Sinusitis affects millions of people and has a significant impact on quality of life. Symptoms include nasal congestion, excessive mucus drainage, facial pain/pressure, headaches, and possibly fever. Sinusitis can be treated with medications, allergy treatment, and various types of procedures to alleviate sinus blockage. We provide a tailored approach to each patient and offer state-of-the-art minimally-invasive treatments.
This CT scan shows a cross section of the sinus cavities. The black spaces are healthy sinuses cavities. The sinus cavities are filled with air in a healthy state and air is less dense than soft tissue (gray color) and bone (white color). The largest triangular sinuses are called the maxillary sinuses.
This CT scan shows severe blockage and sinusitis on one side and partial blockage on the other side. This patient had completely obstructed breathing on the worse side. The sinus cavities are filled with gray color instead of black--which means the sinuses are extremely swollen and full of retained and entrapped mucus and infection.
A small flexible wire is inserted into the opening of the sinus. The surgeon will use a small scope to view the insertion.
A cylindrical balloon is passed over the wire and the sinus passage is dilated as the balloon is inflated with water.
The sinus is irrigated with saline to remove infected mucus and promote healthy drainage.
The instruments are removed and there is no need for nasal packing. The sinus passage is now wide open so the sinus can return to a healthy state.
This short video shows the surgeon's view of dilation of the maxillary sinus. The procedure takes about thirty seconds. We have performed balloon sinuplasty on hundreds of patients with great success. It is a simple office procedure with minimal downtime.
Another great new treatment for nasal symptoms is called cryotherapy or Clarifix (TM) . This technique targets the hyperactive nerve endings inside the nose. It is the increase in nerve activity that results in nasal swelling and excessive mucus. The procedures helps to relieve nasal symptoms by freezing the nerve ending which weakens the nerve activity. Cryotherapy is similar to freezing a skin lesion but in this case we are treating the specific anatomic location of the posterior nasal nerve.
The yellow lines show the location of the posterior nasal nerves inside the nose. When these nerves are stimulated it causes excessive swelling and mucus production.
Nerve tissue is more sensitive to temperature so an effective way to selectively inhibit nerve tissue activity is to freeze the area over the nerve. We use a special instrument designed by Arrinex, Inc.
After the procedure the nerves are still present but their function is attenuated in such a way as to decrease nasal congestion and drainage.
More severe cases of sinusitis may result in the formation of nasal polyps, which are fleshy growths inside the nose and sinuses. The polyps tend to gradually get worse until patients lose their sense of smell and never breathe clearly. Sinus surgery is a common outpatient surgery to remove polyps and relieve the physical blockage of the sinus passages.
This video presentation explains the anatomy of the sinuses and how sinus surgery helps to alleviated chronic sinusitis and nasal polyps.
The nasal septum is a thick layer of cartilage and mucus membrane in the midline of the nasal cavity. Sometimes the cartilage is curved because of prior injury or asymmetric growth. If the septum is deviated then it can affect nasal breathing. This CT scan shows the deviated septum highlighted by the yellow dots.
Septoplasty is an outpatient procedure under general anesthesia that takes about one hour. Patients may go home the same day of the procedure. First, an incision is made inside the nose and the deviated portion of the cartilage is exposed by elevating off the mucus membrane. Next, the deviated portion of the cartilage is removed and reshaped until it is straight. Then the mucus membrane is sutured back together creating a straight septum and an open nasal airway on both sides.
This video shows the basic steps of septoplasty surgery.
The nasal turbinates are structures inside the nose that help to warm and humidify the air as we breathe. However, due to inflammation from allergies or sinusitis the turbinates oftentimes become swollen and enlarged. This results is difficulty breathing thru the nose on one or both sides. The CT scan shown here highlights severe swelling of the turbinate indicated by the blue dots.
Turbinate reduction is performed in the office using topical and local anesthesia. A small probe is inserted into the turbinate and radiofrequency energy is applied to created a controlled reduction of the soft tissue. As the area heals there is scar contraction which helps to create more breathing room inside the nose.
This short video shows the endoscopic view of a turbinate treatment procedure.