Does smoking prevent sinus surgery from making patients feel better? Over the years, evidence and expert opinion have varied on this topic. As a result, some surgeons refuse to provide endoscopic sinus surgery (ESS) for active smokers, while others will operate because they believe surgery improves quality of life.
Maintaining sinus patency after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS) has long been an issue; as many as 23 to 47 percent of patients require revision surgery after FESS. Now, a new drug-eluting, bioabsorbable stent manufactured by Intersect (Palo Alto, Calif.) is being billed as a “breakthrough treatment [that] improves outcomes for sinus surgery,” according to a news release from the company. The device, which received pre-market approval from the U.S. Food and Drug Administration (FDA) in August, has been studied since 2008. It is currently available in Texas, New York, Philadelphia, New Jersey, Atlanta, Ohio and Kentucky.
Oral appliances may work better than CPAP for some patients
Six years after balloon sinuplasty was introduced to the otolaryngology community, it remains an evolving technology. “In my opinion, balloon dilatation has great potential, but it’s still trying to find its proper place in the ENT arena,” said Ralph Metson, MD, clinical professor of otology and laryngology at Harvard Medical School and Massachusetts Eye and Ear Infirmary in Boston.
It is now well recognized that pathogens found in biofilms play a role in many mucosal-based otolaryngologic-related infections, but what that role is and how to prevent or treat biofilms remain unknown, concluded a panel of experts convened here on Sept. 17 at the 2011 American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting.
Medicare requirements for physician supervision of speech-language pathologists conducting videostroboscopy (CPT 31579) and nasopharyngoscopy (CPT 92511) will move from the strictest level of oversight back to no national supervision level starting in October.
For patients who undergo septoplasty to repair a crooked septum, reconnecting pieces of cartilage and stabilizing the cartilage during the healing process is critical to achieving straight alignment of the nasal septum. Stabilizing cartilage is particularly challenging for patients who require correction of severe septal deviations or severe post-traumatic deformities that are often both functional and cosmetic.
A 14-year-old boy sustained blunt trauma to the forehead from a foul-tipped baseball. Significant past medical history consisted of allergic rhinitis treated with over-the-counter cetirizine (Zyrtec). On examination, the patient had right frontal sinus depression with overlying edema. There were no palpable nasal bone or orbital rim abnormalities. Baseball threads were seen on the overlying skin as well as ecchymosis on the nasal dorsum and under both eyes.
Problems with the nasal valve that lead to difficulty with breathing can be tricky, in terms of both diagnosis and treatment, said a group of experts here at the Triological Society’s Combined Sections Meeting on Jan. 28.
When patients with allergic rhinitis don’t respond to medical therapy, an otolaryngologist’s arsenal of treatment includes surgical options. Among these is radiofrequency (RF) turbinate reduction, also known as RF turbinate ablation or turbinoplasty, an office procedure that advocates say is cost-effective and minimally invasive, with fewer complications than other surgical remedies. Some otolaryngologists, however, are still hesitant to use this relatively new therapy.