptoms. The nose is examined after decongesting the nose with a decongestant spray. Your doctor will spray the nose with oxymetazoline (Afrin) or neosyneprine spray. After a few minutes to allow the lining of the nose to shrink, the nose is re-examined. A nasal endoscopy exam may be needed to visualize the back end of the lower turbinate as well as the middle and upper turbinates. In some people, a sinus CT (Cat Scan) will be needed to determine the cause of the enlargement.

Nasal Valve Collapse or Stenosis

The nasal valves are examined before and after spraying the nose with a decongestant spray such as oxymetazoline (Afrin). The nose is first checked to see if there is significant collapse of the nostrils when breathing in. One nostril is plugged and the exam is repeated. The examination is again repeated after pulling outward on the cheek, up on the tip of the nose, or after insertion of a Qtip into the nose and pushing outward. These examinations can determine whether collapse of the valve is contributing to nasal obstruction.

Nasal Polyps

The diagnosis of nasal polyps is made by examination of the entire inside of the nose. Since polyps may arise in the sinuses or from the structures in the nose, polyps may not be visible without a nasal endoscopy exam. The nose is examined after decongesting the nose with a decongestant spray. Your doctor will spray the nose with oxymetazoline (Afrin) or neosyneprine spray to shrink the lining of the nose and a lidocaine spray to numb the surface of the nose. After a few minutes to allow these medications time to work, the nose is then re-examined. A nasal endoscopy exam is done in the office and will be needed to visualize the sinus drainage areas of the nose and the back parts of the nose. A thin (3 millimeter) endoscope is inserted into the nose to allow a magnified view of the nasal membranes. In some people, a sinus CT (CAT scan) will be needed to determine if there are polyps within the sinuses.

Nasal Deformities

External nasal deformities are diagnosed by simply looking at the nose and feeling the nasal bones and nasal cartilages. Internal nasal deformities are diagnosed by examination of the entire internal part of the nose. Since the septum extends about 3 inches back, the entire nose must be examined. The nose is examined after decongesting the nose with a decongestant spray. Your doctor will spray the nose with oxymetazoline (Afrin) or neosyneprine spray and after a few minutes, the nose will be re-examined. A nasal endoscopy exam may be needed to visualize the back part of the septum.

Nasal Fractures

Nasal fractures may diagnosed by simply looking at the nose and feeling the nasal bones and nasal cartilages. Usually, there will be bruising over or around the nose, and there may have been some bleeding at the time of injury. If the fracture can’t be seen or felt, an X-ray may be needed. Fractures of the septum are diagnosed by examination of the entire internal part of the nose. Since the septum extends about 3 inches back, the entire nose must be examined. The nose is examined after decongesting the nose with a decongestant spray. Your doctor will spray the nose with oxymetazoline (Afrin) or neosyneprine spray and after a few minutes, the nose will be re-examined. A nasal endoscopy exam may be needed to visualize the back part of the septum.

Nose bleeds (Epistaxis)

Nose bleeds are diagnosed by looking at the inside of the nose to determine the site of bleeding. It is important to identify the bleeding site so that it can be treated. If the bleeding site can’t be seen, then treatment of the bleeding is much less precise and less successful. Since bleeding can come from any part of the nose, the entire internal part of the nose must be examined. Your doctor will spray the nose with oxymetazoline (Afrin) or neosyneprine spray and after a few minutes, the nose will be re-examined. A nasal endoscopy exam may be needed to visualize the back part of the nose for the site of bleeding.