Practice Focus » Rhinology

Structural Support: Surgeons extol the cartilage stability provided by a new nasal implant

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.

Baseball Foul Tip Causing Frontal Sinus Fracture

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.

Another Option for Allergic Rhinitis?: Study examines long-term safety, efficacy of RF turbinoplasty

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.

Lingering Issues: Challenges remain in repairing CSF leaks

Once the province of neurosurgeons, cerebrospinal fluid (CSF) leak repair is now handled mostly by otolaryngologists. This change has occurred over the past couple of decades, during which time the evolution of endoscopic tools and techniques has made possible extracranial rather than intracranial repair. The success rate for repairing these leaks from below has reached about 90 percent, particularly for small leaks.

Old Problem, New Focus: Otolaryngologists tailor allergy treatments to geriatric patients

Allergic rhinitis among the elderly poses a particularly difficult diagnostic challenge for the otolaryngologist. As people age, they undergo immunosenescence. The thymus, which produces T cells against new invaders, atrophies markedly after adolescence, and this decline results in a less robust immune response to bacteria, viruses and presumably allergens (J Pathol. 2007;211(2):144-156). Consequently, physicians have assumed that allergies should decline as people age.

A Patient Experiment

Berrylin J. Ferguson, MD, FACS, FAAOA, associate professor of otolaryngology and director of the Division of Sino-Nasal Disorders and Allergy at the University of Pittsburgh School of Medicine in Pittsburgh, Pa., uses the following form to help determine which allergy treatments will work best for each patient.

Treating Allergic Rhinitis: A Patient Experiment

Berrylin J. Ferguson, MD, FACS, FAAOA, associate professor of otolaryngology and director of the Division of Sino-Nasal Disorders and Allergy at the University of Pittsburgh School of Medicine in Pittsburgh, Pa., uses the following form to help determine which allergy treatments will work best for each patient.