Rhinology and Skull Base
Medical and surgical care for nasal breathing, sinus disease, septal problems, and the adjacent skull base.
Overview
The nose warms, humidifies, and filters the air we breathe and plays a central role in smell, while the sinuses connect closely to the orbit, teeth, and skull base. When structure or chronic inflammation interferes with these functions, our surgeons combine in-office evaluation, imaging, and medical or surgical treatment.
The Rhinology and Skull Base division at Norelle Health in New York City focuses on disorders of the nose, sinuses, nasal airway, and smell, along with conditions at the boundaries between the sinuses, orbit, dental structures, and skull base. Patients often come in after months or years of congestion, postnasal drip, recurrent infections, facial pressure, reduced smell, nasal obstruction, failed medical therapy, or prior sinus procedures. The first goal is to determine whether symptoms are inflammatory, anatomic, allergic, dental, reflux-related, or a combination. Sinus disease is not diagnosed by symptoms alone. Chronic sinusitis is confirmed with a careful history and objective evidence such as nasal endoscopy or CT imaging. Dental infections, implants, and maxillary tooth disease can contribute to odontogenic sinusitis, allergies can drive inflammation without requiring surgery, and structural problems such as nasal valve collapse, deviated septum, and turbinate hypertrophy can make a patient feel blocked even when the sinuses are clear. For conditions at the skull base, such as cerebrospinal fluid leaks, skull base tumors, and pituitary adenomas, our surgeons use endoscopic endonasal techniques and collaborate with neurosurgery when clinically appropriate. Care is tailored so that medical therapy, minimally invasive procedures, and more comprehensive endoscopic surgery are each used when they fit the problem.
Areas of Focus
- Care for chronic sinusitis, rhinitis, nasal polyps, and fungal sinus infection
- Correction of deviated septum and septal perforation
- Endoscopic sinus surgery, including revision sinus surgery
- Endoscopic skull base surgery for CSF leaks, tumors, and pituitary adenomas, with neurosurgery collaboration when appropriate
Need guidance?
Our patient coordination team is available to answer questions and schedule your evaluation with the right specialist.
Contact UsSinus and Inflammatory Disease
Sinus disease, polyps, inflammation, and the medical and surgical care that addresses them.
1 of 22 · Chronic Sinusitis
Chronic Sinusitis
Chronic rhinosinusitis is ongoing nose and sinus inflammation, confirmed by symptoms plus objective findings, and treated with individualized care.
ConditionAcute Sinusitis
Acute sinusitis is short-term nasal and sinus inflammation that usually follows a cold, and most episodes improve without surgery.
ConditionRecurrent Acute Sinusitis
Recurrent acute sinusitis is several distinct sinus infections within a year that fully clear in between, which prompts a search for an underlying, treatable cause.
ConditionNasal Polyps
Nasal polyps are soft, noncancerous growths from inflamed nasal and sinus lining that can block airflow, reduce the sense of smell, and worsen chronic sinus symptoms.
ConditionFungal Sinusitis
Fungal sinusitis covers several conditions in which fungus contributes to sinus disease, ranging from mild, noninvasive forms to rare invasive infections that require urgent treatment.
ConditionAllergic Fungal Rhinosinusitis
Allergic fungal rhinosinusitis is a chronic inflammatory sinus disease with nasal polyps and thick allergic mucin, distinct from invasive fungal infection.
ConditionOdontogenic Sinusitis
Odontogenic sinusitis is maxillary sinus inflammation driven by a dental source, such as infection, an implant, a root canal, or an extraction site. It often causes one-sided symptoms and needs coordinated ENT and dental care.
ConditionFrontal Sinus Disease
The frontal sinuses drain through a narrow, complex pathway, so frontal disease can be persistent and sometimes needs specialized surgical care.
ConditionSphenoid Sinus Disease
The sphenoid sinus sits deep in the head near critical nerves and vessels, so disease there can cause atypical symptoms and deserves careful evaluation.
ConditionSinus Mucocele
A sinus mucocele is an expanding, mucus-filled pocket in a blocked sinus that can press on the eye or skull base and usually needs drainage.
ConditionUnilateral Sinus Disease
One-sided sinus symptoms deserve focused evaluation because the causes range from dental and fungal disease to benign tumors and, occasionally, cancer.
ConditionAspirin Exacerbated Respiratory Disease
Aspirin-exacerbated respiratory disease (AERD) combines asthma, recurrent nasal polyps with chronic sinusitis, and respiratory reactions to aspirin and other NSAIDs, often causing severe, hard-to-control sinus inflammation.
ConditionBiologic Therapy for Nasal Polyps
Biologic medications target the inflammation behind nasal polyps and are an option for selected patients alongside topical therapy and surgery.
ProcedureEndoscopic Sinus Surgery
Endoscopic sinus surgery is a minimally invasive procedure performed through the nostrils to open blocked sinus drainage pathways and remove obstructing inflammatory tissue or polyps. It is considered when symptoms, endoscopy, imaging, and medical therapy support it.
ProcedureBalloon Sinuplasty
Balloon sinuplasty is a minimally invasive procedure that uses a small balloon to gently widen blocked sinus drainage openings, often performed in the office for selected patients with recurrent or chronic sinusitis.
ProcedureRevision Sinus Surgery
Revision sinus surgery is a repeat endoscopic procedure for patients whose sinus symptoms persist or return after earlier surgery, addressing scarring, retained partitions, polyps, or untreated disease.
ProcedureImage-Guided Sinus Surgery
Image-guided sinus surgery uses a navigation system linked to your CT scan to track instruments in real time, helping the surgeon work safely in complex, revision, or skull-base-adjacent sinus anatomy.
ProcedureAdvanced Frontal Sinus Surgery
Advanced frontal sinus surgery opens the narrow frontal sinus drainage pathway for severe, recurrent, or revision frontal sinus disease when standard endoscopic surgery and medical therapy have not been enough.
ProcedureSteroid Implant for Nasal Polyps
A steroid-eluting sinus implant is a small, dissolvable device placed in the sinus or nasal cavity that releases anti-inflammatory medication over time to treat nasal polyps and support healing after sinus surgery.
ProcedurePostoperative Sinus Debridement
Postoperative sinus debridement is an in-office cleaning after sinus surgery that removes crusts, clots, and debris so the sinuses heal well and stay open during recovery.
ProcedureSinus Surgery Recovery
Sinus surgery recovery covers what to expect after endoscopic sinus surgery, including saline rinses, in-office cleaning visits, activity limits, and how breathing and drainage improve over the following weeks.
ProcedureRisks and Complications of Sinus Surgery
A balanced guide to the common and uncommon risks of endoscopic sinus surgery, how risk is reduced, and which symptoms after surgery need urgent evaluation.
Nasal Breathing, Rhinitis, and Smell
Nasal airflow, drainage, sensation, and the nerve-driven causes of congestion and postnasal symptoms.
Chronic Rhinitis
Chronic rhinitis is long-lasting inflammation or irritation of the nasal lining that causes ongoing congestion, runny nose, sneezing, and postnasal drip from allergic or non-allergic triggers.
ConditionLoss of Smell
Loss of smell, or olfactory dysfunction, is a reduced or absent sense of smell that can follow viral infection, nasal and sinus inflammation, head injury, or aging, and often warrants evaluation to find a treatable cause.
ConditionEpistaxis and Nosebleeds
Epistaxis, or nosebleeds, ranges from minor bleeding at the front of the nose to less common, heavier bleeding from the back; most are easily managed, but recurrent or severe bleeding deserves evaluation.
ConditionEmpty Nose Syndrome
Empty nose syndrome is a paradoxical sense of nasal blockage and dryness despite an open nasal airway, often after turbinate surgery.
ConditionSinus Headache Versus Migraine
Many headaches labeled as sinus headaches are actually migraine, so careful evaluation helps avoid unnecessary antibiotics or surgery.
ProcedureNasal Valve Repair
Nasal valve repair strengthens or widens the narrow sidewall region of the nasal airway to improve breathing when the valve collapses during inhalation or stays narrowed at rest.
ProcedurePosterior Nasal Nerve Ablation
Posterior nasal nerve ablation is a minimally invasive, often office-based treatment that reduces overactive nerve signals driving chronic runny nose and congestion in selected patients with chronic rhinitis.
ProcedureVidian Neurectomy
Vidian neurectomy is an endoscopic procedure that interrupts the vidian nerve to reduce severe, persistent runny nose and congestion from chronic rhinitis that has not responded to medical therapy.
Skull Base, Pituitary, and CSF Leak
Endoscopic care at the boundary of the nose, sinuses, and brain, with neurosurgery collaboration when appropriate.
CSF Leak
A CSF leak occurs when cerebrospinal fluid escapes through a defect in the skull base, often causing clear, watery nasal drainage and raising the risk of meningitis if it is not addressed.
ConditionPituitary Adenoma
A pituitary adenoma is a usually benign growth of the pituitary gland at the skull base that may alter hormone levels or press on nearby vision pathways.
ConditionSkull Base Tumors
Skull base tumors are growths, often benign, that develop at the bottom of the skull where the brain meets the nose, sinuses, and major nerves and vessels.
ConditionSkull Base Fracture
A skull base fracture is a break in the bones at the bottom of the skull, usually after significant head trauma, that can injure nearby nerves and the barrier between the nose and brain.
ConditionSkull Base Osteomyelitis
Skull base osteomyelitis is a serious infection of the bone at the base of the skull that requires hospital-based, multidisciplinary care.
ConditionMeningocele and Encephalocele
A meningocele or encephalocele is a herniation of the lining of the brain, or brain tissue, through a skull-base defect, often linked to a CSF leak.
ConditionCraniopharyngioma
A craniopharyngioma is a benign but locally challenging tumor near the pituitary gland that can affect vision and hormones and needs multidisciplinary care.
ConditionChordoma and Chondrosarcoma
Chordoma and chondrosarcoma are rare bone tumors of the skull base that often need combined surgery and radiation and long-term surveillance.
ConditionSkull Base Meningioma
A skull base meningioma is a usually benign tumor of the brain's covering whose symptoms and treatment depend heavily on its location.
ProcedureEndoscopic Skull Base Surgery
Endoscopic skull base surgery reaches tumors and lesions at the base of the skull through the nose and sinuses, a minimally invasive approach performed together with neurosurgery when appropriate.
ProcedureEndoscopic Pituitary Surgery
Endoscopic pituitary surgery removes a pituitary tumor through the nose and sphenoid sinus, a minimally invasive skull-base approach performed together with neurosurgery.
ProcedureEndoscopic CSF Leak Repair
Endoscopic CSF leak repair seals a defect in the skull base where cerebrospinal fluid drains into the nose, using endoscopic techniques through the nostrils to restore the barrier between the nose and the brain.
ProcedureSkull Base Fracture Repair
Skull base fracture repair addresses fractures at the base of the skull that cause a cerebrospinal fluid leak or other complications, often using endoscopic techniques through the nose and coordinated with neurosurgery.
ProcedureSkull Base Reconstruction
Skull base reconstruction rebuilds the barrier between the nose and the brain after skull-base surgery or a CSF leak, using grafts and flaps to seal the defect and reduce the risk of leak and infection.
Tumors, Orbit, and Lacrimal
Sinonasal tumors and conditions near the eye and tear-drainage system, managed with coordinated specialty care.
1 of 8 · Inverted Papilloma and Sinonasal Tumors
Inverted Papilloma and Sinonasal Tumors
Inverted papilloma and other sinonasal tumors are growths in the nose and sinuses that are often benign but can behave aggressively or, less commonly, become cancerous, so they require specialist evaluation and usually surgery.
ConditionNasal and Sinus Cancer
Nasal and sinus cancer is a rare malignancy of the nasal cavity or paranasal sinuses that often causes persistent one-sided nasal blockage, bleeding, or facial pressure and needs prompt specialist evaluation.
ConditionJuvenile Nasopharyngeal Angiofibroma
Juvenile nasopharyngeal angiofibroma is a rare, highly vascular benign tumor in adolescent males that causes nasal blockage and severe nosebleeds.
ConditionOlfactory Neuroblastoma (Esthesioneuroblastoma)
Olfactory neuroblastoma is a rare cancer that arises from smell-related tissue high in the nose and is treated with coordinated surgery, radiation, and surveillance.
ConditionSinonasal Melanoma
Sinonasal melanoma is a rare mucosal cancer of the nose and sinuses that differs from skin melanoma and needs specialized surgery and oncology care.
ProcedureOrbital Decompression
Orbital decompression makes more room for the eye by removing bone or fat around the eye socket, most often for thyroid eye disease that causes bulging, pressure, or vision concerns.
ProcedureDacryocystorhinostomy (DCR)
Dacryocystorhinostomy (DCR) treats a blocked tear duct by creating a new drainage pathway between the tear sac and the nose, often performed endoscopically through the nostril without an external scar.
ProcedureEndoscopic Orbital Surgery
Endoscopic orbital surgery reaches selected problems of the eye socket through the nose and sinuses, used in chosen cases for decompression, abscess drainage, biopsy, or tumor surgery alongside ophthalmology.