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Sinus Problems

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Sinus issues encompass a large spectrum of symptoms that can affect the patient’s quality of life and can lead to significant financial burden.   At Sonoran ENTA, we are able to appropriately diagnose distinct sinus and nasal issues for specific and appropriate therapies.   Therapies are broken down into medical and surgical.

What is Sinusitis?

Acute bacterial sinusitis is an infection of the sinus cavities caused by bacteria. It typically preceded by an upper respiratory infection/cold, allergy exacerbation, or by general environmental irritation. Typical treatment includes an antibiotic after appropriate diagnosis by an Otolaryngologist. With inflammation, the nose and sinuses become unable to drain appropriately. Symptoms can include purulent nasal drainage, nasal obstruction, and facial pain/pressure.  The sinus infection is likely bacterial if infection lasts longer than 10 days.  Chronic sinusitis occurs with symptoms and signs that persist longer than three months.  Symptoms may be less severe than acute sinusitis.

Sinusitis Treatments:

  • Antibiotic therapy – Diagnosis would preclude use of an appropriate antibiotic. Additionally, an oral or nasal spray or drop decongestant may help, though it is important to avoid long term OTC medication usage without physician supervision.

  • Surgery – Sometimes surgery is necessary with failure of medical therapy for chronic sinusitis. Surgical goal is to relieve obstruction of the sinuses and thus the infection. Functional endoscopic sinus surgery (FESS) is recommended for sinus disease, where a scope is used by the surgeon to inspect the nose, and appropriately remove diseased tissue (sometimes polyps). This typically requires a general anesthesia, though in office procedures are available will be made between you and your doctor, depending on your individual circumstances.

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General Tips for Preventing Chronic Sinusitis:

 

Whether you are dealing with an allergy exacerbation, cold or sinusitis, sinuses can be cleared initially: Using an oral decongestant or a short course of nasal spray decongestant

  • Hydration to maintain nasal thin discharge.

  • With flying, using a nasal spray decongestant before take-off and descent (one hour) to prevent blockage of the sinuses allows drainage.

  • With allergies, avoid contact with allergens that trigger attacks.  You may use over-the-counter or prescription antihistamines and/or a prescription nasal spray to control allergy attacks

  • Allergy testing, is important in diagnosis of underlying allergic rhinitis for appropriate allergy treatments

Medical Therapy:

Though there are a multitude of over-the-counter medications available today, the selection and combinations are not so obvious to sufferers.   There are appropriate situations for over the counter medications, though prescription medications can still come into play.

Consultation with the Otolaryngologists at Sonoran ENTA will demystify sinus therapy, and appropriate prescription therapy if indicated, including decongestants, antihistamines, nasal steroid/antihistamine sprays, antibiotics, steroids, etc.

Surgical Therapy and Procedures:

Surgery has the goal of opening and draining the sinuses or opening the nasal airway for improved nasal and sinus ventilation. There are multiple surgeries performed by the Otolaryngologists at Sonoran ENTA that are available in a wide range of invasiveness and recovery time.

In-Office CT scans

 

Our in office CT scans are convenient, fast, and utilized for surgery.

In-Office Procedures

    

  • ClariFix Cryotherapy  (Nasal Drainage) – Using cold treatment called ‘cryotherapy’, the ClariFix device reduces your runny, stuffy nose by interrupting the signals these out of balance nerves send. This process in non-invasive and patients will spend about an hour in the office. Most patients will notice an improvement in 2-6 weeks post treatment. 

    • Goes to the root of the problem: the inflamed nasal lining and underlying nerves

    • Delivers cold temperatures to the out of balance nerves in the back of the nose

    • Stops the source of the symptoms for lasting relief

  • Vivaer Procedure  (Nasal Congestion) - This is a procedure done in the office or used in combination with surgical procedures to treat the lateral nasal wall and soft tissue of the septum. This tool and procedure is less invasive than other modalities. Dr. Lara and Dr. Kang are the first Otolaryngologists in Tucson to offer this procedure and have the most experience performing. Click here to read more about this procedure and what you can expect before, during, and after.

  • The Celon Elite Method  (Nasal Congestion) - involves selective thermotherapy to reduce the size of the nasal turbinates. The mucous membrane on the surface of the nasal turbinate which is vital for filtering and purifying the air we breathe, remain intact. This minor procedure can be carried out under local anesthesia. From start to finish, the procedure takes no longer than 10-15 minutes and you can feel a marked difference after just a few days. To read more about the procedure and benefits, visit our Celon Elite by Olympus page. 

  • RELIEVA TRACT®  (Nasal Congestion) - A minimally‐invasive option for nasal obstruction The RELIEVA TRACT® Nasal Dilation System is an instrument intended to provide increased intranasal space to facilitate access for endonasal and transnasal procedures and/or temporarily address nasal obstruction by displacing the inferior turbinate and lower nasal septum

Operating Room Procedures

  • Septoplasty – This is the straightening of the septum (wall between the nostrils) to improve nasal airflow and ventilation to the sinuses.

  • Turbinate Reduction – Turbinates are folds of tissues on the inside side walls of the nose that may cause obstruction mechanically.   Turbinate reduction is performed multiple ways to the get the same goal of reduced turbinate size and therefore improved nasal airflow.

  • Functional Endoscopic Sinus Surgery (FESS) – Sinus surgery goals encompass opening and draining the sinuses (air filled cavities in the head) that may be the source of sinus infections chronically.

    1. Traditional FESS – This technique is utilized en face of chronic sinusitis that does not respond to medical therapy. This may include a small removal of tissue that is obstructive to the sinus cavity drainage sites, which may include polyps, swollen mucosa/tissue, or bone. Microdebriders are used to resect small amounts of tissue to open the sinuses.

    2. Stereotactic CT Guidance – This is a tool used in the operating room, that utilizes a CT scan (x-ray of the sinuses) and creates a map of the sinuses in 3D form for the surgeon to effectively have a “GPS” to follow for the intricacies of sinus surgery. This is used to avoid complications of damage to the brain, eyes, and blood vessels, and allows for a more complete sinus surgery.

Vivaer Airway Remodeling

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Have you experienced any of the following symptoms?

  • Trouble breathing through your nose

  • Nasal congestion or stuffiness

  • Nasal blockage or obstruction

  • Trouble sleeping

  • Inability to get enough air through your nose during exercise or exertion

 

Your quality of life may be impacted by a common problem. Nasal airway obstruction limits airflow through the nose. Millions of people suffer from this condition and you may be one of them if you regularly find it difficult to breathe. Until now, your only options were medications that offer temporary relief and invasive surgeries that are oftentimes more painful and have a long recovery period.

VIVAER, A New Option

The new VIVAER Nasal Airway Remodeling treatment is performed in the office setting and gently reshapes your nasal tissues to help you breathe more easily. By using a small hand-held device, your physician reshapes the tissues inside your nose to help improve airflow without any incisions.

Clinical study subjects who underwent the Vivaer non-invasive procedure for treating nasal airway obstruction reported the following results:

  • 92% of subjects improved their ability to breathe through their nose

  • 94% of subjects improved their ability to get enough air through their nose during exercise or exertion

  • 92% of subjects improved their sleep quality at night

  • 88% of subjects were satisfied overall with the treatment and would recommend it to friends and family

 

What to Expect: Before, During, & After Your VIVAER@ Nasal Airway Remodeling Procedure

Pre-Procedure:

Evaluation/Consultation

  • Your doctor will evaluate your symptoms of nasal airway obstruction by performing a modified Cottle maneuver

  • This is a simple approach where your doctor places a narrow instrument in your nose to gently lift the tissue in your nasal valve area. This simulates the changes that may be created by undergoing the Vivaer treatment. 

  • If the modified Cottle maneuver creates a significant improvement in your nasal breating, you will most likely benefit from the Vivael Nasal Airway Remodeling treatment.

 

Day of Procedure:

  • The treatment is performed under local anesthesia, giving you the option to drive yourself to and from your appointment.

  • We recommend arriving to the procedure with some food and fluids in your body. There is no need to restrict diet for this treatment.

 

Procedure:

  • Your doctor will first numb the inside of your nose with cotton balls soaked in topical anesthetic. After a few minutes, your doctor will remove the cotton balls and further numb your nose with a brief injection of local anesthetic. 

  • Next, your doctor will position the Vivaer stylus just inside the front part of your nasal passage. By pressing the stylus gently in place, the doctor starts a treatment cycle that last 18 seconds. The stylus stays in place for another 12 seconds as the treated tissue cools. 

  • The same steps are repeated, usually, in the three adjacent locations in the nasal passage. The procedure is repeated in the other nostril, and you’re finished. 

  • Since the procedure doesn’t require general anesthesia, you don’t need to get a ride to the office, and you can leave shortly after the procedure is complete.

 

Post-Procedure

During the first few days following your procedure you may experience some inflammation and tenderness at treatment site.

  • If you need to blow your nose, please so gently

  • Do not pinch or manipulate the treatment area

 

During the First 3 weeks following your procedure you may experience some congestion and crusting at treatment site. Your doctor may recommend using certain nasal sprays/rinses and applying ointments to the treated area. Please contact your doctor’s office with any additional questions.