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Nose and Sinus

Nose and Sinus referral principles:

  • E-advice via SCI Gateway – please use!
  • Patients can be referred on SCI gateway to Lauriston, St John’s or East Lothian Community Hospital
  • Maximise medical therapy first –chronic rhinosinusitis is a long-term inflammatory condition which requires optimised, prolonged treatment prior to referral:
    • the ENT specialist view is that topical nasal fluticasone can be used for longer than 12 weeks without necessarily referring;
  • Referrals for rhinosinusitis for red flag symptoms are accepted where urgent diagnosis is required;
  • Septal issues causing significant obstruction – please refer, as there are no alternative treatments – but advise a very long wait (might be 2 years);
  • Nasal and sinus tumours are exceptionally rare;
  • Anosmia can persist after Covid infection and patient education and self-management are key.

Nose Emergencies:

  • Patients presenting within two weeks of a nose fracture who have not attended A&E and have a SIGNIFICANT deformity – please discuss with on-call ENT at St Johns.
  • For severe, prolonged nose bleeds not responding to first aid and needing specialist input – please refer to A&E – see epistaxis for further detail.

Service Information – please see the ENT welcome page.

C.M. & G.MacD 20-02-23