PATIENT INFO
Nose Leaflets

Adenoid Surgery
Adenoids are tiny glands located at the back of the nose in an area called the nasopharynx (refer to figure 1a). In younger children, these glands play a role in combating germs. However, after the age of approximately three years, it is believed that adenoids become unnecessary. The body can still effectively fight off germs even without adenoids, and there is no compelling evidence suggesting that their removal negatively impacts the immune system or increases the likelihood of infections. Adenoids likely contribute to infection resistance mainly during the initial three years of life, and if they start causing more harm than good after that period, removal might be considered.
Anosmia / Smell disorders
Anosmia is the medical term for the absence or loss of the sense of smell. Various medical terms describe different alterations in the sense of smell:

– Hyposmia refers to a diminished sense of smell.
– Parosmia is the experience of smells being different from what is anticipated.
– Phantosmia involves perceiving smells that do not actually exist.
– Congenital anosmia denotes the complete inability to smell from birth.

Healthcare professionals often collectively categorize these conditions as “smell disorders.”

Blocked Nose
The feeling of a blocked nose is commonly known as nasal obstruction, a stuffy nose, or nasal congestion. The degree of nasal obstruction can differ among individuals. While some may find even mild blockage bothersome, others with more severe nasal obstruction may not experience a significant impact on their daily activities. Your specialist will consider the severity of your nasal obstruction when creating a treatment plan tailored to your needs.
Catarrh
Catarrh is a common but challenging sensation to articulate, as its meaning varies from person to person. Some use the term to express a sensation of mucus at the back of the nose, while others associate it with a buildup of mucus in the throat. For some individuals, it simply signifies the persistent need to clear their throat. Although not distinctly defined in medical textbooks, the term originates from ancient Greek, meaning ‘to flow down.’ Those with catarrh often experience this feeling continuously, sometimes lasting for years. While most people may experience a bit of catarrh during a cold or flu, which typically clears up swiftly, individuals with chronic catarrh often describe it as akin to a perpetual cold without the accompanying symptoms.
Chronic rhinosinusitis in children
Chronic rhinosinusitis is a persistent condition necessitating ongoing treatment. Key effective treatments include saline rinses and nasal steroid sprays. There is no substantiated evidence supporting the use of antibiotics for children with chronic rhinosinusitis. In specific cases, some children may require adenoid removal through surgery to manage their symptoms. Additionally, older children with particular conditions might undergo endoscopic sinus surgery as part of their treatment plan.
Flexible Nasal Endoscopy
Flexible nasal endoscopy is a procedure employed to examine the interior of the nose, including the back of the nose, voice box, throat, and tongue. It utilizes a flexible telescope known as an endoscope. This commonly performed procedure can take place in outpatient clinics, hospital wards, or emergency departments. Individuals experiencing issues with the ear, nose, throat, or voice box may undergo flexible nasal endoscopy as part of their diagnostic process.
Hayfever
Hayfever is the colloquial term for cold-like symptoms triggered by inhaling plant pollens during specific times of the year. In individuals allergic to plant pollen, inhalation leads to inflammation of the lining inside the airways, affecting the nose (rhinitis), eyes (conjunctivitis), throat, ears, and potentially the lungs. The inflammation in the nasal lining is specifically termed rhinitis. Often referred to as Seasonal Allergic Rhinitis, hayfever occurs during periods when various plants release their pollen. Pollen, among other allergens, can induce allergic reactions.
How to do nasal irrigation (washes)
Begin with nasal irrigation before using any nasal drops, spray, or ointment. Preferably, utilize pre-prepared medications or sterile water to reduce the risk of infection. While standing in front of a basin, squirt the solution into each nostril, directing the stream toward the back of your head, not the top. It’s okay if the solution flows from one nostril to the other; this indicates effective nasal cleansing. Initial mild irritation is normal and should diminish over time as you continue these nasal washes.
How to use nasal drops
Start by washing your hands and gently blowing your nose. Gently shake the nasal drops, then twist the cap anti-clockwise to remove it. If using a nasule, twist off the top part to open it. Lie on your back with your head just off the bed, tilting it backward so that your chin points upward. Breathe normally through your mouth while administering the prescribed number of drops into each nostril. Remain in this position for two minutes after applying the drops. Once the drops are in both nostrils, clean the nozzle and securely replace the cap.
How to use nasal ointment
Start by washing your hands. Twist the cap anti-clockwise to remove it. Squeeze a pea-sized amount of ointment onto the tip of your little finger and apply it just inside each nostril at the front. Avoid inserting your finger more than 1cm into the nostril. Alternatively, gently insert the nozzle of the tube into the nostril and squeeze out a pea-sized amount of ointment. Gently press your nostrils together and massage to help evenly spread the ointment throughout your nose. If you’re applying it for someone else, a swab such as a cotton bud can be used.
How to use nasal sprays
Begin by washing your hands and gently blowing your nose. Gently shake the nasal spray, then twist the cap anti-clockwise to remove it. Keep your head upright and insert the nozzle tip into one nostril, ensuring the other nostril stays open. Hold the bottle with your index and middle finger at the top and your thumb at the bottom (refer to Figure 1a). Aim to direct the spray away from the septum, and you may find it more convenient to use your right hand for spraying your left nostril and vice versa (see Figure 1b). Inhale gently as you spray, avoiding strong sniffing to prevent the spray from traveling past the nose into the throat. After spraying both nostrils, clean the nozzle and securely replace the cap.
Juvenile nasopharyngeal angiofibroma (JNA)
Begin by washing your hands and gently blowing your nose. Gently shake the nasal spray, then twist the cap anti-clockwise to remove it. Keep your head upright and insert the nozzle tip into one nostril, ensuring the other nostril stays open. Hold the bottle with your index and middle finger at the top and your thumb at the bottom (refer to Figure 1a). Aim to direct the spray away from the septum, and you may find it more convenient to use your right hand for spraying your left nostril and vice versa (see Figure 1b). Inhale gently as you spray, avoiding strong sniffing to prevent the spray from traveling past the nose into the throat. After spraying both nostrils, clean the nozzle and securely replace the cap.
Nasal injuries
Begin by washing your hands and gently blowing your nose. Gently shake the nasal spray, then twist the cap anti-clockwise to remove it. Keep your head upright and insert the nozzle tip into one nostril, ensuring the other nostril stays open. Hold the bottle with your index and middle finger at the top and your thumb at the bottom (refer to Figure 1a). Aim to direct the spray away from the septum, and you may find it more convenient to use your right hand for spraying your left nostril and vice versa (see Figure 1b). Inhale gently as you spray, avoiding strong sniffing to prevent the spray from traveling past the nose into the throat. After spraying both nostrils, clean the nozzle and securely replace the cap.
Nasal polyps
Nasal polyps develop from the nasal lining and frequently stem from the ethmoid sinuses, which drain into the side wall of the nasal cavity. These polyps consist of inflammatory fluid and, although they can be linked to allergy and infection, the precise reason why some individuals develop them while others do not remains unknown. Nasal polyps are often associated with broader health conditions such as late-onset asthma in adults, aspirin intolerance, or cystic fibrosis.
Nosebleeds (Epistaxis)
Epistaxis is the medical term for bleeding from the nose, and it can happen to anyone. Nosebleeds are slightly more prevalent in men than in women. While they are more common in the elderly, they are also quite frequent in children, with over half of children aged between 6 and 15 years experiencing nosebleeds regularly. These incidents are likely to occur in the morning or late evening but can happen unexpectedly at any time.
Rhinitis and hayfever
Rhinitis is the medical term for inflammation in the lining of the nose, which contains cells responsible for producing mucus. This mucus serves to trap particles entering the nose. When the nasal lining is swollen, it produces an excess of mucus, leading to nasal blockage and difficulty in breathing.

Rhinitis can extend its impact to the sinuses, eyes, ears, and lungs. When it affects both the nose and sinuses, it is termed rhinosinusitis. If this condition persists for more than 12 weeks, it transforms into chronic rhinosinusitis (CRS). Additional information on chronic rhinosinusitis with or without nasal polyps can be found in the ENT UK e-leaflets. There is also an e-leaflet available specifically addressing chronic rhinosinusitis in children.

Rhinoplasty
Rhinoplasty is a surgical procedure designed to alter the shape of the nose, and the specific type of rhinoplasty chosen depends on the particular area of the nose requiring correction.

The procedure can involve straightening the nose, making it smaller or larger, and removing bumps. The shape of the nasal tip can also be modified, and changes to the nose’s overall shape may include the addition or removal of pieces of cartilage or bone.

In cases where the nasal septum, the wall separating the nose into right and left, is twisted, it may need correction simultaneously. This combined operation is known as septorhinoplasty, and more information on septal surgery can be found in the corresponding leaflet.

Rhino-Sinusitis and Dairy Allergy
If your child experiences rhino-sinusitis, a persistent runny nose, you may have considered the possibility of a milk or dairy allergy, a topic often discussed in the media and on certain websites. Some believe that milk leads to increased mucus, contributing to rhino-sinusitis, possibly due to the throat-coating sensation when drinking milk. However, this sensation is similar with other thick fluids and doesn’t necessarily mean more mucus is produced. It’s important to note that there is no established link between drinking milk and excess mucus. Milk allergy affects about 5% of infants, but when present, the symptoms are more pronounced than those in the nose, and it doesn’t solely cause nasal symptoms.
Septal surgery
The nasal septum is a slender partition comprised of cartilage and bone that separates the two nostrils. Occasionally, the nasal septum may become twisted or bent, narrowing the inside of the nose, typically on one side, and causing a feeling of nasal blockage. This deviation can result from a previous nose injury, or it may develop naturally. To address this issue, a corrective surgical procedure called septal surgery or septoplasty can be performed to straighten the nasal septum.
Septorhinoplasty
The shape of your nose is determined by the structure of the bone and cartilage inside, along with the thickness of the skin covering them. The hard upper part of the nose, resembling a roof, is formed by the nasal bones. The middle and tip of the nose consist of softer cartilage. The nasal septum, a thin piece of cartilage and bone between the nostrils, is typically straight. However, in some individuals, the nasal bones and septum may become bent or twisted, often resulting from an injury, which might have occurred during childhood. Such injuries can break the nasal bones and septum, causing them to shift. This can distort the upper, bony part of the nose, leading to a narrowed inside and a sensation of nasal blockage.
Sinus infection (Sinusitis)
The head contains four pairs of sinuses that play a role in regulating the temperature and humidity of the air reaching the lungs. Starting as small pouches in newborns, these sinuses extend from the inside of the nose to the bones of the face and skull. Over childhood and into young adulthood, they grow and expand, eventually transforming into air pockets or cavities lined with the same mucous membrane found in the nose. These sinuses are connected to the inside of the nose through smaller openings called ostia.
Sinus surgery for chronic rhinosinusitis with nasal polyps
The head contains four pairs of sinuses that play a role in regulating the temperature and humidity of the air reaching the lungs. Starting as small pouches in newborns, these sinuses extend from the inside of the nose to the bones of the face and skull. Over childhood and into young adulthood, they grow and expand, eventually transforming into air pockets or cavities lined with the same mucous membrane found in the nose. These sinuses are connected to the inside of the nose through smaller openings called ostia.
Sinus surgery for chronic rhinosinusitis without nasal polyps
Rhinosinusitis refers to the inflammation of the lining of the nose and sinuses. To be diagnosed with rhinosinusitis, one must experience nasal blockage, nasal discharge, or both, along with potential symptoms such as a poor sense of smell or facial pain. Children may also exhibit a cough. When these symptoms persist for more than 12 weeks, it is termed Chronic Rhinosinusitis (CRS). Short-term symptoms lasting a few weeks are typically caused by a viral infection, often the common cold.

There are two main types of CRS: with and without nasal polyps. Nasal polyps are small, round growths that develop inside the nose—refer to the ENT UK booklet “Sinus surgery for chronic rhinosinusitis with nasal polyps.”

In CRS without nasal polyps, the lining of the nose may be swollen, and the lining may be covered in discolored mucus.

Tumours of the nose
The term “tumour” originates from Latin and means swelling, but it’s important to note that not all swellings are cancerous. Benign tumours grow slowly and do not invade local structures, making them the most common type in the sinonasal cavity. Malignant tumours, commonly referred to as cancer, invade local tissues and have the potential to spread to distant parts of the body.

Sinonasal tumours are rare, constituting only 10% of all head and neck tumours, affecting approximately 10 individuals per million each year. These tumours can arise from various structures in the nose, including the lining, blood vessels, nerves, and even bone or cartilage.