501 N Graham, Suite 455, Portland, OR 97227

10330 SE 32nd Ave, Suite 320 Milwaukie, OR 97222

Chronic Sinus Problems

Chronic rhinosinusitis is an inflammatory condition involving the nose and paranasal sinuses, with symptoms persisting for 12 weeks or longer. Common symptoms include facial pressure, nasal congestion, nasal drainage, and decreased sense of smell. Chronic sinus problems can result from infection, allergies, and nasal polyps obstructing the sinus openings.

We offer a variety of procedures to evaluate and treat chronic sinus problems. Nasal endoscopy can be performed in clinic on your initial visit using either a flexible fiberoptic endoscopic camera or a rigid endoscopic camera. The camera is placed into the nose to evaluate the nasal cavity and sinus passages. Results of the procedure are available in real-time and can be reviewed with you during your appointment.

Another technique for evaluating the sinuses is imaging. NorthWest ENT utilizes a low-radiation CT scanner formulated specifically for looking at the nasal and sinus anatomy. This CT scan can be done in clinic, takes only a few minutes to complete. It provides images that can be viewed immediately following the scan. The CT images can be used to assist with diagnosis and surgical planning,and can be used to provide calibrated image-guidance if surgery is indicated.

For patients with nasal polyps identified on nasal endoscopy or CT scan, we offer state of the art treatment options including the following:

Balloon Sinuplasty: Balloon sinuplasty devices are endoscopic tools that can be used either in the operating room or in some cases, in the physician’s office under local anesthesia. The balloon sinuplasty is a catheter-based device used to create a durable opening in the sinuses and assist otolaryngologists in further meeting the goals of clearing blocked sinuses, restoring normal sinus drainage and function, and preserving normal anatomy and mucosal tissue. The procedure is performed by passing a flexible guidewire into the blocked sinus. Then a balloon is advanced over the guidewire and is inflated to gently expand the sinus opening.

PROPEL Sinus Stent: PROPEL represents a medical breakthrough clinically proven to improve surgical outcomes for chronic sinus sufferers. PROPEL is the first and only device clinically shown to keep the sinuses open after surgery, precisely deliver anti-inflammatory medication directly into the healing tissues, and then dissolve. The innovative sinus stent decreases postoperative scarring and inflammation, reducing the need for additional surgical procedures as well as oral steroids and their potential side effects. At the same time, PROPEL’s spring-like, lightweight design means patients usually can not even tell it is there.

SINUVA (mometasone furoate) sinus implant: Dr. Varela offers a non-surgical procedure for patients who suffer from repeat nasal polyps with SUNIVA (mometasone furoate) sinus implant. SINUVA is proven to reduce polyps, nasal congestion. and obstruction. SINUVA is a sinus implant that treats nasal polyps without surgery. During a routine office, Dr. Varela will use topical and/or local anesthesia to numb the nose and sinuses. SINUVA is then placed into the sinus cavity through the nasal opening. SINUVA’s design provides 2-in-1 approach: open the sinus cavity, and release anti-inflammatory medication to treat nasal polyps for up to 90 days. Benefits include significant reduction in nasal obstruction and nasal congestion, and significant improvement in impaired sense of smell.


DUPIXENT (dupilumab) injection: DUPIXENT is a biologic medication previously used in the treatment of asthma and atopic dermatitis, and newly approved for the treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP). DUPIXENT targets the underlying inflammation that plays a role in CRSwNP. One benefit of this medication is that it is not a steroid. DUPIXENT comes in a pre-filled syringe and can be administered by patients at home. It is administered subcutaneously once every 2 weeks.

About a home sleep study we offer

Watermark integrated home sleep technology is a fast, simple and cost effective alternative for the diagnosis and treatment of obstructive sleep apnea. After identification of appropriate candidates for testing through a validated OSA risk questionnaire, home sleep testing equipment is provided to the patient by the provider. The Watermark sleep testing devices have been validated to be as effective as an in-lab sleep studies, yet with the convenience and simplicity of being performed in the comfort of the patients home at a fraction of the cost. Upon completion of the 2 night study, the information is uploaded to the WM Sleep Portal where the study data is auto-processed, undergoes a technical QA edit and professional interpretation by Dr. Adrian Varela, board certified sleep physician before being returned to the ordering provider for diagnosis, all within 48 hours.