Chronic sinusitis or recurrent acute sinusitis is treated initially pharmacologically. However, when medical treatment fails, is ineffective or there are anatomical factors that predispose to chronic inflammation, surgical treatment is warranted.
Today, the preferred nasal and paranasal surgical approach is endoscopic and is called functional endoscopic sinus surgery (FESS). These procedures are performed under visual observation resorting to high definition optic transmission inside the nose, obviating the need for external excisions, and hence, no scars. There are many types of nasal packing available. However we choose a biodegradable material (a sponge that will naturally disintegrate into a gel) making the post-operative period comfortable for the patient. In the presence of septal deviations or hypertrophic rhinitis, these situations should be treated during the same procedure (see septoplasty and turbinectomy).
Rhinitis occurs when there is inflammation/hypertrophy (increase in size) of the inferior turbinates (structures present in the nose responsible for the filtration, humidification and warming of the inspired air). There are several causes for rhinitis, of which the most common is allergic rhinitis. Just like in sinusitis, rhinitis can be treated medically (with antihistamines, nasal corticosteroids, nasal douching with saline water, etc…). When treatment is insufficient, a surgery called turbinectomy is an alternative. Many surgical procedures have been developed at treating the inferior turbinates. However we prefer turbinectomy by radiofrequency ablation, a simple and painless procedure, which can be performed under local anesthesia or general anesthesia in an outpatient basis (in both adults and children).
The above paragraphs aim to demonstrate the possibility of functional nasal surgery, which can and should be performed together when considering an aesthetic surgery like a rhinoplasty.