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 sinusitis is more than long-lasting pressure or congestion, and a focused evaluation pairs symptoms with objective evidence of inflammation before comparing treatment options.
ConditionAcute Sinusitis
Most short-lived sinus symptoms begin with a viral illness and improve without antibiotics, and evaluation focuses on recognizing the patterns that suggest bacterial infection or a complication.
ConditionRecurrent Acute Sinusitis
Repeated sinus infections are not automatically recurrent acute rhinosinusitis, and evaluation focuses on whether episodes are distinct, clear in between, and explained by a treatable cause.
ConditionNasal Polyps
Nasal polyps can block airflow, impair smell, and recur because they are part of an inflammatory disease, not simply growths to remove.
ConditionFungal Sinusitis
"Fungal sinusitis" includes very different diseases, and a noninvasive fungal ball, allergic fungal rhinosinusitis, and invasive fungal infection do not share the same urgency, testing, or treatment.
ConditionAllergic Fungal Rhinosinusitis
Allergic fungal rhinosinusitis is an intense inflammatory response associated with thick allergic mucin, polyps, and characteristic imaging—not an invasive fungal infection.
ConditionOdontogenic Sinusitis
One-sided maxillary sinus disease, foul drainage, or symptoms following dental work may originate from a tooth, implant, extraction site, or oral–sinus communication, and care depends on confirming both the sinus disease and the dental source.
ConditionFrontal Sinus Disease
The frontal sinus drains through a narrow, highly variable pathway close to the orbit and skull base, so persistent disease often needs a plan tailored to the anatomy.
ConditionSphenoid Sinus Disease
Sphenoid sinus symptoms can be vague, yet the sinus lies beside the optic nerves, carotid arteries, pituitary region, and cranial nerves, so findings there deserve careful evaluation.
ConditionSinus Mucocele
A sinus mucocele is an expanding, mucus-filled cavity caused by blocked drainage, and its urgency depends on location, growth, and pressure on the orbit or skull base.
ConditionUnilateral Sinus Disease
Disease limited to one side of the nose or sinuses deserves a deliberate differential diagnosis, because causes range from dental infection and fungal disease to benign tumors and cancer.
ConditionAspirin Exacerbated Respiratory Disease
AERD links chronic sinus inflammation and nasal polyps with asthma and respiratory reactions to aspirin and other COX-1 inhibitors, so care is planned across the sinuses and lower airway together.
TreatmentBiologic Therapy for Nasal Polyps
Biologics can reduce inflammation and polyp burden for selected patients with severe chronic rhinosinusitis with nasal polyps, alongside medical therapy and surgery.
ProcedureEndoscopic Sinus Surgery
Endoscopic sinus surgery improves drainage, removes obstructive disease, and creates access for ongoing topical treatment when medical therapy is not enough.
ProcedureBalloon Sinuplasty
Balloon sinus dilation can widen selected sinus openings without removing tissue, but it is not the right treatment for every form of sinus disease.
ProcedureRevision Sinus Surgery
A revision evaluation reconstructs the original diagnosis and operation, reviews imaging and pathology, and defines the specific problem a second sinus procedure would solve before recommending more surgery.
ProcedureImage-Guided Sinus Surgery
Surgical navigation links instruments to a patient's preoperative scan to provide an additional localization tool during selected complex sinus and skull-base operations.
ProcedureAdvanced Frontal Sinus Surgery
Advanced frontal sinus procedures are reserved for frontal sinus disease that cannot be managed with medical therapy or a more limited drainage procedure.
TreatmentSteroid Implant for Nasal Polyps
Steroid-eluting sinus implants deliver anti-inflammatory medicine locally in selected postoperative or recurrent-polyp situations, as one part of a broader plan for nasal polyps.
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 the newly opened drainage pathways stay clear.
Patient GuideSinus Surgery Recovery
Recovery after sinus surgery is shaped by the diagnosis, extent of surgery, and the treating team's instructions, which separate expected congestion and drainage from same-day concerns over the first month.
Patient GuideRisks and Complications of Sinus Surgery
Every sinus operation has potential complications, and this guide supports informed consent by explaining common temporary effects, less common complications, and the symptoms that need immediate help.
Nasal Breathing, Rhinitis, and Smell
Nasal airflow, drainage, sensation, and the nerve-driven causes of congestion and postnasal symptoms.
Chronic Rhinitis
A constantly runny, congested, or reactive nose is not one diagnosis, and evaluation separates allergic and nonallergic patterns, medication effects, structural obstruction, and chronic sinus disease before choosing treatment.
ConditionLoss of Smell
Smell loss can result from blocked odor access, injury to the olfactory system, infection, trauma, medication, aging, or neurologic disease, and evaluation establishes the timeline and identifies treatable causes.
ConditionEpistaxis and Nosebleeds
Most nosebleeds stop with correct pressure, but recurrent, heavy, or one-sided bleeding can reflect dryness, medication effects, blood-pressure or clotting issues, trauma, vascular lesions, or tumors and deserves evaluation.
ConditionEmpty Nose Syndrome
Empty nose syndrome is a paradoxical sense of obstruction and dryness despite an open nasal airway that may occur after turbinate surgery, requiring careful, uncertainty-aware care.
ConditionSinus Headache Versus Migraine
Facial pressure and congestion can occur during migraine, so many headaches labeled as sinus headaches are actually migraine, and careful evaluation prevents unnecessary antibiotics or surgery.
ProcedureNasal Valve Repair
Nasal valve repair begins with a dynamic examination and a complete airway diagnosis before considering grafts, implants, or other techniques to improve breathing.
ProcedurePosterior Nasal Nerve Ablation
Posterior nasal nerve ablation is an office-based option for selected patients with chronic rhinitis that remains bothersome despite appropriate medical care.
ProcedureVidian Neurectomy
Vidian neurectomy is a more invasive nerve procedure reserved for selected severe, treatment-resistant rhinitis, with careful attention to dry-eye risk and less invasive alternatives.
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 true cranial cerebrospinal-fluid leak creates a pathway between the space around the brain and the nose, so evaluation confirms whether one-sided clear drainage is CSF and locates the defect.
ConditionPituitary Adenoma
Pituitary adenomas are not managed by size alone; hormone production, pituitary function, vision, growth, MRI anatomy, medication response, and patient goals determine the right path.
ConditionSkull Base Tumors
"Skull base tumor" describes a location, not a single disease; diagnosis, growth pattern, cranial-nerve effects, and the relationship to the brain, arteries, orbit, and pituitary determine the safest treatment path.
ConditionSkull Base Fracture
A suspected skull-base fracture is a trauma emergency, not an elective office diagnosis; after emergency care, specialist follow-up addresses CSF leak, smell loss, cranial-nerve injury, and reconstruction.
ConditionSkull Base Osteomyelitis
Skull base osteomyelitis is a serious infection of the bone at the base of the skull that usually requires hospital-based, multidisciplinary care.
ConditionMeningocele and Encephalocele
A meningocele or encephalocele is a herniation of the brain's lining, or brain tissue, through a skull-base defect that may be linked to a cerebrospinal fluid leak.
ConditionCraniopharyngioma
A craniopharyngioma is a benign but locally challenging tumor near the pituitary gland that can affect vision, hormones, and other functions.
ConditionChordoma and Chondrosarcoma
Chordoma and chondrosarcoma are rare bone and cartilage tumors of the skull base that often need combined surgery, 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 endonasal skull base surgery reaches selected lesions through the nose, avoiding some external incisions while requiring careful planning around the brain, optic nerves, carotid arteries, pituitary, and cranial nerves.
ProcedureEndoscopic Pituitary Surgery
Endoscopic pituitary surgery reaches selected pituitary and sellar lesions through the nasal corridor, with the decision guided by hormones, vision, and imaging.
ProcedureEndoscopic CSF Leak Repair
Successful CSF leak repair depends on confirming the leak, locating the defect, understanding why it occurred, and building a closure suited to its size, flow, and anatomy.
ProcedureSkull Base Fracture Repair
Most skull-base fractures are first managed in a trauma hospital and not every fracture needs surgery; repair is considered for defined complications such as a persistent CSF leak or unstable defect.
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
A one-sided nasal or sinus mass should not be assumed to be an ordinary inflammatory polyp; inverted papilloma is usually benign but can recur and may coexist with malignancy.
ConditionNasal and Sinus Cancer
Nasal cavity and sinus cancers are uncommon and biologically diverse, so planning should begin with expert pathology and imaging review before accounting for subsite, spread, resectability, and the functions treatment may affect.
ConditionJuvenile Nasopharyngeal Angiofibroma
Juvenile nasopharyngeal angiofibroma is a rare, highly vascular tumor that most often affects adolescent males and can cause recurrent one-sided nosebleeds and nasal obstruction.
ConditionOlfactory Neuroblastoma (Esthesioneuroblastoma)
Olfactory neuroblastoma is a rare cancer arising high in the nasal cavity near the smell fibers and anterior skull base, treated with coordinated surgery, radiation, and surveillance.
ConditionSinonasal Melanoma
Sinonasal mucosal melanoma is a rare cancer of the nasal and sinus lining that differs from skin melanoma and needs expert pathology, staging, and coordinated treatment.
ProcedureOrbital Decompression
Orbital decompression makes more room for the eye by removing bone, fat, or both 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 opening between the tear sac and the nose, often done endoscopically through the nostril, which generally avoids a skin incision.
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.