Medication is often the first treatment we try before surgery. Your physician may recommend:

• Sinus rinses: Rinsing your nasal and sinus passages can thin mucous and relieve stuffiness.
• Nasal sprays and oral pills: Steroids and antihistamines taken orally or as a nasal spray can help reduce inflammation and allergic reactions.
• Targeted therapy: Targeted therapies reduce the chemicals in your body that cause inflammation. For example, the monoclonal antibody drug Duplixent® is a targeted therapy for chronic sinusitis with polyps, used when other treatments are not effective.

For people with allergies, we also partner with local practices to offer allergy shots and sublingual (under the tongue) allergy treatment, where available.

We provide nasal cauterization to stop nosebleeds. Cauterization closes blood vessels using a chemical solution or electrical current.

At UVM Health, you also have access to the latest minimally invasive procedures to treat nasal blockages and chronic rhinitis. These in-office treatments deliver low-temperature radiofrequency energy or extreme cold to the nasal tissues. They can help open nasal passageways, relieve congestion and stop a constantly runny nose. These include:

• Rhineair®, which uses radiofrequency energy to calm overactive nerves
• ViVaer®, which uses low temperature radiofrequency energy to open nasal blockages and shrink inflamed tissue

Nasal surgery options we offer to improve breathing include:

• Rhinoplasty: Strengthens the structure of your nose to help you breathe
• Septoplasty: Straightens a deviated septum
• Turbinate reduction: Reduces the size of the turbinate structures inside your nose so you can breathe better

When sinus surgery is part of your treatment plan, its role is often to enhance the effectiveness of nasal sprays and rinses. Surgery also allows for better drainage.

We perform endoscopic sinus surgery by inserting a thin camera (endoscope) through your nostril. You receive general anesthesia to help you sleep through the procedure. With the guidance of this camera, we insert tools through the nostril to remove polyps and open sinuses. For the best results, our surgeons may combine state-of-the-art technologies with endoscopic sinus surgery, including:

• CT navigation: CT imaging in the operating room helps guide precise placement of the endoscope.
• Balloon sinuplasty: We inflate a tiny balloon inside your sinuses to open them.
• Steroid-eluting stents: We insert steroid-coated wire coils inside your sinuses to keep them open and deliver a continuous dose of anti-inflammatory medicine.

Our nasal and sinus specialists collaborate with neurosurgeons to perform through-the-nose (transnasal) surgery to reach the base of the brain. These complex procedures require extensive skill and experience.

We work closely with oculoplastic surgeons (ophthalmologists trained in plastic surgery) to treat eye conditions with through-the-nose endoscopic surgery. Specific procedures include:

• Orbital decompression to relieve excess pressure inside the eye that occurs with thyroid eye disease (Graves’ disease)
• Tear duct surgery (dacrocystorhinostomy) to open a blocked tear duct