Nose and sinus related problems
In response to the coronavirus (COVID-19) pandemic, we have made significant changes to how we deliver our services in order to help protect our patients, visitors and staff.
Please find guidance for rhinology patients with links to supportive information including how to contact us.
You can seek advice from your GP if you have concerns about ongoing or worsening symptoms related to your nose and/or sinuses, such as:
- increasing and severe nasal obstruction causing sleep disturbance
- severe facial pain or pressure
- new onset (over three weeks) of one-sided nasal obstruction or facial pain
- one-sided blood-stained nasal discharge
- increasing nosebleeds (if the bleeding is severe and not stopping after 15 minutes of applying pressure to the nose you need to be seen by a doctor immediately).
If your query is urgent, please call us on 020 7188 8872 from Monday to Friday, 8am-5pm.
Advice related to patients with chronic rhinosinusitis
If you are already diagnosed with chronic rhinosinusitis, we encourage you to continue with your regular medications. Saline rinses and nasal steroid sprays are available over the counter and you can get repeat prescriptions from your GP. There is no risk related to continued use of topical nasal steroids as they are not absorbed into the body.
For patients with aspirin exacerbated respiratory disease (AERD)/'Samter's triad' who has been desensitised you should continue with your daily aspirin treatment.
If you are on a maintenance dose of oral steroids for chronic rhinosinusitis it may be worth discussing if you should continue this treatment with your ear, nose and throat (ENT) or respiratory consultant.
Patients with chronic rhinosinusitis, including those with nasal polyps, or who have had previous sinus surgery, can have a COVID-19 nasal swab test if required without any increased risk.
If you are diagnosed with chronic rhinosinusitis and suddenly experiencing any of the following symptoms, it may be an indication of complications to chronic rhinosinusitis and you should seek emergency medical care.
- severe headache
- swelling and redness around the eyes
- neurological symptoms such as new onset drowsiness, numbness of the cheek, a change in vision or weakness.
Watch patients' advice video on You Tube relating to chronic rhinosinusitis and COVID-19.
Advice related to patients with loss of sense of smell
Loss of sense of smell is one of the most common symptoms of COVID-19 infection. Many COVID-19 positive patients also experience other symptoms such as fever, chills, fatigue, shortness of breath, chest pain, and stomach problems, but loss of sense of smell and/or taste may be the only symptom. Onset is typically sudden and severe, but may also be partial, or associated with smell alteration. Any new change in your sense of smell during the pandemic should prompt self-isolation and testing. If you are worried that you may be infected with COVID-19 you should contact NHS 111 for advice.
If you are known to have chronic rhinosinusitis and suddenly lose your sense of smell it may be worth to consider if you are infected with COVID-19, especially if you are not experiencing a simultaneous worsening in nasal obstruction. If you are worried that you may be infected with COVID-19 you should contact NHS 111 for advice.
For many people, the loss of smell and taste associated with COVID-19 improves within 2-4 weeks. There is no need for any specific treatment during this time.
The duration of loss of smell and taste is not related to being infectious and so you should follow the current guidance with regards to self-isolation.
In about 10% of individuals, loss of smell and taste continues after four weeks.
In these cases there may be some benefit from a short course of oral corticosteroids, but there are side effects that should be considered.
Smell training is an effective treatment and should be considered by anyone with smell loss lasting for more than four weeks.
We have worked with two patient groups to provide resources to help and allow you to share experiences with others who have been affected – there are sections on smell training, advice sheets and further guidance.
Advice related to hay fever
Hay fever or seasonal allergic rhinitis is caused by an allergic reaction to pollen. Symptoms include nasal obstruction, a runny nose, sneezing, red eyes, watery eyes, coughing, and itching of the nose, eyes, mouth or throat. Hay fever and COVID-19 infection display some overlapping symptoms; however, fever, chills, fatigue, chest pain, shortness of breath and stomach problems are not typical symptoms of hay fever. If you are worried that you may be infected with COVID-19 you should contact NHS 111 for advice.
If you suffer from hay fever, we advise you ease your symptoms with oral antihistamines, intranasal antihistamines and nasal steroid sprays, and saline rinses which are all available over the counter. Speak to the pharmacist about the best treatment for you. If you are already using allergy medication it is safe and recommended to continue. Allergen specific immunotherapy can also be sustained, however, it should be paused during a severe COVID-19 infection.
Hay fever advice for patients:
Video comparing COVID-19 with hay fever and asthma symptoms:
Nasal deformity and nasal obstruction
We are unable to offer corrective nasal surgery (rhinoplasty) for cosmetic purposes. If you have been referred with breathing problems due to a deviated nasal septum, you will need a face-to-face assessment, which will be arranged as soon as we can.
Useful links and websites