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Page 1 Treating Chronic Nasal Congestion & Runny Nose Nasal Congestion & A Runny Nose: You don't have to live with it anymore! For people with chronic nasal congestion or runny noses, a new procedure called turbinate radioablation using radiofrequency (RF) can now change their lives. This procedure is directed to the walls of the nasal cavity and shrinks tissues in the nose. It will allow better breathing for those who have a deviated septum but are not candidates for the surgery to correct it. The RF treatment is minimally invasive, painless and is most effective in ending the cycle of nasal congestion indoor, outdoor, asleep or awake!Why do we have postnasal drip and runny nose?Runny nose and other symptoms along with it, also called rhinitis is a reaction that occurs in the nose and throat when airborne irritants (allergens) trigger the release of histamine. Histamine causes inflammation and fluid production in the fragile linings of nasal passages, sinuses, and even your eyelids. The build up and secretion of a thick mucous from the nasal passages as well as your sinuses create the postnasal drip. Are there different types of rhinitis?Yes. Generally we divide them into two categories: Allergic and non-allergic rhinitis. There are two types of allergic rhinitis: one is seasonal which occurs particularly during pollen seasons and the other is perennial which occurs throughout the year.What causes allergic rhinitis?The most-common causes of allergic rhinitis are: pollen, dust mites, mold and animal dander.What are the symptoms of allergic rhinitis? Usually a person with allergic rhinitis may have one or several of these symptoms: sneezing, congestion, runny nose, itchy nose, throat, eyes, and ears, nosebleeds and clear discharge from the nose. Persons with perennial allergic rhinitis may also have these additional symptoms: snoring, recurrent ear infections, breathing through the mouth or tired and fatigued during the day. Basically to correct these problems you must find the source and avoid it!
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What causes nonallergic rhinitis?

Fumes, odors, temperature changes, atmospheric changes, smoke and other irritants could cause non-allergic rhinitis. You can have postnasal drip and nasal congestion due to many factors including use of medications and chronic sinus problems.

Nasal polyp, deviated septum with enlarged turbinate are amongst the most common reason for chronic nasal congestion. These types of problems are what could be addressed surgically with radioablation (such as Coblation) and traditional nasal surgeries.

What are the symptoms of non-allergic rhinitis?Usually a person with non-allergic rhinitis may have one or several of these symptoms: sneezing, nasal congestion, runny nose, itchy nose, throat, eyes, and ears. Treatment options are oral medications, nasal sprays, immunotherapy, allergy injections and surgery (for some conditions).
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Treating Chronic Nasal Congestion - RF Treatment

What surgical options are available?

There are many surgical options available depending to your particular problem. They include turbinectomy, septoplasty, Polypectomy, radioablation using Coblation or Somnoplasty.

What is nasal radioablation?

Radioablation is a term that Dr. Madani started using in 1997 while doing research on using heath to reduce the volume of tissues. The study was performed on variety of systems including CoblationTM, SomnoplastyTM/SM and EllmanTM. Using these devices we were able to remove and /or reduce the volume of the tissues in the soft tissue, nasal turbinates and the tonsils enabling rapid and precise tissue removal or shrinkage with minimal damage to the surrounding tissue. This was associated with a number of surgical and clinical advantages, including easier treatment, less invasive procedures, reduced surgical time, and less post-operative pain.

What should I expect prior to the procedure?Prior to the procedure, you would have an opportunity to review and discuss your medical and social history with the doctors. A unique computer presentation will facilitate your understanding of not only chronic nasal congestion but also possibly the underlying upper airway obstruction. You will then be examined and advised of the degree of your problem. The options and alternatives will be discussed. If you are a candidate for radioablation procedures, the procedure could be performed on the day of your consultation.What should I expect during the procedure? Your visit on the day of your procedure is easier than a simple visit to your dentist. In fact, you will be sitting in a dental chair while local anesthesia is administered. The entire procedure takes less than ½ hour. You will be fully awake but completely numb in the nasal area. A specialized computer controlled probe designed to deliver certain amount of heath is placed into the tissues of the nose. These tissues are called inferior nasal turbinate, which basically are the tissues in the side, bottom of your nose. The heath of the probe causes changes in the size and thickness of the turbinates and opens up your nasal passages. It can also reduce the postnasal drip and snoring. The healing process may take up to 3 months. Most patients find this procedure easier than having their teeth cleaned. Once again no surgeon can guarantee a perfect results because your body has to respond appropriately to these treatments. But you can rest assure that we will do our best to take care of you and in this particular field we have the greatest knowledge and expertise needed for treating individuals who suffer from snoring and sleep apnea and chronic nasal congestions.What should I expect after the procedure? Nasal congestion can be expected to be worse immediately after the procedure due to swelling of the tissues. Improvement is usually seen after two to four weeks and continues to progress for up to several months. A second procedure may be needed six to eight months following the initial treatment for further resolution of the problem. No narcotic pain medication or antibiotic is needed (except in medically compromised patients) following the treatment. For alleviation of post-operative discomfort, over-the-counter pain medication is sufficient.
Page 4 Treating Chronic Nasal Congestion History & Side Effects of RadioablationHow long has CoblationTM treatments been performed for chronic nasal congestion? Dr. Mansoor Madani introduced the application of the CoblationTM for the treatment of chronic nasal congestion and snoring in July 1999. However, electrosurgical equipment and techniques have been used in medicine for about 100 years. First, practitioners thought that passing currents through the body (Diathermy) has certain healing properties. Seventy years ago, RF energy was first used as a cauterizing device in general surgery.More recently, RF energy has been used to treat supra-ventricular arrhythmia in non-invasion cardiology and for rhizotomy procedures in neurology to reduce muscle contraction. RF energy has been used successfully for treatment of prostate tumors. While highly useful and effective, some of these instruments generate extreme heat that can produce collateral damage to surrounding tissue. Lasers were introduced in mid 20th century. They offered a number of benefits over electrosurgery and have gained widespread use for treatment of many illnesses and medical conditions including snoring and mild sleep apnea. However, the most recent radiofrequency treatment including Somnoplasty TM/SM and CoblationTM are promising, minimally invasive techniques with the least amount of pain and at the same time with excellent results. Although further studies are required for both systems, in nasal turbinate surgery, radiofrequency energy is our number one choice of treatment.What are the side effects of the radioablation?Swelling and increased nasal drainage are the main side effect after turbinate radioablation which usually lasts up to 3-4 weeks. Most of our patients report no pain following either palatal or turbinate radioablation procedure. If any pain is endured, over-the-counter pain relievers such as Ibuprofen or Tylenol are recommended. Does this procedure affect the voice in any way?There has not been any report of voice change with our patients. Are the taste buds affected in anyway?No. The taste buds are not affected in any way.Are these procedures/ devices approved by the FDA (United States Food & Drug Administration)?Yes. In July of 1997, the FDA approved a new outpatient treatment for habitual snoring; using radiofrequency (SomnoplastyTM/SM). Later it was also approved for turbinates, tonsils and the tongue. FDA also approved Coblation procedures in 1999. Where can I go to have the nasal radioablation procedure? Experience is the key factor when searching for a qualified surgeon. As one of the pioneers and specialists of laser surgery, Dr. Madani, who has performed thousands of laser procedures, now offers a combination of laser and radiofrequency treatment at his center. He has dedicated all his time and researches in developing new techniques to find a solution for snoring, sleep apnea and nasal congestion. To learn more about this procedure, or to find out if you are a candidate for radiofrequency or laser surgery, contact Dr. Madani's state-of-the-art office at 1-800-206-2000.
Page 3 Treating Chronic Nasal Congestion Nasal SpraysNasal sprays are for temporary relief of the symptomsI am taking nasal decongestants & antihistamines all the time. Is it safe and how do they work?Long-term use of nasal decongestants and antihistamines may actually worsen your congestion. Antihistamines help to decrease the release of histamine, possibly decreasing the symptoms of itching, sneezing, or runny nose. Some examples of antihistamines are diphenhydramine (Benadryl) or hydroxyzine (Atarax). These medications may cause drowsiness. There are some antihistamines that would not make you drowsy such as cetirizine (Zyrtec) or loratidine (Claritin). Decongestants help by making the blood vessels in the nose smaller, thus, decreasing congestion. In general it is recommended that if you do wish to take an over the counter nasal decongestant try to limit the usage to less than a week. If your symptoms continue, you must be checked by your doctor. How about steroid nasal sprays? Steroid nasal sprays help to temporarily decrease the swelling in the nose. Steroid nasal sprays work best when used before the symptoms start, but can also be used during a flare-up. Can I use decongestant medication for rest of my life?You must understand that all medication will do is reduce the symptoms, they do not cure obstruction of the nose if is due to a deviated septum or enlarged turbinates nor they correct presence of polyps in your sinuses or your nasal passage. All medication could have side effects and in some cases could be harmful. This does not apply that all surgeries are successful either! Long-term use of nasal sprays could be harmful to your body.Make your appointment online now for consultation & evaluation.
Treating Chronic Nasal Congestion Nasal SpraysNasal sprays are for temporary relief of the symptomsI am taking nasal decongestants & antihistamines all the time. Is it safe and how do they work?Long-term use of nasal decongestants and antihistamines may actually worsen your congestion. Antihistamines help to decrease the release of histamine, possibly decreasing the symptoms of itching, sneezing, or runny nose. Some examples of antihistamines are diphenhydramine (Benadryl) or hydroxyzine (Atarax). These medications may cause drowsiness. There are some antihistamines that would not make you drowsy such as cetirizine (Zyrtec) or loratidine (Claritin). Decongestants help by making the blood vessels in the nose smaller, thus, decreasing congestion. In general it is recommended that if you do wish to take an over the counter nasal decongestant try to limit the usage to less than a week. If your symptoms continue, you must be checked by your doctor. How about steroid nasal sprays? Steroid nasal sprays help to temporarily decrease the swelling in the nose. Steroid nasal sprays work best when used before the symptoms start, but can also be used during a flare-up. Can I use decongestant medication for rest of my life?You must understand that all medication will do is reduce the symptoms, they do not cure obstruction of the nose if is due to a deviated septum or enlarged turbinates nor they correct presence of polyps in your sinuses or your nasal passage. All medication could have side effects and in some cases could be harmful. This does not apply that all surgeries are successful either! Long-term use of nasal sprays could be harmful to your body.
Page 5 Treating Chronic Nasal Congestion ResultsEnjoy nature with fewer worries of allergies!Would I have more bleeding with CoblationTM? No! The CoblationTM method can simultaneously achieve coagulation of smaller blood vessels as well as reducing the tissue volume. Bleeding is generally not expected with this procedure. The same technology, when operated in sub-ablation mode, is also capable of producing hemostasis in larger vessels as well as tissue contraction. In contrast with laser, which causes significant thermal damage, CoblationTM is based on a none-thermal mechanism of action that produces volumetric tissue removal through molecular dissociation and is thus associated with a low potential for thermal damage. Coblation is promising and minimally invasive, it requires multiple treatments and takes between four to eight weeks to work. Our long-term assessment of CoblationTM treatment is even more promising. The duration of the procedure is substantially shorter (less than 15 seconds), the results are more immediate and patients may be treated in a single visit.How does CoblationTM work? Bipolar technology uses low-level radiofrequency (RF) energy to create precisely controlled temperatures (less than 85 oC) in soft tissue, causing collagen fibers to realign without causing tissue necrosis. The bipolar modality of the technology also precisely controls the depth of energy penetration by drawing current back to the tool before it has penetrated too deeply, further protecting collateral soft tissue from thermal damage. How can turbinate radioablation help?Continuous use of medications can be avoided by a new procedure called Thermal Ablation. Patients report 40-60% improvement in the symptoms of obstruction, congestion and watery nasal drainage resulting from either allergic or vasomotor rhinitis following radiofrequency treatment. The RF is used to reduce the troublesome turbinates by creating a layer of scar tissue just beneath the surface. This layer of scar acts like a corset to prevent the turbinate from swelling and producing such excessive mucus. The procedure is done as an outpatient under local anesthesia and takes only a few minutes. The treatment of nasal airway obstruction can result in dramatic and extremely satisfying improvement. Once treatment is completed, most patients will be able to breathe more freely, reduce dependence on over-the-counter and prescription medications and experience a new freedom from chronic nasal problems. As nasal swelling is reduced, headaches caused from sinus congestion are significantly reduced and nasal breathing, particularly at night, is dramatically improved. Please note that the results vary significantly between patients and results are not guaranteed.
Why We SnoreWe all snore occasionally, but in most cases it is a problem that self-corrects and does not bother anyone. In some, it is compounded by a deadly condition of impeded breathing. Basically, you stop breathinganywhere from a few seconds up to 20, 30, or even 100 times or more per minute This stoppage of breathing plus snoring along with a few other symptoms are known as obstructive sleep apnea.I snore and stop breathing, could I die from it? In fact, you can have very serious complications if you suffer from sleep apnea. With sleep apnea, you are more prone to have: * Heart attack (myocardial infarction) or MI * Stroke * Hypertension * Emotional issues & mood problems (getting agitated & upset easily, having shorter attention span, depression, having anxiety) * Sexual problems * Car accidents * Lose time from your work and unable to perform well at work * Increased chance of stopped breathing altogether (higher morbidity & mortality), so a patient with sever obstructive sleep apnea and other risk factors such as obesity, high cholesterol level, hypertension, etc has much higher chance of dying young and/or while they sleep! It has been estimated that over 3800 people die every single year from complications of sleep apnea in the United States only. How about my life, my job? Quality of life issues range from sleeping in separate bedrooms, body fatigue, irritability, nervousness, arguments and even divorce has been brought up by many couples. * Personal financial impacts range from an increased cost of medical care, prescription & over the counter drug expenses. * Institutional impacts at work could range from: * Job related Illness and injuries to self as well as coworkers *Increased Healthcare expenses to self as well as employee *Causing injuries to others (buss & truck drivers) *Inability to focus & concentrate at work *Inability to perform complex tasks *Afternoon job performance issues *Reduced problem solving ability *Tired & sleepy at work *Reduce productivity Why is it that more men snore than women? We have examined over 20,000 patients for snoring and sleep apnea and have operated on several thousand patients. We estimate that ration of Men versus women are 9:1. We believe that a major reason is the mens body size, and their anatomy. We cant disregard genetics, hormones and other factors either. HomeSnoring 2009ServicesTonsilsOnline FormsMeet UsPhoto GalleryDr MadaniSurgical InstructionsOral SurgeryCE CourseContact UsPost Op Oral SurgeryJaw SurgeryDental ImplantsDr PazokiDr SouriFacial TraumaDISCLAIMERVideosReferring Doctors