Recent blog posts – Alabama Nasal & Sinus Center
Balloon sinuplasty
I revisit balloon sinuplasty today because we are still getting a lot of questions about this technology and the role it plays in treatment of sino-nasal disease.
Studies show safety and efficacy of the balloon in opening sinuses. However, does a tool that is safe and effective mean it is necessary. More to the point, does this tool change the indications for surgery on the sinuses? Furthermore, is it the right tool for your case? The role of balloon catheter dilation for treatment of chronic rhinosinusitis was recently reviewed in an article in Otolaryngology – Head and Neck Surgery. The conclusion of the authors was that current evidence supporting the role of balloon sinuplasty for treatment of chronic rhinosinusitis is incomplete. Interestingly, the review of several studies found that sinus surgery cases done in the operating room have better quality of life outcomes and longer duration of effect than in-office sinus procedures. This seems to make some sense in that the surgeon can be more aggressive in the operating room, with the patient under general anesthesia, than she/he can in the office setting with only topical anesthetic. In addition, the in-office cases are likely patients with lower disease burden than those taken to the operating room and thus the magnitude of improvement is less. There are certainly many reasons for these findings, but at least it should be a word of caution for the patient and/or surgeon hoping to cure chronic sinus disease with a simple catheter passed into the sinus while the patient is awake in the office, ready to go back to work that afternoon.
… Last modified on Thursday, February 04, 2016
Thoughts on Thanksgiving.
Thanksgiving, man! Not a good day to be my pants.
–Kevin James
… Last modified on Tuesday, December 01, 2015
Sinusitis and Headaches
What is the most common symptom of a “sinus infection”? If you are like most people, you most likely think of sinus headache as a primary problem with sinus infection. Both sinusitis and headaches are very common problems. Because the sinuses are located in the front of the head, where most headaches occur, there is bound to be a lot of overlap between these two diagnoses.
… Last modified on Monday, August 31, 2015
Two Ears Are Better Than One….
Have you ever had a family member tell you that you need a hearing aid? Or that you need to get your hearing checked. Or, have you noticed that you can sleep through a thunderstorm while others around you are awakened. Well, our tendency is to blow off these signs as yet another reason not to attend the next family reunion – all those crazy folks, you know. However, it might be prudent to consider for a moment that you might have hearing loss (gasp!). One of the things I do here at Alabama Nasal and Sinus Center is take care of people with hearing loss. Husbands who cannot hear wives and play the TV way too loud and wives who have to constantly ask others to repeat themselves are the types of people I see commonly in my office. We are very fortunate to have two outstanding audiologists on our staff that we work with to rehabilitate patients with hearing loss. Together, the physician and audiologist can diagnose and treat the underlying cause of your hearing loss, if possible. The audiologist has further expertise in fitting, programming, and servicing hearing aids for those who need them. If you or a family member are experiencing hearing loss, you might be considering the use of hearing aid amplification
As hearing care professionals, we are often asked, “Do I need two hearing aids, or can I wear just one?” Wearing hearing instruments on both ears is often recommended and will provide advantages that only one hearing aid will not.
… Last modified on Wednesday, August 19, 2015
Rest
I just came back from a short trip to Sandestin, Florida for The Deep South Otolaryngology Meeting, where the ENT societies of Alabama, Mississippi, and Louisiana get together to discuss boogers and stuff related to ear, nose, and throat care. We had a great meeting, with lots of excellent speakers and lively discussion of relevant topics to those who practice otolaryngology.
The time away gave me a chance to contemplate life a little. I was able to bring my family along on the trip, so all of my time not spent in the meeting was spent with my wife and children either eating something tasty or playing in the Gulf of Mexico. The juxtaposition of professional development alongside really great family time serves as a window into one of life’s greatest challenges – the work time –family time balance. There is a tendency (for me) to feel guilty about attending meetings when my kids are waiting for me to take them to the beach or the arcade. Then, when I’m at the arcade, there is a temptation (for me, at least) to worry that maybe I should be networking more with colleagues or writing a paper or whatever. In both cases, I have learned that the secret to happiness and success in both arenas is presence. Don’t be in one place thinking of what you should be doing in another. Don’t be distracted by what happened at work or what you left hanging at work when your teenage daughter is talking to you about her day. Be present. Or, as Dr. Kevin Elko says, “Be where your feet are planted.” Be fully engaged wherever you are. People, especially your family, want your presence. They want your undivided attention. But, you have a lot of other responsibilities. True. Don’t we all. So, manage your life (notice, I did not say manage your time – we all have the same amount of time in the day and each of our days are numbered) in such a way that you have allotted time for work, family, faith, recreation, etc. Contrary to what the culture tells us, this type of positive, proactive life management begins with rest. The principle of Sabbath – deep abiding rest in the knowledge that God is in control and will provide all you need – is in view here. We work from our rest. We rest to clear our minds, let our souls catch up to our bodies, and prepare both for the next season. I encourage you to make Sabbath a regular part of your week and year. Make a plan and stick to it, but don’t be ruled by it – be flexible. Set goals and execute the plans to reach those goals. Prioritize those five fundamental areas of your life: faith, family, faculty (work and hobbies), fitness, and fun. I hope that challenges you and helps you a little.
… Last modified on Monday, June 22, 2015
Hey guys, did you miss me? Well, ready or not, here we go with the final installment of Sinusitis Guidelines. Also known as ansers to hot boiling questions (regarding sinusitis).
1. If I have acute bacterial rhinosinusitis (ABRS), do I have to take an antibiotic?
No, both watchful waiting and antibiotic therapy are proven ways to treat ABRS. Most people get better naturally, and antibiotics only slightly increase symptom relief (about 10 to 15 people must use antibiotics to get 1 more person better after 7 to 15 days).
… Last modified on Tuesday, June 09, 2015
I’m back, gang! Today, I present here, for your education and enlightenment, our summary of the clinical practice guidelines for adult sinusitis as it applies to the patient. The following will be in question/answer format.
1. What are the sinuses?Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows (a) air from the nose to enter the sinuses and (b) mucus made in the sinuses to drain into the nose.
2. What is sinusitis?
Sinusitis, also called rhinosinusitis, affects about 1 in 8 adults annually and generally occurs when viruses or bacteria infect the sinuses (often during a cold) and begin to multiply. Part of the body’s reaction to the infection causes the sinus lining to swell, blocking the channels that drain the sinuses. This causes mucus and pus to fill up the nose and sinus cavities.
3. How can I tell if I have acute sinusitis?
You have acute sinusitis when there has been up to 4 wk of cloudy or colored (not clear) drainage from the nose, plus one or both of the following: (a) a stuffy, congested, or blocked nose; (b) pain/ pressure/fullness in the face, head, or around the eyes.
4. How can I tell if my sinusitis is caused by viruses or bacteria?
Acute viral sinusitis is likely if you have been sick less than 10 days and are not getting worse. Acute bacterial sinusitis is likely when you do not improve at all within 10 days of getting sick or when you get worse within 10 days after beginning to get better.
5. Why is it important to tell if my sinusitis is caused by bacteria?Because sinusitis is treated differently according to cause, acute viral sinusitis does not benefit from antibiotics, but some patients with acute bacterial sinusitis may get better faster with an antibiotic.
6. How long will it take before I feel better?
Most patients with ABRS feel better within 7 days, and by 15 days about 90% are cured or improved.
7. Is there anything I can do for symptomatic relief?
There are several ways to relieve sinusitis symptoms that should be discussed with your doctor to decide which are best for you: a. Acetaminophen or ibuprofen can relieve pain and fever. b. Saline irrigations, or washing out the nose with salt water, can relieve symptoms and remove mucus that is hard to blow out. c. Nasal steroid sprays can reduce symptoms after 15 days of use, but the benefit is small (about 14 people must use them to get 1 person better), and side effects include headache, nasal itching, and nose bleeds.
d. Decongestants may help you breathe easier and can be taken as a nasal spray (for no more than 3 days in a row, to avoid worsening congestion) or dry mouth.
… Last modified on Tuesday, June 09, 2015
Hello, world! Did you miss me? Ready to talk Sinusitis again? Remember our last post was about definitions. Well, let’s continue that theme.
Viral rhinosinusitis: Acute rhinosinusitis that is caused by, or is presumed to be caused by, viral infection. A clinician should diagnose viral rhinosinusitis when;
• symptoms or signs of acute rhinosinusitis are present