Nasal Congestion Archives

Turbinate Reduction

Drfisher on March 2, 2023

What is Turbinate Reduction?

Designed and Developed by Donald P. Dennis, M.D

The Dennis Bipolar Turbinate Probe for Turbinate Surgery was designed to perform bipolar submucosal coagulation of the inferior one-half of the inferior turbinate longitudinally.

Description of Design (probe for turbinate surgery)

The probe design includes a pencil grip for easy handling with a bayonet needle mount for easy intranasal visualization during surgery with parallel 4 cm needles affixed 3 mm apart for precision tissue destruction.

Surgical Technique of Turbinate Surgery

Five- percent topical cocaine pledgers are placed in the nose for approximately five minutes and then withdrawn. The turbinates are injected each with 2 cc of two percent xylocaine with 1:100,000 epinephrine. This allows some hydrodissection of the turbinate tissue from the turbinate bone and the added submucosal fluid protects against cautery bony necrosis (if the patient has a history of cardiac problems, plain two percent xylocaine is used). The needles are placed in the inferior one-half of the inferior turbinate approximately 2 mm into the turbinate tissue and a test dose of current is given to be sure the machine is working properly and that current is being delivered properly.

The Elmed Generator setting is approximately four. After the correct setting is established with a test dose, the needles are then inserted the full length of the turbinate submucosally in the inferior one-half of the inferior turbinate longitudinally. One to two second spurts of electrical current are used until visualblanching occurs. After blanching occurs, the probes are removed. The same procedure is performed on both sides and the patient is dismissed to return to work. The nose opens immediately and in many cases, the postoperative edema is not enough to completely obstruct the airway again.

Post-Op Care

The patient is allowed to blow both nostrils gently: Saline irrigation with one quarter teaspoon salt in a six ounce glass of water with an ear bulb syringe twice a day has been found to be very helpful in keeping crusting to a minimum. The patient returns to the office in two weeks when the final crust can be removed, provided the turbinates have not been too vigorously coagulated. Initially an approximately 3% postoperative bleeding rate was observed at a two to three week interval. This was easily stopped with cotton balls saturated with Afrin nose drops and external pressure applied. This was associated with too vigorous turbinate coagulation in all cases; therefore, it is strongly recommended that coagulation be discontinued immediately after blanching is observed.

Advantages of the Dennis Probe in the Treatment of Chronic Obstructive Turbinate Hypertrophy

It can be used in the office with local anesthesia
There is no intraoperative or postoperative pain
There is no packing necessary
The patient may return to work the same day
The high cost of hospitalization and anesthesia is avoided
The method is reliable
It gives precision tissue coagulation
It may be repeated in the office in ten minutes if necessary; however, the author has not found it necessary to date
The bayonet mount allows good visualization during surgery with precision handling
It is safe and effective in children with chronic obstructive turbinate hypertrophy and chronic rhinorrhea.

Nasal Valve Reconstruction

Drfisher on March 2, 2023

For those that have nasal valve obstruction or narrowing, a nasal valve reconstruction surgery may be necessary. A nasal valve reconstruction, completed by an ENT expert like Dr. Fisher, can have dramatic results and benefit your health.

Nasal valve collapse surgery is a nasal valve repair surgery focused on increasing air flow through the nasal cavity. This nasal valve repair can be a great solution for patients with nasal valve collapse or other health issues. If you’re considering any form of nasal valve surgery, contact Dr. Fisher today for a consultation!

Endoscopic Sinus and Polyp Surgery

Drfisher on March 2, 2023

An endoscopic sinus surgery or nasal polyps surgery is a common nasal procedure. A functional endoscopic sinus surgery, also known as a nasal polyps surgery, can provide dramatic results. Check out our endoscopic sinus surgery before and after testimonials. The endoscopic sinus surgery procedure, or simply the nose polyps surgery, is one form of nasal polyp removal surgery.

The surgery to remove polyps can have amazing results. Sinus polyp surgery can be very impactful on a patient’s life. The endoscopic sinus surgery recovery time is minimal. Nasal polyp surgery recovery is done at home and is minimally invasive normally.

If you’re considering polyp removal surgery, contact Dr. Fisher for a nasal polyp surgery consultation.

Septoplasty

Drfisher on February 28, 2023

The nasal septum is the partition that separates the right and left nasal cavities. The front part of this wall is made of cartilage. A thin, bony plate forms the back part. It is covered with a mucous membrane. This area can sometimes be malformed or become injured. When either of these problems is present, a deviated septum (one part of the nasal cavity is smaller than the other) may result. If the septum deviates into one or both nasal cavities it can cause breathing difficulty, block the normal flow of mucous from the sinuses when a person has a cold, and prevent proper drainage during a sinus infection. Deviated septum is relatively common but rarely causes complications. A septoplasty is a form of plastic surgery used to straighten the nasal septum.

A septoplasty can be performed under general anesthesia, in which the person is put to sleep for the procedure. It may also be done under local anesthesia, with numbing only of the area involved in the surgery. An incision is made in the front of the septum. The cartilage and bony structures beneath are exposed. Crooked portions of the septal bone and cartilage are then removed. To hold the straightened septum in place, small plastic sheets, splints, or packing may be used.

After surgery, the person is taken to the surgery recovery room until the anesthesia wears off. The nose may have packing in place. The person may be anxious at first, and feel he or she is not getting enough air. The individual will be instructed to breathe through his or her mouth. Medication will be available to decrease the discomfort and nausea. The person will be taken to the recovery room once the anesthesia has worn off. Often, the individual may go home the same day. An antibiotic may be given to prevent infections.

Balloon Sinus Dilation

Drfisher on February 28, 2023

What is Balloon Sinus Dilation?

Balloon sinus dilation is an in-office minimally invasive procedure designed to treat chronic or recurring sinusitis, a condition in the sinuses where inflammation obstructs the sinus opening, leading to mucous build-up. This often stagnant mucous which often leads to bacteria growth infection and further swelling.

In a balloon sinus dilation a small balloon is inserted into the affected area and inflated to dilate the treatment area, expanding the sinus opening and drainage pathways to restore sinus drainage.

The procedure is done in office and can be performed under local anesthesia. The length of the procedure is dependent on specific condition and anatomy for each individual. Patients can expect to spend between one and a half to two hours at the office. This time includes pre and post treatment examination.

In most cases, patients can resume normal activities immediately after treatment. However, Dr. Fisher may recommend refraining from very strenuous activities (such as heavy lifting) for a week after the treatment. Please contact our office so we may help you determine if balloon sinus dilation is the best fit for you.

What is in office balloon sinus dilation?

Balloon sinus dilation is a minimally invasive treatment for chronic or recurrent sinusitis. In a balloon sinus dilation procedure, your physician uses a small balloon to dilate or expand the sinus opening and drainage pathways to restore sinus drainage. Balloon sinus dilation can be performed in an office, under local anesthesia.

How does balloon sinus dilation work to treat chronic or recurrent sinusitis?

In chronic and recurrent sinusitis, blocked sinus drainage pathways can prevent effective drainage and healing. When first line medication therapies fail to resolve symptoms and inflammation, or patients experience multiple bouts of sinusitis, balloon sinus dilation may be an appropriate treatment option. The goal of balloon sinus dilation is to expand the sinus openings and drainage pathways in order to aid drainage and promote healing. After locating the treatment area and applying local anesthesia, your physician will place the small balloon, inflate the balloon to dilate the treatment area, and then deflate and remove the balloon.

How long does the balloon sinus dilation procedure take?

Procedure length is dependent on your specific condition and anatomy. You should expect to spend around one and a half to two hours at the office, to allow time for pretreatment preparation and post treatment examination. Consult your physician to better understand the details of your procedure.

What are the benefits of an in office balloon sinus dilation procedure?
Office based procedures performed under local anesthesia allow you to avoid the negative effects, costs or risks associated with general anesthesia.

Will the procedure require any anesthesia?

Balloon sinus dilation can be performed under local anesthesia, in an office. In certain circumstances, balloon sinus dilation may also be used in combination with modern sinus surgery tools. In these instances, it may be performed in an operating room, under general anesthesia.

How quickly after treatment can I return to normal activities?

Many patients can resume normal activities immediately. Your doctor may recommend you refrain from very strenuous activities (such as heavy lifting) for a week after the treatment.

Are there any potential risks and complications associated with balloon sinus dilation?

As with any medical intervention, potential risks and complications exist with balloon sinus dilation. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of balloon sinus dilation at consultation. Possible side effects include but are not limited to post-operative bleeding; pain and swelling; allergic reaction to anesthesia or other medications administered during the procedure; or infection. Your condition may not respond to this treatment.

Is balloon sinus dilation suitable for everyone?

Only your physician can tell you if balloon sinus dilation is a viable option to treat your sinusitis. Experience has shown that many patients with recurring or persistent sinusitis can be treated with balloon sinus dilation. For more information on balloon sinus dilation, or office based sinus treatments, visit www.SinusSurgeryOptions.com.

Sinus Facts

Sinus infection may be caused by anything that interferes with airflow into the sinuses and the drainage of mucous out of the sinuses.
Sinus infection may be caused by anything that interferes with airflow into the sinuses and the drainage of mucous out of the sinuses.
Sinus infection may be caused by anything that interferes with airflow into the sinuses and the drainage of mucous out of the sinuses.

Balloon Sinuplasty

Drfisher on January 25, 2023

What is Balloon Sinuplasty?

First, we should know what sinusitis is and what are the common symptoms of it.

Sinusitis is an inflammation of the sinus lining. If the sinus opening becomes swollen shut, normal mucus drainage may not occur, and this may lead to infection and inflammation of the sinuses. Common symptoms include: facial pain, pressure, congestion or fullness, difficulty breathing through the nose, discharge of yellow or green mucus from the nose, teeth pain, loss of the sense of smell or taste, headache, fatigue, sore throat, and bad breath.

Endoscopic Sinus Surgery (with Balloon Sinuplasty™ technology)

The technology utilizes a small, flexible, Sinus Balloon that is placed into the nose to reach the sinuses. The Sinus Balloon is gradually inflated to gently restructure the previously blocked sinus opening which helps to restore normal sinus drainage and function. There is minimal bleeding, and many patients have been able to return to normal activities within 24 hours. Clinical research has indicated that the Balloon Sinuplasty™ system is a safe and effective instrument in dilating blocked sinuses.

What is PROPEL®

Chronic Sinusitis: One of America’s Most Common Health Conditions

31 million people are afflicted with chronic sinusitis each year, making it one of the most common health conditions in the United States.

The sinuses are air-filled cavities located within the bones around the nose and eyes that allow for natural ventilation and drainage. In Chronic Sinusitis, the sinus linings become inflamed, blocking the natural drainage passageways and leading to chronic infections and nasal obstruction.

Patients with chronic sinusitis often suffer from debilitating symptoms such as facial pain or pressure, nasal congestion and difficulty breathing, discolored nasal discharge, loss of smell and taste, headache, fatigue and depression.

A Need to Improve Treatment Outcomes

Chronic sinusitis often requires a complex combination of surgical and medical treatments. When sinusitis does not respond to medications, surgery to enlarge the openings that drain the sinuses may be an option.

Each year, 500,000 patients undergo ethmoid sinus surgery to treat the condition. Although sinus surgery is effective, the majority of patients experience recurrent symptoms within the first year; as many as 25 percent then undergo revision surgery due to recurrent obstruction of the sinus cavity.

Chronic Sinusitis Patients Have A New Weapon – PROPEL®

The goal of surgical treatment for chronic sinusitis is to enlarge the inflamed or obstructed sinus passageways. Post-surgery check-ups are required to inspect the sinus cavities to monitor for inflammation and scarring and treat accordingly with surgery and/or oral steroids.

The dissolvable PROPEL Steroid-Releasing Implant is the first in a new category of products offering localized, controlled delivery of steroid directly to the sinus tissue to maintain the openings created in surgery.

Applying principles of coronary drug-eluting stents to sinusitis sufferers, the spring-like implants gradually deliver an advanced steroid with anti-inflammatory properties (mometasone furoate) directly to the sinus lining, then dissolve into the body following endoscopic sinus surgery. The result is improved surgical outcomes, reducing the need for additional surgical procedures and for systemic steroids, which can have serious side effects.

Three rigorous clinical trials have demonstrated that the implant is safe and maintains the results of sinus surgery by propping open the sinus cavities and decreasing post-operative scarring and inflammation. Reducing these factors is proven to improve long-term outcomes and to reduce the need for repeat surgery and oral steroids, which can have serious side effects. PROPEL is the only product used in sinus surgery to be supported by level 1-A evidence.

Sinus Facts

Sinus infection may be caused by anything that interferes with airflow into the sinuses and the drainage of mucous out of the sinuses.