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Nose Procedures
Overview
A blocked or runny nose, facial pressure and a poor sense of smell are among the most common reasons people see an ENT specialist. In Delhi NCR, seasonal pollen, dust and winter air pollution can make nasal allergies and sinus problems flare up, and what feels like a lingering cold can go on for weeks.
Most nose and sinus problems are treated with medicines, correctly used nasal sprays, saline rinses and allergy control. When symptoms persist despite good medical treatment, or when there is a structural cause such as a deviated septum or nasal polyps, endoscopic surgery performed through the nostrils can open blocked passages without cuts on the face.
Dr. Savyasachi Saxena uses nasal endoscopy to look inside the nose during the consultation, explains what your CT scan shows, and recommends surgery only when it is likely to make a meaningful difference. Children with enlarged adenoids that cause mouth-breathing, snoring or ear problems are assessed and treated too.
Your specialist
Dr. Savyasachi Saxena, MBBS, MS (ENT)
ENT & Head-Neck Surgeon · HOD, Fortis Hospital, Noida
What we treat
Conditions treated
Chronic sinusitis
Inflammation of the sinuses lasting 12 weeks or more, causing blockage, thick discharge, facial pressure and a reduced sense of smell.
Acute and recurrent sinusitis
Sinus infections that usually follow a cold. Most settle with medical treatment; frequent episodes call for a closer look at the underlying cause.
Nasal polyps
Soft, non-cancerous swellings of the sinus lining that block the nose and dull the sense of smell. They often respond to steroid treatment; larger or persistent polyps may need endoscopic removal.
Deviated nasal septum
A bent partition between the nostrils that can block one or both sides, contribute to snoring and make sinus drainage harder.
Allergic rhinitis and enlarged turbinates
Sneezing, itching and a runny or blocked nose triggered by dust mites, pollen or pollution. Swollen turbinates that don't shrink with medicines can be reduced surgically.
Enlarged adenoids in children
Adenoid tissue at the back of the nose can cause mouth-breathing, snoring, a nasal voice and repeated ear problems.
Fungal sinusitis
Ranges from a fungal ball in one sinus to allergic fungal sinusitis. Invasive fungal infection in people with uncontrolled diabetes or low immunity is an emergency.
Nasal and sinus tumours
Growths inside the nose, such as inverted papilloma or angiofibroma, need careful evaluation, imaging and often endoscopic removal.
Signs & symptoms
Symptoms to watch for
Any of these, especially if they last or keep coming back, are worth discussing with an ENT specialist.
- A blocked nose on one or both sides for more than a few weeks
- Thick nasal discharge, or mucus dripping down the back of the throat
- Pain or pressure around the cheeks, eyes or forehead
- A reduced or lost sense of smell
- Frequent sneezing, itching and watery discharge
- Snoring or breathing through the mouth
- Repeated nosebleeds
- Blood-stained discharge or symptoms on one side only
Diagnosis
How it's diagnosed
Tests are chosen for your symptoms — not everyone needs all of them.
- 1
Diagnostic nasal endoscopy
After a numbing spray, a thin telescope shows the septum, turbinates, sinus openings, polyps and the back of the nose on a screen. It takes a few minutes during the consultation.
- 2
CT scan of the paranasal sinuses
Shows the extent of sinus disease and the anatomy in detail, and is essential before planning sinus surgery.
- 3
Allergy evaluation
Blood tests or skin prick tests, when needed, to identify triggers for allergic rhinitis.
- 4
Biopsy
A small tissue sample is taken if a growth looks unusual or is present on one side only.
- 5
Airway and sleep assessment
For snoring or suspected sleep apnoea, the nose is assessed together with the throat, and a sleep study may be advised.
Treatment
Treatment options
Treatment is tailored to the cause and severity of your problem. Where they are appropriate, non-surgical options are considered first.
- Non-surgical
Medical management
Steroid nasal sprays used with the right technique, saline irrigation, antihistamines, and antibiotics only when a bacterial infection is likely. Reducing exposure to allergens and pollution is part of the plan.
- Surgical
Functional Endoscopic Sinus Surgery (FESS)
Performed through the nostrils with an endoscope to clear blockages and open the natural drainage pathways of the sinuses while preserving healthy lining. It is considered when chronic sinusitis or polyps don't improve with adequate medical treatment.
- Surgical
Endoscopic septoplasty
Straightens a deviated septum through the nostril, with no external incision, to improve airflow and access to the sinuses.
- Surgical
Turbinate reduction
Shrinks enlarged turbinates using chemical, LASER, microdebrider or endoscopic techniques while preserving their role in warming and humidifying the air you breathe.
- Surgical
Adenoidectomy
Removal of enlarged adenoids in children, endoscopically or with coblation, to relieve blockage, snoring and related ear problems.
- Surgical
Endoscopic removal of polyps and tumours
Benign growths and selected tumours are removed through the nose under endoscopic vision. Some cases need an open approach such as a Caldwell-Luc operation or maxillectomy.
All procedures offered
- Diagnostic Videoendoscopy & Nasopharyngoscopy
- Turbinate Surgery (Chemical, LASER, Microdebrider, Endoscopic)
- FESS — Functional Endoscopic Sinus Surgery
- Endoscopic Tumour Removal
- Endoscopic Septoplasty
- Caldwell-Luc Surgery & Maxillectomy
- Ethmoidectomy
- Endoscopic Adenoidectomy
- Coblation Adenoidectomy
After treatment
Recovery & aftercare
- 1
Endoscopic nose surgery is usually done under general anaesthesia, often with a short hospital stay.
- 2
Expect a blocked nose, some blood-stained discharge and crusting for the first one to two weeks. If nasal packs are used, they are removed when your surgeon advises.
- 3
Saline rinses help clear crusts and speed healing. Follow-up visits for endoscopic cleaning are an important part of getting a good result.
- 4
Avoid blowing your nose hard, heavy lifting and strenuous exercise in the early days. Many people return to desk work in about a week, but your surgeon will guide you.
- 5
Chronic sinusitis and polyps can come back, so keep using any sprays prescribed after surgery.
Safety
Possible risks
- Bleeding, either soon after surgery or, less often, days later
- Crusting, infection or scar bands (adhesions) inside the nose
- A temporary change in the sense of smell
- Recurrence of polyps or sinus disease
- Rare but serious: injury to the eye socket or the thin bone at the base of the skull, which surgeons take specific precautions to avoid
Every procedure carries some risk. Dr. Saxena explains the risks that apply to you, and the alternatives, before you decide on any treatment.
Getting help
When to see an ENT specialist
Book a consultation if
- A blocked or runny nose lasting more than 10 days, or sinus symptoms that keep returning
- Loss of smell that doesn't recover after a cold
- Nasal allergies that aren't controlled with basic medicines
- Your child breathes through the mouth, snores regularly or has repeated ear infections
- Nosebleeds that happen again and again
Get urgent care if
- Swelling or redness around the eye, double vision or reduced vision with sinusitis
- Severe headache, high fever, confusion or a stiff neck
- Black crusts in the nose, facial numbness or skin discolouration, especially with diabetes or low immunity
- A nosebleed that doesn't stop after 20 minutes of firm pressure
In an emergency, call 112 or go to the nearest hospital emergency department.
FAQs
Frequently asked questions
Does sinus surgery leave a scar on the face?
Endoscopic sinus surgery and septoplasty are performed through the nostrils, so there is no external scar. Only a few specific tumours or complications need an external approach, and this would be discussed with you in advance.
Will my nasal polyps come back after surgery?
Polyps can recur, particularly in people with asthma or allergies. Surgery opens the sinuses so that sprays and rinses reach the lining better, and continuing the prescribed treatment afterwards lowers the chance of recurrence. Regular follow-up helps catch regrowth early.
Is it safe to use a steroid nasal spray for a long time?
Steroid nasal sprays act mainly on the nasal lining and are generally considered safe for long-term use at recommended doses. Decongestant sprays are different: using them for more than a few days can cause rebound blockage. Use any spray only as your doctor advises.
Does a deviated septum always need surgery?
No. Many people have a slightly bent septum without any symptoms. Septoplasty is considered when the deviation clearly causes blockage, affects sinus drainage or interferes with other treatment, and medicines haven't helped.
Does air pollution make sinus problems worse?
Polluted air irritates the lining of the nose and can worsen allergic rhinitis and sinus symptoms, especially during winter smog in Delhi NCR. Saline rinses, a well-fitted mask on high-pollution days and treating allergies can help. Symptoms that persist deserve an ENT check-up.
At what age can adenoids be removed?
Adenoidectomy can be done in young children when enlarged adenoids cause significant breathing problems, disturbed sleep or repeated ear trouble. The decision depends on symptoms rather than age alone, and adenoids naturally shrink as children grow.
Further reading
This page gives general information for patients and is not a substitute for a medical consultation. Diagnosis and treatment depend on an individual examination.