Kris Lay, M.D. – Alabama Nasal & Sinus Center
“What’s up with the balloon, doc?” That is a question that Dr. Sillers and I hear several times a week. I have written blog posts about balloon sinuplasty previously, which can be found on the website. So, for the two people who read that blog (thanks mom and dad!) some of this material will be redundant. Today’s post is meant to further explain our position on balloon sinuplasty and answer the question whether or not balloon sinuplasty is right for you.
… Last modified on Tuesday, September 30, 2014
Health care is changing. That’s not news, but these changes are affecting physicians and patients on a daily basis. It has become increasingly important for patients to understand how their insurance works for them and what their responsibilities are related to deductibles. Many patient’s deductibles have increased so that their payment responsibilities at the point of service may be higher than the usual copays to which they are accustomed.
… Last modified on Tuesday, July 29, 2014
Today, I will continue discussion of one of the newest technologies introduced to the armamentarium of the sinus surgeon, balloon sinuplasty. A a reminder, the balloon sinus dilator is a tool that utilizes a small wire catheter that can be placed into a sinus opening and then the balloon attached to the catheter inflated to widen the sinus opening. Dr. Sillers and I were involved in the initial testing of this new technology in 2002. Dr. Sillers was much more instrumental than I, as he was the Chair of the Rhinology Division of the Department of Otolaryngology – Head and Neck Surgery at the University of Alabama – Birmingham at the time and I was but a lowly resident. Dr. Sillers gave me the opportunity to utilize the balloon on one of his first patients to undergo the balloon procedure, much to the chagrin of the research team from the company that made the balloon and was conducting the initial study. Seriously, you could feel the tension in the room skyrocket as Dr. Sillers handed me the instruments. Pencil leads were snapping like so many twigs in a windstorm. I’m quite certain that the data point that was that patient was likely excluded from the study, though the patient did very well. We have since treated numerous patients with chronic rhinosinusitis (“sinus” for those here in the South) both medically and surgically. Some of our surgical patients have been good candidates for use of the balloon. Most, however, do not need just a balloon, but more complete dissection of the paranasal sinus cavity, especially the ethmoid sinuses, which lie in the area between the eyes. The majority of chronic sinusitis patients have ethmoid sinus disease. The balloon is ineffective in this region. Balloon sinuplasty can only dilate the natural ostium of the maxillary, frontal, and sphenoid sinuses. For patients who have isolated disease in the aforementioned sinuses, balloon sinuplasty may be a good option. In a few select cases, the balloon may be used in conjunction with other instruments to open the sinuses. Currently, most of our balloon-worthy patients are treated in the office. This keeps costs down and is usually more convenient for the patient. In addition, some patients cannot undergo anesthesia and an in-office procedure done under topical/local anesthetic only is a great option.
… Last modified on Tuesday, May 20, 2014
If you listen to talk radio or read the advertisements in newspaper and other circular publications, you have likely heard about balloon sinuplasty. “That first breath of air through my nose.., etc.” Balloon sinusplasty is a relatively new tool, which can be used for surgical treatment of patients with chronic sinusitis. Long ago, (in a galaxy far, far, away) sinus surgery was done through open techniques, where incisions were made on the face or under the lip to expose the facial bones and then the sinus cavities. A great advance in sinus surgery came with the development of endoscopic surgical techniques. Commonly termed functional endoscopic sinus surgery (or FESS), the endoscopic approach relies upon in-depth knowledge of the nasal cavity and paranasal sinuses and illumination and visualization of these structures with small diameter endoscopes. The surgical technique is to remove a limited amount of tissue and bone to re-establish the natural outflow of the native sinuses. Standard FESS techniques were first developed in Europe and later took hold in the United States in the 1980’s. In addition to the endoscope, the sinus surgeon has a plethora of tools available to precisely and conservatively remove tissue that is diseased to allow the sinuses to drain as they should. In standard FESS, grasping and cutting instruments and even a microdebrider will be used to achieve the desired results. Over the years, as technique advanced, new instruments were developed to aid the surgeons in safely and effectively performing these types of surgeries. One such tool to arrive on the scene was the sinus balloon dilator.
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… Last modified on Thursday, March 06, 2014
One of the most anxiety producing events that may occur during a visit to the ENT is the nasal endoscopy or fiberoptic laryngoscopy. This is understandable. We are hard wired to avoid allowing foreign objects into our bodies, especially our noses. In addition, the endoscopy is done without general anesthesia -you are awake for this thing! I’m here to set your mind at ease. Nasal endoscopy and fiberoptic laryngoscopy are very important tools that we use to evaluate the head and neck anatomy of our patients. In office endoscopy is very safe and virtually no adverse effects or complications are ever encountered. In our office here at ANSC, we have a state of the art set-up with each room set up as an endoscopy suite. That means that you and/or your family/friends can watch on your own screen as the endoscopy is performed. I know some of you will not want to watch, and that is OK. Either way, the endoscopy is a great way to define anatomy, ensure accurate diagnosis, and educate patients and family. I am proud to say that I’m not asking you to do anything that I haven’t had done to me several times. If I can survive it, so can you!.
… Last modified on Thursday, December 05, 2013 Last modified on Friday, October 11, 2013
There is a lot of confusion out there these days regarding what foods to eat. Eat this, not that. Well, now that may cause cancer in small rodents if taken in excess, so careful eating THAT. What’s an omnivore to do? So many options turns into so many possible land mines. Well, I hope that I can ease you mind a little with this post.
… Last modified on Thursday, November 21, 2013
Well, sports fans, as we look forward to Fall Saturdays spent cheering for our favorite college football team, many of us will be facing the prospect of suffering the other days of the week with seasonal allergies. Yes, ragweed, pigweed, Goosefoot, Lamb’s quarter (yummy!), and Russian thistle (oh, my!) are filling the air this month. Symptoms of seasonal allergic rhinitis include sneezing, watery eyes, nasal congestion and runny nose. You may also experience headaches and blurred vision as a result of the onslaught of histamine, as your body reacts to the numerous unseen particles of pollen floating in the air or carried on clothing. All of these symptoms, in addition to hormonal changes triggered by the allergic response, make sleep difficult. The end result is a person walking around in a fog, with decreased productivity at work and diminished capacity for life at home.
… Last modified on Friday, October 04, 2013
A recent article in the International Forum of Allergy & Rhinology (Vol. 1, Issue3, pp.219-224) got me thinking about what really concerns the patient considering endoscopic sinus surgery. What struck me, as an Otolaryngologist (Ear, Nose, and Throat physician), is that what appears to worry patients is not always discussed with the patient before surgery. Typically, my pre-operative counseling discussion with a patient considering surgery reviews the risks of endoscopic sinus surgery, including, but not limited to, risk of orbital injury or blindness, cerebrospinal fluid leak, bleeding and infection. However, the data from the article cited above reveals that patients are most concerned about the wait time for surgery, followed by concerns about undergoing anesthesia, the problem not being fixed by the surgery, and pain and discomfort. Believe it or not, most patients will not raise these types of questions in the pre-operative interview. I encourage you, dear reader, to not be intimidated by the white coat. Go ahead and ask the doctor about that which worries you most. The only dumb question is the one you never ask.
… Last modified on Friday, October 04, 2013