John Austin, MD, FACS

Brownsville & Harlingen ENT Physician

Why do I Have a Runny Nose?

Does ClariFix Cryotherapy work for runny nose?

Many adults have problems with nasal congestion and a chronic runny nose. This can be a common problem with several different causes. A visit with a board certified Ear, Nose, & Throat physician should be your first trip for this common nasal problem.

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What is Chronic Rhinitis?

A thorough examination will include a history of your symptoms, and an examination of your complete ENT organ system. This will include a nasal endoscopic examination and possibly a CT scan of your nose and sinuses. They will ask about prior medications you may have tried including OTC and prescribed. They can include nasal steroids, antihistamines, decongestants, oral steroids, and allergy therapy.

Once your doctor has determined from your history and examination what the likely source of your problem is, they will assess you for several causes of a runny nose, medically termed rhinitis. The first common causes that should be evaluated for are sources like indoor allergens, outdoor allergens, tobacco exposure, and pollutant exposure.

How to treat Chronic Rhinitis

Most of the previously mentioned causes can be eliminated with alterations in exposure, and sometimes with topical nasal steroids like Flonase, Nasacort, or Rhinocort.   A topical antihistamine steroid combination (Dymista) is also sometimes effective.

Another effective treatment is a topical decongestant, combined with a saline nasal rinse, and followed with a nasal steroid (fluticasone). The plan is to get the nasal mucosa open with a decongestant, clean the nose with a saline rinse, and then use a nasal steroid to decrease the swelling and inflammation that can cause a runny nose.

What Causes Chronic Rhinitis?

Other causes of rhinorrhea that are usually temporary and resolve spontaneously are the rhinitis produced by viral infections. These are commonly associated with other symptoms including fever, malaise, sore throat, and possibly swollen lymph nodes. These common viral infections and are usually short-lived and are treated symptomatically. Bacterial infections of the nose and sinus have been addressed in my other blogs.

What is Vasomotor Rhinitis?

Some patients have a condition called vasomotor rhinitis, which is a physiologic process where the nerve endings in the nose overstimulate the glands that produce mucus in the nose, and thus too many secretions– We commonly call this a runny nose. This is often associated with other phenomenon that stimulates these involuntary nerves including, crying and eating. Patients with vasomotor rhinitis can often produce what seems like constant nasal secretions and may have to constantly blow or otherwise clear their nose.

Another treatment option

Atrovent (ipratropium) is a topical nasal spray that has been prescribed for many people and is very effective in alleviating the symptoms of runny nose, especially in the elderly and for those whose symptoms are worse after they eat. For most patients, Atrovent is quite effective, but it may require long term treatment.

ClariFix Cryotherapy for Chronic Rhinitis

There is a relatively new and effective office-based treatment known as cryotherapy which uses a cryosurgical tool (trade name of the device is ClariFix). This treatment is approved by the FDA as a safe and effective treatment for vasomotor rhinitis. It is intended to be a one-time therapy.

The treatment is done in our ENT physician office, where I apply a topical anesthetic to the nose and then inject lidocaine in the area to be treated. The treated area is the nasal branches of the vidian nerve. Using an endoscope to guide the location of the device the treatment takes just minutes to perform. There is very little discomfort associated with the treatment, and the onset is usually achieved within 10 days.

To find out if you are a candidate for the cryotherapy for chronic rhinitis please call (956) 350 8787. 

To learn more about ClariFix Cryotherapy, click here.

What to Expect at Your ENT Visit

Dr. Austin

As an ENT physician, I often see patients with many different problems that affect the head and neck. Often times the primary complaint is pain, which can vary from a dull constant ache to sharp repetitive pain. Often the pain has been present for a long time. It may increase with certain positions, eating, swallowing, chewing, temperature or barometric pressure changes.  It may be accompanied be signs of infection like a temperature or swelling of the face. It may be recent in onset or may have been present for a longer period of time. So you decide to see an ENT – Now what?

At the initial evaluation for facial pain, I always start by taking the patient’s history. A rule of thumb in my practice is to listen to the patient tell their story uninterrupted for several minutes to try and learn what is bothering them the most. When a patient comes in to see me, it’s helpful if they’ve already thought about what bothers them the most. It’s a good idea to write your symptoms down ahead of time.

Questions to prepare for:

  • What is the primary reason for your visit?
  • Where is the pain located?
  • How long has it been present?
  • Is it constant, sharp or dull?
  • Does anything make it worse or better?
  • Does a weather change make it worse?
  • Have you tried any medications to see if they help?

Medications
Knowing what medicines you have tried and what did not help is very important in identifying the underlying problem. Be sure to let us know if you’re taking:

  • OTC pain meds like Tylenol, ibuprofen (Advil) or Aleve
  • Nasal medicines: antihistamines (Zyrtec, Allegra, Claritin, Benadryl)
  • Decongestants (Sudafed), mucolytic (guaifenesin)
  • Nasal sprays, like steroids, decongestants (afrin)
  • Topical antihistamines
  • Nasal rinses like a saline product or a netti pot. Antacids like Pepcid, Nexium, omeprazole, Protonix, or Dexilent.
  • Antibiotics – you’ll want to know the name and long you’ve taken it. Snap a pic of the bottle!

Allergies
If you suspect the pain may be allergic or seasonal think ahead what allergens have been present when your symptoms started. In Central Texas we have very predictable allergy seasons: Cedar, Oak, Ragweed, fall tree pollens, grasses and the constant molds. If you have been to an allergist try and remember the doctor’s name and when were you tested.  If you were tested for allergies what were the results of the test? Did you take allergy shots; were they recommended?

The Exam
With 25 years of clinical experience, I give every patient a thorough examination of their ear, nose, mouth and throat regions and will examine the muscles, structures and glands of the neck. Then I’ll examine your nervous system as it relates to the head and neck. Often times a thorough examination will require the use of a microscope for the ears, or a nasopharyngeal endoscope.

The head and face is a complex organ with many different types of tissue in a small space. Muscles, bone, cartilage, sinuses, nerves, teeth, tendons, blood vessels, and sensory end organs are just some of the tissues that make up the face and head. The head is supported by the neck, which also has its own group of tissues that can contribute to pain, but I’ll address that in a future blog.

Costs
Tests performed on the ear, nose and throat region are billed as separate procedures. Your insurance will often cover these procedures.

An ENT physician is a subspecialist, highly trained in examination and treatment of the complex regions of the head and neck, but occasionally further testing may be recommended; this might include routine x-rays or blood tests, or more extensive tests like a CT scans or MRI.

I will work to the best of my ability to identify and treat your ailment and get you back to enjoying life!

Nasal Polyps

nasal polyps

Image Credit

Nasal polyps are a common occurrence, particularly in adults. Nasal polyps are noncancerous and, depending on size, may come with no symptoms at all. Treatment of nasal polyps ranges from medications to surgery. 

Nasal Polyps:  An Overview

What are Nasal Polyps?

According to the Mayo Clinic, nasal polyps are “…soft, painless, noncancerous growths on the lining of your nasal passages or sinuses.” The U.S. National Library of Medicine states “[t]hey often grow where the sinuses open into the nasal cavity.” Anyone can get these benign growths, though they are most frequent in adults aged 20 or older. In a paper published by the National Center for Biotechnology Information, polyps in the nasal cavity affect “…up to four percent of the population.”

What are the Causes of Nasal Polyps?

In the same paper on this condition, it is stated that the cause of nasal polyps is currently unknown. Though there is much research on these growths, scientists still do not know why some people are affected while others are not. The Mayo Clinic suggests that there is “…some evidence that people who develop polyps have a different immune system response and different chemical markers in their mucous membranes than do those who don’t develop polyps.” According the U.S. National Library of Medicine, it seems that if you have problems with any of the following you may be more likely to form polyps:

  • Aspirin sensitivity
  • Asthma
  • Chronic sinus infections
  • Cystic fibrosis
  • Hay fever

Because the cause is at this point unknown, and may vary from case to case, it is important to seek specialized medical attention for the most effective treatment.

What are the Symptoms of Nasal Polyps?

Just as the cause of nasal polyps varies from case to case, so do the symptoms. If you have small polyps, you may exhibit no symptoms at all. Large polyps are often associated with:

  • Runny nose
  • Congested nose
  • Postnasal drip
  • Decrease in sense of smell
  • Loss of sense of taste
  • Snoring
  • Facial pressure – particularly over your forehead
  • Frequent headaches
  • Upper teeth pain
  • Itching in the area surrounding your eyes
  • Constant feeling that you have a cold

What are the Treatment Options?

The goal in treatment is to reduce the size of, or completely eliminate, the polyps. Even with treatment there is a chance that polyps will form in the nasal cavity once again. Treatment begins when you schedule an appointment with a medical professional. An ENT will begin with a nasal examination and may order a CT scan of your sinuses. Some polyps are treatable with medications, while others may require an endoscopic surgery. Though medications may alleviate symptoms associated with polyps, they very rarely get rid of the polyps.

Medications commonly used to treat nasal polyps include:

  • Steroid nasal sprays
  • Corticosteroid pills
  • Allergy medications
  • Antibiotics – these are used to treat a sinus infection associated with polyps, not the actual nasal polyps

If you have fairly large or troublesome polyps, your doctor may decide that an endoscopic surgery is your best option. This type of surgery involves the use of an endoscope, a thin, lighted tube with instruments attached at the end, to remove the polyps. It is possible that even with surgery the polyps will return.

Dr. John Austin – The Trusted Provider

Dr. John Austin has been providing superior service to the Austin area since 1995. Dr. Austin is board certified in Otolaryngology and was the first Austin ENT to be certified by the American Board of Facial Plastic and Reconstructive Surgery. Dr. Austin has extensive experience, impressive credentials and practices in three offices throughout the Austin area. To schedule an appointment today, contact one of our three office locations.

 

Turbinate Reduction Surgery

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Turbinate reduction surgery is a procedure that aims to reduce the size of nasal turbinates (or nasal concha) to increase airflow through the nasal passages. This surgery is minimally invasive and does not require a lengthy recovery time. Dr. John Austin is highly skilled at providing patients with relief from nasal obstruction due to enlarged turbinates. 

What are Turbinates?

The United States National Library of Medicine and National Health Institute states: “The inside walls of the nose have 3 pairs of long thin bones covered with thin tissue. These bones are called nasal turbinates.” John’s Hopkins Medicine describes the job of nasal turbinates as “to clean and humidify the air as it moves through your nose into your lungs.”

Turbinate hypertrophy is a condition in which the nasal turbinates become enlarged. When turbinate hypertrophy occurs, the result can be nasal obstruction. Nasal obstruction is a problem as it:

  • Leads to congested and labored breathing
  • Increases trouble breathing during sleep
  • Can induce chronic nosebleeds
  • Can cause chronic sinus infections

Turbinate Reduction Surgery

The goal of turbinate reduction surgery is to “correct the problem of nasal obstruction by reducing the turbinate size and thereby decreasing airway resistance while preserving the natural function of the turbinates,” according to Johns Hopkins Medicine. Turbinate reduction surgery aims to improve airflow through the nasal passages. The surgery may also help reduce both nasal drainage and post-nasal drip.

Some patients who require turbinate reduction surgery might undergo a surgical septoplasty at the time of the turbinate reduction surgery. A surgical septoplasty “is performed to straighten a deviated, or crooked, nasal septum.” A deviated septum is an incredibly common occurrence, indeed it is rare for a doctors to see septums that are truly straight. Surgical septoplasty may be performed simultaneously with turbinate surgery in order to further improve airflow and reduce nasal discharge and post-nasal drip.

The methods for surgical turbinate surgery vary from case to case. However, most frequently the procedure is done using a nasal endoscope. A nasal endoscope is a thin tube that is inserted into the nose and provides the doctor with a magnified view of the area during surgery. Turbinate reduction may be done under both local or general anesthesia.

Johns Hopkins Medicine describes the surgical procedure, saying: “Your surgeon makes an incision in the lining mucosa of the turbinate and carefully removes the underlying bone of the turbinate. Your doctor may elect to use a micrdebrider to thin the tissue around the turbinate. Alternatively, they may be cauterized with radio frequency or electrical current (cautery or radiofrequency surgery).”

Benefits to Turbinate Reduction Surgery

The first major benefit to turbinate reduction surgery is the improved airflow and relief from nasal obstruction. Also, the surgery may reduce the amount of nasal drainage and post-nasal drip. Turbinate reduction surgery is completed entirely via the nostrils, so there is no facial scarring to worry about. Most patients are able to return home the same day they have the surgery.

The Provider You Can Trust

Dr. John Austin has been serving the Austin area as an ENT expert since 1995. In 1997, Dr Austin became the first ENT physician in the Austin area to become certified by the American Board of Facial Plastic Surgery and Reconstructive Surgery. Dr. Austin is also a board certified Otolayrngologist.

Dr. Austin and his staff provide the care and convenience you desire. With three office locations in the Austin area, there is sure to be one located near you. Dr. Austin provides turbinate reduction surgery in addition to a vast list of other ENT conditions. Stop suffering and start your journey to wellness and a healthier, happier life by contacting Dr. John Austin today.

Deviated Septum

deviated septum

What is a Deviated Septum?

The nasal septum is the thin walled structure between your nasal passages. It is highly common to have a nasal septum that is not perfectly centered, leaving one nostril larger than the other. The American Academy of Otolaryngology states that nearly 80% of septums are not centered. A displaced nasal septum is referred to as a deviated septum. Often, a crooked septum is not a cause for concern. However, there are instances where the nasal septum is so displaced that it causes difficulty breathing or contributes to a tendency for crusting or bleeding along the nasal passages as the drying effect of breathing occurs. Causes of deviated septums include a birth defect or a nasal injury.

What are Symptoms of a Deviated Septum?

Most cases of a displaced septum result in no symptoms at all. In cases of severe septum deformities, the following symptoms may be present:

  • Nostril obstruction
  • Facial pain
  • Nosebleeds
  • Tendency to sleep on a particular side
  • Loud breathing while asleep

If any of the following symptoms are present, it is important to visit an ENT:

  • Frequent nosebleeds
  • Obstructed nostrils
  • Chronic or recurring sinus infections

How is a Deviated Septum Treated?

There are several ways to manage symptoms caused by an off-center septum. Some of the treatments intended to manage symptoms include:

  • Decongestants
  • Antihistamines
  • Nasal Spray

In order to actually correct a deviated septum, surgery is required. The two surgeries used to treat crooked septums are:

  • Septoplasty – During a septoplasty, the surgeon will straighten and correctly position the septum. In order to do this, your surgeon may need to remove pieces and replace them.
  • Rhinoplasty – A rhinoplasty is surgery that reshapes and modifies the shape of the nasal bones and cartilage.

If you are experiencing symptoms such as frequent nosebleeds or chronic sinusitis, a deviated septum could be to blame. Contact Dr. John Austin today to schedule an appointment for the correction of your deviated septum.

Nasal Airway Obstruction

nasal airway obstructionImage credit

Nasal airway obstruction impacts daily activities such as breathing, eating and sleeping. Dr. John Austin is experienced in treating patients with nasal airway obstruction. 

 

The Nasal Cavity

Your nasal cavity is an air-filled space in the interior of your nose. The nasal cavity is lined with a mucous membrane  and is separated, ideally in the center, by a wall of cartilage and thin bone, known as the septum. The septum is what creates your right and left nostrils. Additionally, there are six curved bones covered by expansile tissue in the nasal cavity that are called turbinates, or nasal concha. These paired turbinates function to cleanse, condition and heat (or cool) the air you breathe. Once the air has passed through your nostrils, it travels via the respiratory tract to your lungs.

Causes of Nasal Airway Obstruction

There are several common causes for nasal airway obstruction. The most frequently experienced causes include:

  • Enlarged Turbinates – Known as turbinate hypertrophy, enlargement of the turbinates can be a cause of nasal airway obstruction. Turbinate hypertrophy is an incredibly commonplace condition, though it is not a large cause for concern in many. The enlarged turbinates can make breathing through one, or both, nostrils nearly impossible.
  • Deviated Septum – The American Academy of Otolaryngology estimates that as many as 80% of Americans experience an off-center septum. While this is not a problem in many instances, it can increase the likelihood of chronic sinusitis and be a contributing factor to nasal airway obstruction. A septum being crooked makes breathing with one of the nostrils significantly more difficult.
  • Nasal Polyps – Polyps are benign growths that appear on the lining of the nasal cavity. These growths can congest the nasal cavity, making it harder to breath.
  • Enlarged Adenoids – The adenoid tissue, located in the back of the nose, generally shrinks late in the teen years. If the adenoid tissue does not get smaller, it can contribute to chronic sinus infections and airway obstruction. Enlarged adenoids are not just problematic in terms of airway obstruction; they may also indicate the presence of a tumor.

In addition to these causes of nasal airway obstruction, the condition can also occur as a result of a foreign object, swollen nasal lining due to allergies and certain medications, such as nasal decongestant sprays.

Treatments

Ultimately, the treatment for your nasal airway obstruction is determined by the cause of the problem. Often, the condition can be treated with the use of nasal corticosteroids or topical antihistamines. Other causes of nasal airway obstruction require surgery to treat. Potential surgeries used to correct obstruction of the nasal cavity include:

  • Septoplasty – When the cause of the obstruction is a deviated septum, surgery to correct the deviation is a treatment. During this surgery, the crooked cartilage and bone of the septum are straightened.
  • Surgery of the Turbinates – These surgeries are commonly known as turbinate reduction surgery or turbinate resection. Often these procedures occur at the same time of a septoplasty. Some methods, such as radiofrequency reduction, shrink turbinates without removing tissue or bone. In some instances, it may be necessary to remove a portion of the turbinate.

Dr. Austin has served the Austin area since 1995. His experience and care make him the leading choice for your Austin ENT doctor. Contact his office today to learn more about your nasal airway obstruction and how it can be treated.

Brownsville ENT

(956) 350-8787
4770 North Expy.
Suite 304
Brownsville, TX 78526

Harlingen ENT

(956) 428-4221
510 Victoria Ln.
Suite 5
Harlingen, TX 78550

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