Why the Advanced ENT & Allergy Sinus Center?

Sinusitis is the most common chronic medical condition in America today. This disorder of the upper airway affects over 30 million Americans and can lead to debilitating pain and a decline in the quality of life. The development of The Sinus Center grew out of the recognition that patients in our area, suffer from sinus and allergy problems more than most. A comprehensive approach is needed to tackle the complex problems we see daily. Our approach is state of the art, focusing on non-surgical and surgical solutions when necessary. Advances such as in-office CT scanning, packless sinus surgery, and minimally invasive procedures were first introduced to our community by Sinus Center physicians. Even today, our physicians continue on the leading edge of development through our nationally recognized research center – which brings innovation to our patients before it becomes available to the general public.

Today, the Sinus Center flourishes as the region’s leading center for patients suffering from sinusitis.

Did you know:

  • Recurrent Sinusitis is defined as four sinus infections in a year typically with periods of relief. Recurrent Sinusitis is different than Chronic Sinusitis. Chronic sinusitis is defined by symptoms lasting longer than 12 weeks.
  • Sinusitis is the most persistent medical condition affecting men and women of all ages.
  • The incidence of sinusitis has steadily increased over the last 15 years. The exact cause of this increase has not been determined, although many believe that pollution and other environmental problems may be contributing factors.
  • Those with chronic sinusitis report more pain, depression, and fatigue in their lives than do patients with angina, chronic heart failure, or back pain.

Services & Surgery

  • Sinus CT Scan Xoran MiniCAT™
  • Balloon Sinuplasty for the treatment for sinusitis
  • Endoscopic Sinus Surgery
  • Packless Sinus Surgery
  • Image Guided Sinus Surgery
  • SINUVA™ Sinus Implant – Treatment for Nasal Polyps
  • VIVAER® Non-Invasive Nasal Airway Remodeling

Sinus Surgery News

To avoid poking through to the brain or into the orbit of an eye, there’s a device around the patient’s head with a guidance system that tells the surgeon, in three dimensions, exactly where his sharp instruments are on a CT scan of the patient’s head.

Differences Between Sinusitis and Allergy Symptoms

It’s springtime and you have a stuffy nose, sinus pain, fatigue, and a reduced sense of smell and taste. You head to the local pharmacy for over-the-counter medication to treat your allergies. There is only one problem, these are the symptoms of a sinus infection, not allergies. Most allergy patients can’t tell the difference, according to a recent survey by the Asthma and Allergy Foundation of America.

Ultra fast, Point of Care CT Imaging for sinuses and ear canal (XORAN MINICAT)

We were the first private ENT practice in the country to become ICACTL accredited for our ultra fast, point of care CT Scanner Xoran MiniCat. We are the only ENT practice in the region that can offer your patients this new low dose radiation scanner.

What is MiniCAT™?

The Xoran MiniCAT™ is a compact, upright volume computed tomography system designed for high-resolution bone window imaging of the sinuses, temporal bones, and skull base. MiniCAT™ provides immediate access to images at the patient’s point-of-care, resulting in a faster diagnosis and treatment.

Patients will enjoy the convenience of ultra fast imaging, a faster diagnosis, and the ability to begin their treatment more quickly. MiniCAT™ has a lower radiation dose than conventional (full-body) CT, and affords your patients the comfort of sitting upright in an open design, minimizing claustrophobia. Immediate imaging allows your patient to visualize their anatomy and leads to better compliance with the recommended treatment protocol.

Plain X-rays (like a basic chest X-ray) are not used much anymore in the evaluation of the sinuses. The best image of the sinuses can be obtained with a CT (computer tomography) scan. CT scans allow the physician to examine the sinuses in detailed cross-sections.

The CT scanner resembles a large donut. Unlike getting an MRI, it is rare for patients to feel claustrophobic because they are not enclosed within the scanner. The scan is painless and takes less than 10 minutes. There are now miniature CT scanners in our offices. These are less intimidating in appearance and only take a few minutes to get a full sinus examination.

The interior of the sinuses, which often cannot be seen on endoscopy unless the patient has had prior surgery, can be viewed on the CT scan images. If desired the sinuses can be imaged in more than one angle to obtain images from the above, side, or front views. There are also office-based and operating room-based computers that can allow the reconstruction of additional planar views and even 3-D reconstructions which may allow for more detail and better surgical planning. These types of scans are often called navigational scans. They allow the CT scan images to be displayed during the surgery as a system that can track the location of the surgical tools inside the nose overlaid upon the x-ray images. These types of scans can be very useful for more difficult cases or in cases where prior surgery and scar tissue/disease may change the usual landmarks inside the nose. Our Kentucky and Indiana offices use Xoran scanning systems.

Balloon Sinuplasty™

Balloon Sinuplasty™ technology is an FDA-cleared, endoscopic, catheter-based system for patients suffering from sinusitis. The technology uses a small, flexible, Sinus Balloon Catheter to open up blocked sinus passageways, restoring normal sinus drainage and function. When the sinus balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.

1. Gain Access to the Sinus.

To gain initial sinus access, our sinus guide catheter is introduced into the nasal cavity to target the sinus ostia under endoscopic visualization. Our sinus guidewire or our sinus illumination system is introduced through the sinus guide catheter and gently advanced into the target sinus.

2. Inflate the Balloon Across Ostium.

The sinus balloon catheter is introduced over the sinus guidewire or sinus illumination system and positioned across the blocked ostium. The position of the sinus balloon catheter is confirmed and the balloon is gradually inflated to open and remodel the narrowed or blocked ostium.

3. Deflate and Remove the Balloon.

The sinus balloon catheter is then deflated and removed, leaving the ostium open allowing the return of sinus drainage. There is little to no disruption to the mucosal lining.

The Benefits in Using the Balloon Sinuplasty ™technology

Safe and Effective

While the use of any surgical instrument involves some risk, clinical studies have indicated the Balloon SinuplastyTM system to be safe and effective in relieving symptoms of sinusitis.

Minimally Invasive

The technology uses small, soft, flexible devices that enter entirely through the nostrils. These devices gently open blocked sinus openings, and in many cases, without tissue or bone removal.

Reduced Bleeding

Because in many instances no tissue or bone is removed when using this technology, there may be reduced bleeding associated with the procedure. As a result, the need for uncomfortable nasal packing may also be eliminated.

Improved Recovery Time

While recovery time varies with each patient, many people can return to normal activities within 24 hours.

Does Not Limit Treatment Options

This technology is an endoscopic tool and may be used with other medical therapies or sinus surgery techniques. It does not limit future treatment options if you have a progressive disease.

Frequently Asked Questions

What is Sinusitis?

Sinusitis is an inflammation of the sinus lining. It is commonly caused by bacterial, viral, and / or microbial infections; as well as, structural issues such as blockage of the sinus opening (ostium). It may also be caused by allergic reactions or other responses to environmental agents. If the ostium becomes swollen shut, normal mucus drainage may not occur. This condition may lead to infection and inflammation of the sinuses.

What are my Sinuses?

The sinuses are holes in the skull between the facial bones. There are four large sinuses: two inside the cheekbones (the maxillary sinuses) and two above the eyes (the frontal sinuses). There are also smaller sinuses (ethmoidal and sphenoidal sinuses) located between the larger ones. The sinuses are lined with membranes that secrete antibody-containing mucus, which protects the respiratory passages from the onslaught of irritants in the air we breathe.

How do I get Sinusitis?

Most sinusitis is caused by infection (such as a cold or an upper respiratory tract infection) spreading to the sinuses from the nose along the narrow passages that drain mucus from the sinuses into the nose. Allergies to dust, pollen, pet dander, indoor air pollutants, such as cigarette smoke, rug shampoo and formaldehyde (used in the manufacture of carpeting, particle board and plywood); and outdoor pollutants all can induce inflammation. Excessive dryness in homes, offices and commercial airlines from dry-air heating and air-conditioning systems can also inflame the sinuses. Immunologic, as well as structural problems, such as narrow drainage passages, nasal obstruction (tumors, polyps or a deviated septum) are other possible causes of sinusitis.

Many patient with chronic sinus symptoms mistakenly believe they are suffering from recurring viral colds, allergies or even migraine headaches when, in fact, they have a condition that may be successfully treated with antibiotics or surgery.

  • Recurrent sinusitis defined as four sinus infections in a year, is the most persistent medical condition affecting American men and women of all ages, city dwellers and farm residents
  • The incidence of sinusitis has steadily increased over the last 15 years. The exact cause of this increase has not been determine, although many believe that pollution and other environmental problems may be contributing factors.
  • Those with chronic sinusitis report more pain, depression and fatigue in their lives than do patients with angina, chronic heart failure or back pain.

What are the common symptoms of sinusitis?

Common symptoms for Chronic Sinusitis include:

  • Nasal congestion or blockage
  • Discharge of discolored mucus from the nose
  • Discolored post-nasal drainage
  • A dull ache or pressure across the midface, especially between or deep into the eyes
  • A headache that occurs daily for weeks at a time, and is often notably worse in the morning and/or with head movement

Less common symptoms of Sinusitis include:

  • sore throat
  • snoring
  • bad breath
  • chronic throat clearing
  • puffy eyes
  • coughing
  • stuffy ears
  • fatigue, irritability and depression
  • a chronic cold
  • asthma
  • bronchitis

What types of doctors treat sinusitis?

Many types of doctors treat sinusitis, including general and family practice physicians, pediatricians, and allergists. However, if a patient has chronic sinusitis or does not respond to medical treatment, he or she may be referred to a specialist – an Ear, Nose, and Throat (ENT) physician, or otolaryngologist.

How is sinusitis treated?

Two approaches have emerged for treating sinusitis patients:

  • Medical Therapies
  • Endoscopic surgical interventions

Sinusitis is treated initially with medical therapies. Usually, antibiotics or topical nasal steroid sprays are given to reduce mucosal swelling, fight infection, and relieve obstruction at the sinus opening (ostium). Identifying and treating allergies may also help.

These therapies are often effective in reducing sinusitis symptoms. However, for many other patients, these medications are inadequate and sinus surgery may be the next step in finding relief.

Surgery may be indicated for those patients whose symptoms and ostial obstruction persist despite medical therapy. With the advent of FESS (Functional Endoscopic Sinus Surgery), sinus surgery has evolved from open and invasive procedures to less invasive surgical techniques. Along with this evolution, many endoscopic tools have been developed to further assist and help improve FESS techniques. These tools include an array of devices such as the microdebrider and the sinus balloon catheter.

What is "Balloon Sinuplasty™" and Functional Endoscopic Sinus Surgery (FESS)?

The words, “Balloon Sinuplasty™,” when used together, describe the use of a sinus balloon catheter to surgically open the sinus ostia during a FESS procedure. FESS is a minimally invasive surgical procedure to open up air cells and sinus ostia (openings) in patients suffering from chronic sinusitis. FESS involves the insertion of an endoscope into the nose for a direct visual examination of the openings into the sinuses. Using the endoscope and a combination of surgical tools, e.g., curettes, forceps, powered micro-debriders, powered shavers, and / or sinus balloon catheters, surgeons enlarge the patient’s sinus openings to clear passageways in order to restore normal sinus ventilation and drainage.

Endoscopic Sinus Surgery

Endoscopic Sinus Surgery is a procedure used to remove blockages in the sinuses (the space filled with air in some of the bones of the face). These blockages cause sinusitis, a condition in which the sinuses swell and become clogged, causing pain and impaired breathing.

A thin instrument called an endoscope is inserted into the nose, and the doctor views the image on the screen. Much like a telescope with a wide-angle camera lens, the endoscope beams light into different parts of the nose and sinuses, allowing the doctor to see what is causing blockages. Surgical instruments can then be used along with the endoscope to remove the blockages and improve breathing. The surgery is performed entirely through the nostrils with no cutting involved. Therefore, most people can go home the same day.

The procedure can:

  • Relieve nasal blockages
  • Improve breathing
  • Improve the sense of smell and taste
  • Relieve facial pain

The procedure is an effective procedure for:

  • Sinusitis
  • Deviated Septum
  • Polyps
  • Tumors

Packless Sinus Surgery

If you have heard horror stories about sinus surgery they have most likely been due to the intolerable pressure from packing and it’s unpleasant removal. If you talk to patients of The Sinus Center they tell a very different story. Almost all sinus surgery performed by physicians of The Sinus Center is done without packing – “Sinus Surgery”. If any packing is used, it is limited and dissolvable.

Before the mid-1980’s sinus operations were, in fact, very difficult to endure. Many required significant incisions, traumatic tissue manipulation, and very unpleasant nasal packing. Continual advances and improved surgical equipment have made the surgery faster, less traumatic, and produce less blood loss – all of which make the operation easier to tolerate. In addition, advances from our Anesthesia colleagues provide sedation that is easier to recover from.

Image Guided Sinus Surgery

Imagine driving to a familiar destination only someone has removed all the landmarks and street signs you normally rely on. Until recently, ear, nose, and throat surgeons performing endoscopic sinus surgery have faced a similar scenario – navigating the difficult maze of the sinuses with little to guide them except a limited view through an endoscope, knowledge of anatomical landmarks, and general experience. Having well-trained, experienced sinus surgeons using the latest technological advances available helps to minimize recovery and the need for repeat operations.

Approximately 30 percent of patients have recurrent sinus disease. Once you have operated on these patients, you have essentially removed the anatomic landmarks, making subsequent surgery a bit more difficult. Image Image-guided sinus Surgery eliminates that problem. The Sinus Center was one of the first in the region to use state-of-the-art computer systems designed to pinpoint surgical accuracy and minimize sinus surgery complications. Image-guided sinus Surgery allows the physician to see the precise position of the surgical instrument and track his/her movements throughout the surgery. The image-guided system allows the doctor to visualize areas of the patient’s skull anatomy using 3-D computer animation which correlates with the views taken during the patient’s CT scans. The image-guided system is so accurate that a majority of leading medical schools are using the technique to teach future ENT surgeons.

VIVAER® Non-Invasive Nasal Airway Remodeling

Millions of people suffer from nasal airway obstruction, which limits airflow through the nose. Until now, your only options were medications or breathing strips that offer temporary relief and surgeries that are invasive, painful, and often have a long recovery period. Vivaer Airway Remodeling is a new, non-invasive treatment that can be performed in our office to help you breathe more easily.

Nasal Obstruction Causes

Narrowing of the nasal valve may be caused by an enlargement of any of three primary structures, decreasing the overall nasal airway area; the septum, lateral nasal wall, and inferior turbinates.

Nasal Airway Obstruction

The septum, lateral wall, and turbinates form a triangular area known as the Nasal Valve. If any of these tissues are enlarged or crooked, nasal airway size is reduced, causing lower airflow.

  • The septum is the narrow ridge of bone and tissue between the two nostrils that divides the nose in half.
  • The turbinates are fingers of tissue that direct and warm air as it enters the nasal cavity.
  • The lateral wall is the side tissue that forms the outer wall of the nose.

Nasal Obstruction Treatment

Nasal Airway Obstruction has traditionally been treated by ongoing home remedies or traditional nasal surgery. Today there is a third option: VIVAER® Non-Invasive Nasal Airway Remodeling.

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