Patient Resources
Frequently Asked Questions
Find clear answers about sinus conditions, treatments, procedures, and what to expect at our practice.
All Topics
About Our Practice
Sinusitis
Balloon Sinuplasty
Deviated Septum
Rhinitis & Congestion
Nasal Polyps
Sinus Surgery
Snoring & Sleep Apnea
Allergies
Insurance & Billing
Appointments & Prep
About Our Practice
Who is Dr. Cohen and what is his specialty?
Dr. Alen Cohen is a board-certified otolaryngologist (ENT specialist) and founder of the Southern California Sinus Institute. He focuses exclusively on sinus and nasal disorders, offering both surgical and non-surgical solutions.
Where is the Southern California Sinus Institute located?
We are located in the Los Angeles area, serving patients throughout Southern California including West Hills, Woodland Hills, and surrounding communities. Visit our Contact page for the exact address and directions.
What makes this practice a "Sinus Center of Excellence"?
The practice has been designated a Sinus Center of Excellence due to Dr. Cohen’s high surgical volume, specialized training, patient outcomes, and use of state-of-the-art technology for sinus and nasal care.
What conditions does the practice treat?
We treat sinusitis, nasal polyps, deviated septum, chronic rhinitis, nasal congestion, allergies, snoring, sleep apnea, eustachian tube dysfunction, nasal valve collapse, and more.
Does the practice offer in-office procedures?
Yes. Many procedures are performed right in the office, including balloon sinuplasty, endoscopic sinus surgery, polypectomy, eustachian tube dilation, ClariFix, and VIVAER. This avoids the cost and downtime of a hospital visit.
What technology does the practice use?
We use state-of-the-art tools including image-guided navigation systems, advanced endoscopes, ClariFix cryotherapy devices, VIVAER radiofrequency devices, and other minimally invasive platforms.
How do I request an appointment?
You can request an appointment online via our Contact page or call our office directly. We recommend having your insurance information ready.
Do I need a referral to see Dr. Cohen?
It depends on your insurance plan. Some plans require a referral from a primary care physician before seeing a specialist. Check your insurance card or call your insurer to confirm.
Are patient testimonials available?
Does the practice offer educational resources for patients?
Yes. We provide eBooks and detailed educational articles on our Education page and eBooks page covering sinus conditions and treatments.
Sinusitis
What is sinusitis?
Sinusitis is inflammation of the sinus cavities, usually caused by infection, allergies, or structural blockages. It results in congestion, facial pain or pressure, and drainage issues.
What is the difference between acute and chronic sinusitis?
Acute sinusitis lasts less than 4 weeks and is typically caused by a virus or bacteria. Chronic sinusitis lasts 12 weeks or longer and often requires more targeted medical or surgical treatment.
What are common symptoms of sinusitis?
Symptoms include facial pressure or pain, nasal congestion, thick discolored nasal discharge, reduced smell, headache, fatigue, and post-nasal drip.
What causes chronic sinusitis?
Common causes include nasal polyps, deviated septum, allergies, repeated respiratory infections, and structural nasal abnormalities that block sinus drainage.
When should I see a doctor for sinus symptoms?
See a specialist if symptoms last more than 10 days, do not improve with over-the-counter treatment, keep recurring, or are significantly affecting your quality of life.
What is recurrent sinusitis?
Recurrent sinusitis means having 4 or more separate sinus infections per year, each lasting at least 7 days, with symptom-free periods between episodes.
How is sinusitis diagnosed?
Diagnosis involves a physical exam, review of symptoms, and may include nasal endoscopy or CT imaging to evaluate the sinus anatomy and extent of blockage or inflammation.
Can sinusitis cause headaches?
Yes. Sinus headaches result from pressure and inflammation in the sinuses. They typically feel like dull pain or pressure around the forehead, cheeks, or behind the eyes.
What non-surgical treatments are available for sinusitis?
Options include nasal saline irrigation, steroid nasal sprays, antibiotics (for bacterial infections), antihistamines, and decongestants. Allergy treatment may also help if allergies are a root cause.
What if antibiotics do not clear my sinus infection?
If antibiotics fail to resolve symptoms, a structural issue such as nasal polyps or a deviated septum may be blocking drainage. An ENT evaluation and possibly CT scan can identify the cause and guide next steps.
Balloon Sinuplasty
What is balloon sinuplasty?
Balloon sinuplasty is a minimally invasive procedure that uses a small flexible balloon catheter to gently open blocked sinus passages. No tissue or bone is removed.
Is balloon sinuplasty done in the office or hospital?
We offer balloon sinuplasty in both the office setting (under local anesthesia) and in an outpatient surgery center. Most patients qualify for the in-office option.
Who is a candidate for balloon sinuplasty?
Patients with chronic or recurrent sinusitis who have not responded to medications may be good candidates. A consultation and CT scan help determine if the anatomy is suitable for the procedure.
How long does balloon sinuplasty take?
The in-office procedure typically takes about 20 to 30 minutes. Patients usually go home the same day.
Is balloon sinuplasty painful?
Most patients experience minimal discomfort. Local anesthesia is used to numb the area. Some pressure or a pushing sensation may be felt during balloon inflation.
What is the recovery time after balloon sinuplasty?
Most patients return to normal activities within 24 to 48 hours. There is typically no packing and very little downtime compared to traditional sinus surgery.
How effective is balloon sinuplasty?
Clinical studies show significant and lasting improvement in sinus symptoms for the majority of patients. Many patients report fewer sinus infections and reduced reliance on medication after the procedure.
Does balloon sinuplasty permanently fix the sinuses?
The reshaping of the sinus opening is permanent. However, underlying issues like allergies or polyps may still require ongoing management.
Is balloon sinuplasty covered by insurance?
Yes, most major insurance plans cover balloon sinuplasty when medically necessary. Our team handles insurance verification and will confirm your coverage before the procedure.
What is image-guided balloon sinuplasty?
Image-guided balloon sinuplasty uses real-time CT imaging to help the surgeon precisely navigate the sinus anatomy, improving safety and accuracy especially in complex cases.
Deviated Septum
What is a deviated septum?
The nasal septum is the wall dividing the two nostrils. A deviated septum is when this wall is shifted to one side, causing uneven nasal passages. This can obstruct airflow and cause breathing problems.
What symptoms does a deviated septum cause?
Common symptoms include nasal congestion (often worse on one side), frequent nosebleeds, sinus infections, snoring, difficulty breathing through the nose, and facial pain or pressure.
What causes a deviated septum?
It can be present from birth or result from a nasal injury such as a broken nose. Some deviation is very common and affects most people to some degree.
How is a deviated septum treated?
Mild cases may be managed with medications. When symptoms are significant, septoplasty (surgical correction of the septum) is the definitive treatment.
What is septoplasty?
Septoplasty is a surgical procedure to straighten the deviated septum. It is typically performed under general or local anesthesia, with all incisions inside the nose (no external scarring).
Is septoplasty the same as rhinoplasty?
No. Septoplasty corrects the internal septum for breathing improvement and is a functional procedure. Rhinoplasty changes the external appearance of the nose. They can be performed together if both concerns exist.
What is the recovery like after septoplasty?
Most patients return to work within 1 week. Swelling and congestion are normal for 1 to 2 weeks. Strenuous activity should be avoided for about 2 to 3 weeks.
Will there be visible bruising or scarring after septoplasty?
Because all incisions are inside the nose, there is typically no visible scarring. Bruising around the nose or eyes is possible but usually resolves within 1 to 2 weeks.
Is septoplasty covered by insurance?
Yes, septoplasty is typically covered by insurance when it is medically necessary to improve breathing. Purely cosmetic rhinoplasty is not. Our team will assist with pre-authorization.
Can a deviated septum come back after surgery?
In most cases the results are long-lasting. Rarely, the septum may shift slightly over time, particularly if another nasal injury occurs.
Rhinitis & Nasal Congestion
What is chronic rhinitis?
Chronic rhinitis is ongoing inflammation of the nasal lining, causing persistent runny nose, congestion, sneezing, and post-nasal drip. It can be allergic or non-allergic in origin.
What is non-allergic rhinitis?
Non-allergic rhinitis has similar symptoms to allergic rhinitis but is not triggered by allergens. Triggers include weather changes, smoke, strong odors, stress, certain foods, and hormonal changes.
What is ClariFix and how does it treat rhinitis?
ClariFix is an in-office cryotherapy treatment that uses controlled cold temperatures to disrupt the overactive nerves in the nose that cause chronic runny nose and congestion. It provides lasting relief for many patients.
How long does a ClariFix treatment take?
The in-office ClariFix procedure takes about 30 minutes, including preparation. Most patients return to normal activity the same day.
What are enlarged turbinates?
Turbinates are bony structures inside the nose that humidify and filter air. When they become chronically swollen, they can block airflow and cause persistent nasal congestion.
How are enlarged turbinates treated?
Treatment ranges from steroid nasal sprays and antihistamines to in-office procedures such as turbinate reduction using radiofrequency energy, which shrinks the tissue with minimal downtime.
What is nasal valve collapse?
Nasal valve collapse occurs when the walls of the nasal valve area (the narrowest part of the nasal airway) are too weak or narrow, causing significant breathing obstruction especially during inhalation.
What is the VIVAER treatment?
VIVAER is a non-invasive, in-office procedure that uses low-temperature radiofrequency energy to reshape the nasal valve tissue and improve airflow, without cutting or removing any tissue.
What is the LATERA nasal implant?
LATERA is a small absorbable implant placed inside the lateral nasal wall to provide structural support and reduce nasal valve collapse. It gradually absorbs over 18 months while permanent tissue support remains.
Can nasal congestion lead to other health problems?
Yes. Chronic nasal congestion can lead to poor sleep quality, headaches, eustachian tube dysfunction, ear infections, and worsening of conditions like asthma or sinusitis.
Nasal Polyps
What are nasal polyps?
Nasal polyps are soft, noncancerous growths that form on the lining of the nasal passages or sinuses. They are associated with chronic inflammation due to asthma, allergies, or recurring infections.
What symptoms do nasal polyps cause?
Symptoms include persistent stuffiness, loss of smell or taste, runny nose, post-nasal drip, facial pressure, and snoring. Large polyps may cause mouth breathing or significant breathing obstruction.
Can nasal polyps be treated without surgery?
Yes. Steroid nasal sprays, oral steroids, and biologic medications can shrink polyps and relieve symptoms. However, polyps often recur, and surgery may be needed for lasting relief.
What is an in-office polypectomy?
An in-office polypectomy is a procedure to remove nasal polyps in the clinic using local anesthesia. It avoids the need for a hospital or surgery center and typically has a quick recovery.
Do nasal polyps come back after removal?
Polyps can recur, especially if the underlying inflammation is not controlled. Long-term management with nasal sprays and allergy treatment helps reduce recurrence.
Are nasal polyps related to cancer?
Common nasal polyps are benign (noncancerous). However, any unusual nasal growth should be evaluated by a specialist to rule out other conditions.
What is the link between asthma and nasal polyps?
Asthma and nasal polyps are both inflammatory conditions and frequently occur together. Treating nasal polyps effectively often helps improve asthma control as well.
Can allergies cause nasal polyps?
Allergies contribute to the chronic nasal inflammation that can lead to polyp formation. Allergy testing and treatment may be recommended as part of a comprehensive polyp management plan.
Sinus Surgery
What is endoscopic sinus surgery?
Endoscopic sinus surgery uses a thin, lighted camera (endoscope) inserted through the nostrils to visualize and remove blockages in the sinuses. There are no external incisions.
What is minimally invasive image-guided sinus surgery?
Image-guided sinus surgery uses real-time CT imaging to provide precise navigation during surgery. This improves safety and accuracy, especially for complex or revision cases.
When is sinus surgery recommended?
Surgery is recommended when chronic sinusitis, polyps, or structural problems do not respond to medications, or when imaging shows significant blockage that prevents normal sinus drainage.
What is revision sinus surgery?
Revision sinus surgery is performed when a prior sinus surgery did not produce lasting results or when symptoms return. It often requires more detailed planning and image guidance.
How long does sinus surgery take?
It depends on the extent of surgery. Simple cases may take 30 to 60 minutes. More complex or bilateral cases may take 1 to 2 hours. In-office cases are generally faster.
What is recovery like after sinus surgery?
Most patients return to desk work within 5 to 7 days. Nasal congestion, mild bleeding, and crusting are common for 2 to 4 weeks. Follow-up cleanings with your doctor are important for healing.
Is nasal packing used after sinus surgery?
Packing is often not required with modern endoscopic techniques. When used, it is typically absorbable. Dr. Cohen will explain what to expect based on your specific procedure.
What are the risks of sinus surgery?
As with any surgery, risks include bleeding, infection, and anesthesia reactions. Rare risks include eye or brain injury given the proximity of the sinuses. Image-guided navigation significantly reduces these risks.
Can sinus surgery be performed in the office?
Yes. We offer in-office endoscopic sinus surgery under local anesthesia for appropriate patients. This eliminates the need for a surgery center and allows faster recovery.
Will I need to do anything to prepare for sinus surgery?
You will be asked to stop blood thinners and certain supplements before surgery, fast if general anesthesia is used, and arrange for a driver home. Our team will provide complete pre-operative instructions.
Snoring & Sleep Apnea
What causes snoring?
Snoring is caused by vibration of soft tissues in the throat or nose during sleep. Contributing factors include nasal congestion, deviated septum, enlarged turbinates, obesity, and anatomical variations in the throat or palate.
Is snoring the same as sleep apnea?
No. Snoring is noise from partial airway obstruction. Sleep apnea involves complete or near-complete stops in breathing during sleep, which reduces oxygen levels and disrupts sleep quality.
How can nasal problems contribute to snoring?
Nasal obstruction forces mouth breathing during sleep, which increases vibration of throat tissues and worsens snoring. Treating nasal issues such as a deviated septum or enlarged turbinates can significantly reduce snoring.
What snoring treatments are available?
Treatments depend on the cause and may include nasal procedures (septoplasty, turbinate reduction), positional therapy, oral appliances, CPAP, or soft palate procedures. A proper evaluation identifies the best approach.
How is sleep apnea diagnosed?
Sleep apnea is diagnosed with a sleep study (polysomnography), which can be done at a sleep lab or at home. It records breathing patterns, oxygen levels, and sleep stages overnight.
Can sinus surgery help with sleep apnea?
Treating nasal obstruction can improve CPAP tolerance and reduce the severity of sleep apnea. However, it may not fully resolve sleep apnea on its own, especially if the obstruction is primarily in the throat.
What is chronic cough and can it be related to sinus problems?
Yes. Chronic cough is often caused by post-nasal drip from sinusitis or rhinitis. Mucus dripping into the throat triggers a persistent cough reflex. Treating the underlying sinus or nasal issue often resolves the cough.
Is snoring dangerous?
Snoring itself is not dangerous but can signal an underlying obstruction or sleep apnea, which does carry health risks including high blood pressure, cardiovascular problems, and daytime fatigue. Evaluation is recommended.
Allergies
What are environmental allergies?
Environmental (or inhalant) allergies are immune reactions to airborne substances such as pollen, dust mites, mold, and pet dander. They commonly cause nasal symptoms, eye irritation, and can trigger or worsen sinusitis and asthma.
What allergy testing is available?
We offer allergy testing including skin prick testing and blood (RAST) testing to identify specific allergens triggering your symptoms.
What allergy treatment options are available?
Treatment options include allergen avoidance, antihistamines, steroid nasal sprays, allergy immunotherapy (allergy shots), and sublingual (under the tongue) immunotherapy drops or tablets.
Can allergies cause sinus infections?
Yes. Allergic inflammation swells the nasal lining and blocks sinus drainage, creating conditions for bacterial or fungal sinus infections. Controlling allergies is an important part of managing chronic sinusitis.
How long does allergy immunotherapy take to work?
Most patients notice improvement within 3 to 6 months of starting immunotherapy. Full benefit typically develops over 1 to 3 years of treatment.
What is eustachian tube dysfunction and is it related to allergies?
The eustachian tube connects the middle ear to the back of the nose. Allergic or nasal inflammation can cause it to become blocked, leading to ear fullness, muffled hearing, and ear pressure. Treating the underlying allergy or nasal condition often helps.
What is eustachian tube dilation?
Eustachian tube dilation is a minimally invasive in-office procedure that uses a small balloon to open a chronically blocked eustachian tube, relieving ear pressure, fullness, and associated hearing issues.
Is allergy testing painful?
Skin prick testing involves tiny pricks on the skin surface and is generally well tolerated with minimal discomfort. It takes about 20 to 30 minutes to complete.
Insurance & Billing
What insurance plans does the practice accept?
We accept most major insurance plans. Visit our Insurances Accepted page for the current list, or call our office to confirm your specific plan.
Do you offer insurance verification?
Yes. Our team provides insurance verification before your appointment. Use our Insurance Verification page to submit your information in advance.
Are sinus procedures typically covered by insurance?
Most medical sinus procedures including balloon sinuplasty, septoplasty, and endoscopic sinus surgery are covered when medically necessary. Coverage varies by plan, and our team will obtain pre-authorization when required.
What if my insurance requires prior authorization?
Our billing team handles prior authorization requests on your behalf. We will communicate the status and let you know if any additional documentation is needed from your primary care provider.
What happens if I do not have insurance?
We can discuss self-pay options and payment plans. Contact our office directly for pricing and financing information.
Does insurance cover allergy testing?
Many insurance plans cover allergy testing and immunotherapy when medically indicated. Coverage details vary by plan. Our team will verify your benefits before proceeding.
Are in-office procedures billed differently than hospital procedures?
Yes. In-office procedures generally have lower out-of-pocket costs because there are no separate facility fees from a hospital or surgery center. Your cost share (copay, deductible) still applies per your plan.
Appointments & Preparation
What should I bring to my first appointment?
Bring a photo ID, insurance card, a list of current medications, any prior imaging (CT scans, MRI), referral paperwork if required, and a list of questions for the doctor.
How long will my first visit take?
Plan for 60 to 90 minutes for a new patient consultation, which includes a health history review, physical exam, possible nasal endoscopy, and discussion of treatment options.
Will I need a CT scan at my first visit?
Not always. In-office nasal endoscopy is often the first diagnostic step. A CT scan may be ordered if a structural problem, polyps, or complex sinusitis is suspected.
Do I need to stop medications before a procedure?
Blood thinners (aspirin, ibuprofen, warfarin, etc.) and certain supplements should be stopped 7 to 10 days before any procedure. Always follow the specific instructions provided by our office for your procedure.
Can I drive myself home after an in-office procedure?
If sedation or IV medication is used, you will need a driver. For procedures done solely under local anesthesia without sedation, you may be able to drive, but we recommend bringing someone with you.
How do I prepare for a CT scan of my sinuses?
Sinus CT scans require no special preparation. Remove metal jewelry or piercings near the head. The scan is quick (5 to 10 minutes) and does not require dye or fasting in most cases.
What is nasal endoscopy and what should I expect?
Nasal endoscopy involves passing a thin flexible camera through your nostril to examine the nasal passages and sinus openings. The nose is first sprayed with a decongestant and numbing solution. It is mildly uncomfortable but brief.
How soon after surgery will I have a follow-up visit?
A follow-up is typically scheduled within 1 week after surgery for a post-operative exam and, if needed, a nasal cleaning to remove crusting and support healing. Additional visits are scheduled over the following weeks.
Can I eat or drink before an in-office procedure?
For in-office procedures under local anesthesia only, no fasting is typically required. If sedation is planned, you will be instructed to fast for at least 6 to 8 hours beforehand.
What patient resources are available on your website?
Our website offers educational articles, eBooks, condition and treatment pages, and links to patient forms. Visit the Patient Resources page for a full overview.