Medical treatment
Steroid nasal sprays, saline rinses, and short courses of other medicines when appropriate. Many patients need nothing more.
NOSE & SINUS CARE · ISLAMABAD
Sinus problems & nasal blockageassessment and endoscopic surgery.
Dr M Riaz Khokhar assesses long-standing sinus and nasal problems, and offers endoscopic sinus surgery (FESS) and other endoscopic nasal operations when medical treatment has not been enough, at PNS Hafeez Hospital Islamabad.
Evening clinic, Monday to Friday, 5–7 pm. Your appointment time will be confirmed by the clinic.
WHEN TO COME
Reasons to have your nose and sinuses checked.
- A blocked nose that has lasted more than three months.
- Facial pressure or pain, with thick nasal discharge or mucus running down the back of the throat.
- A reduced or lost sense of smell.
- Nasal polyps, or sinus disease seen on a CT scan.
- Sinus infections that keep coming back despite treatment.
- You have been advised sinus or nasal surgery and want to discuss your options.
Most sinus problems improve with nasal sprays, saline rinses and other medicines. Surgery is for the smaller group whose symptoms continue despite proper treatment.
YOUR VISIT
What happens at a nose and sinus consultation.
Bring any CT scans (films or disc), previous prescriptions and the nasal sprays you are using.
1
History and examination
Your symptoms, how long they have lasted, allergies, asthma, and the treatments you have already tried.
2
Nasal endoscopy
A thin camera is passed gently into the nose in the clinic to look at the nasal lining, the septum, any polyps and the sinus openings.
3
CT scan when needed
A CT scan of the sinuses shows the extent of disease and is essential for planning if surgery is being considered.
4
A clear plan
Most patients start with, or continue, medical treatment. Surgery is discussed if symptoms persist.
TREATMENT OPTIONS
Surgery is not the first step.
Allergy control
Identifying and reducing triggers, with regular treatment for allergic rhinitis, which often accompanies sinus disease.
Endoscopic surgery
Considered for chronic sinusitis or polyps that have not responded to medical treatment, and for structural blockage such as a deviated septum.
ENDOSCOPIC SURGERY
What to expect if you need an operation.
The operation
FESS is done through the nostrils with a thin camera and fine instruments, usually under general anaesthetic. There are no cuts on the face. Blocked sinus openings are widened and polyps removed.
Other endoscopic nasal procedures
Depending on the cause of blockage, surgery may include straightening the septum (septoplasty) or reducing enlarged turbinates. These are often done at the same time.
Hospital stay and recovery
Many patients go home the same day or after one night. The nose feels blocked for one to two weeks, and most people take one to two weeks off work. Your own timeline will be discussed before surgery.
Aftercare
Saline rinses and follow-up visits to clean the nose are an important part of healing. Polyps and allergy-related disease usually need continued nasal sprays after surgery.
Risks
These include bleeding, infection, scarring inside the nose and the return of symptoms. Because the sinuses lie next to the eye and the base of the brain, injury to these areas is a rare but serious risk. Dr Khokhar will explain how each applies to you before you decide.
When to seek urgent care
Go to the nearest emergency department if you have:
- Swelling or redness around the eye, double vision or a change in eyesight, with a sinus infection.
- Severe headache with high fever, neck stiffness or drowsiness.
- A nosebleed that does not stop after 15–20 minutes of firm pressure.
- After nasal surgery: heavy bleeding, a change in vision, or clear watery fluid dripping from the nose.
COMMON QUESTIONS
Questions patients often ask.
Will my sinus problem go away without surgery?
Often, yes. Regular nasal sprays and saline rinses control symptoms for many patients. Surgery is considered when a proper course of treatment has not helped.
Is FESS painful?
Most patients describe discomfort and a blocked nose rather than severe pain, and it is usually managed with simple painkillers.
Will there be packing in my nose?
Sometimes. If packing or dressings are used they are often dissolvable or removed within a day or two. This will be explained before your operation.
Can polyps come back after surgery?
Yes. Polyps are caused by ongoing inflammation of the nasal lining, so they can return. Continuing your nasal sprays and attending follow-up lowers that risk.
What should I bring to my appointment?
Any CT scans, previous prescriptions, the nasal sprays you use, and a list of your current medicines and allergies.
Reviewed by Dr M Riaz Khokhar, ENT Consultant · November 2026. This page gives general information and does not replace a consultation.
Ready to arrange a nose and sinus consultation?
Monday–Friday · 5–7 pm · PNS Hafeez Hospital Islamabad