Pearls Of Wisdom
April 05, 2019
Category: Sinus

When is Sinus Surgery Needed?

Have a sinus problem? You're not alone. Millions of people suffer from sinus problems. Sinus problems can negatively affect your quality ofsinus surgery life. Your Austin, TX, ENT Dr. Mark Brown may recommend sinus surgery if other therapies fail to relieve your symptoms. Great Hills ENT offers sinus surgical treatment options to the patients we serve. Read on to find out when sinus surgery is needed.

1. You have structural abnormalities.

Surgery may be an option if your Austin, TX, doctor has identified structural abnormalities of the nose or sinuses. Sinus surgery can correct structural abnormalities within the nose or sinuses that can lead to chronic sinusitis and breathing problems. Sinus surgery can be done with little discomfort. It is a short procedure that has few complications. General or local anesthesia will be administered so that you feel no pain during the procedure.

2. You have a stubborn sinus infection.

Sinusitis, also called sinus infection, is condition in which the cavities around the nasal passages become inflamed. Most sinus infections clear up on their own. Topical nasal steroids, saline sprays, and OTC medicines often bring relief. If you don't get relief from other treatments, your doctor may suggest surgery. The aim of sinus surgery is to open the pathways of the sinuses and clear blockages.

3. You have a fungal sinus infection.

Fungi can be found both in nature, in your home and work environment, and in the air. Sometimes when fungal debris or material is inhaled into the nose and lungs, it may cause a sinus infection. Symptoms are similar to a sinus infection — sinus pain, swelling, and congestion, discharge. Some people will require sinus surgery to clear the sinuses of the fungal infection.

4. Your sinus infection has spread to your bones.

Sinusitis can spread to the bone surrounding the sinuses. This infection can enter the blood vessels and send bacteria to the brain or other parts of the body. Infected bone is difficult to cure. Treatment is generally intravenous antibiotics. In some cases, sinus surgery is needed to correct the problem.

5. You've been diagnosed with nasal polyps.

Nasal polyps are painless benign growths on the lining of your sinuses or nasal passages. They result from chronic inflammation due to allergies, certain immune disorders, recurring infection, asthma, or drug sensitivity. If drug treatment doesn't shrink or eliminate your nasal polyps, you may need sinus surgery to remove the polyps and correct problems with your sinuses.

Sinus problems can affect your day-to-day activities and make life miserable. Get relief today with one of the top ear, nose, and throat doctors in Austin, TX Dr. Mark Brown. Call Great Hills ENT at (512) 258-2300 today to schedule an appointment! Our treatments will relieve your symptoms, so you can make the most of your life!

January 04, 2019
Category: Botox
Tags: botox  

Your facial appearance has changed, and you're not sure you like it. Crow's feet, those lines across your forehead--they distract from yourbotox lively personality and overall youthful attitude. What's the best way to enhance your looks without the expense and downtime of a face lift procedure? Explore what BOTOX can do for you. At Great Hills ENT in Austin, TX, Dr. Mark Brown uses BOTOX injectables to smooth those bothersome wrinkles so you look and feel refreshed.

What is BOTOX?

BOTOX injectables are highly purified, pharmaceutical-grade injections of the botulism toxin. Placed with a super-fine needle under the skin, BOTOX limits the movement of certain facial muscles. Without this movement, muscles relax, and wrinkles become less obvious. Lines caused by muscular movement are called dynamic wrinkles.

Dr. Mark Brown qualifies patients for BOTOX injections right in his Austin, TX, office. This evaluation includes:

  • Inspection of your skin and possible areas of treatment
  • A discussion of how you'd like your appearance to change (realistic goals are important)
  • An outline of the procedure, including therapeutic effects and side effects

BOTOX typically softens the look of forehead lines, crow's feet at the corners of the eyes, vertical lines between the eyebrows, and lines at the corners of the mouth. Additionally, many physicians use BOTOX to treat stubborn and frustrating problems such as migraine headaches, eyelid spasms, hyperhidrosis (excessive sweating), TMJ (jaw joint dysfunction), and more.

The treatment and aftercare

In general, BOTOX treatments take about 1/2 hour at Great Hills ENT. Patients describe feeling a mild stinging sensation with their injections, and afterward, they may see some mild redness and bruising

. However, patients resume their normal activities immediately.

Regarding facial changes, you'll see some mild smoothing right away, with full effects taking one to three days. Results typically last between three and six months.

Wanting a new look?

Look no further than Great Hills ENT and Dr. Mark Brown. Why not contact the office today to inquire about BOTOX treatments? You could become one of the millions of happy BOTOX patients. Phone (512) 258-2300 for an appointment in Austin, TX.

By Mark T. Brown, MD, FACS
October 09, 2018
Category: Botox

Cosmetic Botox: To Seek a Professional or an at Home Party?


    Wrinkles are more complicated than you may think. There are those that are transient, occurring when you raise your eyebrows or frown at your spouse. As soon as you relax they disappear. But over time, when the skin is moved and pleated repeatedly by muscle activity, those wrinkles become more permanent.


Is Botox Safe?Cosmetic Botox Austin, Cedar Park, Round Rock | Great Hills ENT


    Botox is remarkably safe and effective at relaxing facial muscles and preventing active wrinkles. You should also know that Botox helps prevent permanent wrinkles from getting started in the first place. If your skin is not put in a position to wrinkle to begin with, it stays smooth and young looking. Permanent furrows are not allowed to get started and facial skin retains its youthful appearance.


Is Botox for Men or Women?


    Younger looking skin is a positive for men and women personally and professionally. And Botox is a part of that effort in addition to cleansing and moisturizing with the right skin care products. The effects of this very short and surprisingly easy procedure last up to 3 months.


But a friend is having a Botox party at her house? Should I go?


    Believe it or not, it's not as simple as just putting a needle in your face. The muscles of the forehead, for example, are paper thin and it is imperitive that you hit the muscle correctly. Those around your eyebrow have different end points for each person. It is always preferred to have a professional with a background in facial plastics administer the drug.



    If you want to retain that youthful glow, let us know at Great Hills ENT.


TMJ: Temporomandibular Joint

The Real “Jaws”




Image result for no sharks allowed Image result for tmj


What is TMJ?


  The temporomandibular joint (TMJ) is a loose joint connecting the condyle of the mandible also known as your lower jaw to the temporal bone. Muscles of the mouth allow movement of this hinge joint so that the jaw can move in the upward, downward and side to side directions so that we can open and close our mouth for such tasks as but not limited to chewing/swallowing, speaking, laughing, talking, smiling, kissing and yawning ¹. Our facial expressions are attributed to the muscles of the jaw influencing the TMJ.


What causes TMJ Disorder?


  When dysfunction occurs at this joint, it can cause pain, limited jaw mobility or deviations, and even headaches. Disruption of the TMJ can be caused  by trauma whether do to poor dental work or a blow to the face, degenerative changes/arthritis, poor neck and jaw posture/alignment, excessive jaw use from bad habits of gum chewing and nail biting or the more common reason stress². Stress can lead to habitual grinding of teeth and clenching which affects the biomechanics of the jaw and muscle dysfunction due to overuse.


Signs and Symptoms of TMJ


   Some of the signs and symptoms associated with TMJ disorders include clicking and/or popping in the jaw upon opening and closing, difficulty biting or chewing, headaches/migraines, tinnitus, pain in the face including the jaw, behind the eye or front of ear, neck pain, dizziness and/or blurry vision ². Temporomandibular disorder can also cause limited jaw mobility upon opening accompanied with pain.


Related image


How is TMJ Disorder diagnosed?


  Upon noticing these signs and symptoms, going to your doctor or dentist, they can further assess the mechanics of your jaw while listening to the sounds when opening and closing, observe your jaw mobility and press on areas you might deem as sensitive. “If your doctor or dentist suspects a problem with your teeth, dental X-rays may be recommended. Also,  a CT scan can provide detailed images of the bones involved in the joint, and MRIs can reveal problems with the joint's disk ³.”


Who does TMJ Disorder affect?³³


  It has been estimated that about 75% of the general population has at least one sign of TMJ disorder ⁴. Roughly 33% have one symptom that causes them to seek medical help ⁴. The prevalence rate is higher among those 20-40 yrs of age and are 3x as likely to be affected among women than men ⁴. Also people with high anxiety or stressful environments, persons who undergo frequent dental work and/or spend an excessive amount of time on the computer all seem to be linked to higher risk factors for having TMJ disorder ⁴.


Who can treat TMJ Disorder?


  Various health care professional scan help with TMJ disorders including Dentist, Orthodontist, Ears Nose and Throat doctors, Physical Therapist, Psychologist and Chiropractors¹. Dentist and Orthodontist can typically  provide mouth guards for you to protect against bruxism (teeth grinding) and any noted stress on the joint ¹. Ear Nose and Throat doctors can prescribe pain medication/muscle relaxers as well as provide means of treatment for any ear related symptoms as a result of your TMJ disorder. Psychologist can help reduce the stress and reduce bad habits related to cause of poor posture and teeth grinding. Chiropractors can provide joint mobilizations of the neck and jaw to help with proper alignment. Physical Therapist can help reduce pain and improve alignment by assessing and treating the muscular imbalances causing malalignment of the jaw and any cervical related issues impacting poor posture and any impaired balance/dizziness associated with your TMJ disorder.


Is there a cure for TMJ Pain?


  Yes! Depending on the healthcare provider you seek, certain treatments will be rendered. Myofascial release and gentle stretching  of the tight muscles of the jaw and neck can significantly improve posture and decrease tension of the jaw and minimize inflammation. Electrical stimulation and other modalities such as heat can reduce inflammation. Certain exercises prescribed by either your Physical Therapist or Chiropractor may help restore tongue position and improve muscle strength for areas of the neck or jaw where muscle imbalances are causing dysfunction of normal TMJ mechanics. Joint mobilizations can also help with restoring proper alignment especially if you have decreased mobility in jaw either with opening or shifting to the side. Modifying your diet initially to softer fews can provide less stress on the jaw joint and reduce unnecessary clicking and popping. Also, eliminating parafunctional habits such as gum chewing, nail biting, jaw clenching can help decrease tension on the jaw and help lessen inflammation.




  1. Do You Have Jaw Pain? Read This. (2016, March 14). Retrieved from


  1. Mohl, N. Functional Anatomy of the Temporomandibular Joint. Chapter 1 The President’s Conference on the Examination, Diagnosis, and Management of Temporomandibular Disorders. Published by American Dental Association June 1-4, 1982


  1. TMJ disorders. (2017, August 16). Retrieved from


  1. Rugh, J., Solberg, W. Oral Health Status in the United States: Temporomandibular Disorders. Journal of Dental Education. Vol. 49 pgs 398-404, 1985

By Mark T. Brown
January 23, 2018
Category: Sinus


What are Nasal Polyps?

    Nobody wants to hear they have polyps in their nose. This is not your garden variety nasal issues. Most of the time caused by allergy, polyps are a chronic condition that is not often cured with surgery. Usually an allergist is going to provide the best long-term control. But there are times when surgery is needed, even repeatedly in the most extreme cases.

    Polyps grow in response to nasal inflammation. They are relatively discrete mounds of incredibly swollen nasal mucosa (lining). Most of the time it is something in the air that stimulates them to grow. At times, it is a sinus infection that provides the impetuous for their existence. No matter the cause, polyps are disruptive to nasal airflow and tend to cause secondary sinus infections.


Epidemiology and differential diagnosis of nasal polyps.

Chaaban MR, Walsh EM, Woodworth BA - Am J Rhinol Allergy (2013 Nov-Dec)


    Surgery is needed for polyps if medical management can’t keep them at bay and an allergist can’t help you control the environmental reaction that started them in the first place. It is by no means the first choice of treatment unless they are, sometimes quite literally, hanging out of your nose.


Adult-onset woakes' syndrome: report of a rare case.

Schoenenberger U, Tasman AJ - Case Rep Otolaryngol (2015)


The problem with surgery is it is not a permanent fix most of the time. Think about mowing the grass – it just keeps coming back.

    When someone has a significant enough polyp issue to require an ENT to take them to the OR, the surgery should be a part of the process. Combining surgery with aggressive medical management pre- and post-op is often the best way to keep you and your nose healthy.




Mark T. Brown, MD, FACS








Dr. Mark Brown is an Otolaryngologist (Ear, Nose and Throat) specialist at Great Hills ENT in Austin, TX who is double Board Certified in Otolaryngology and Sleep Medicine. Dr. Mark Brown, MD is the author of Smarter Sleep: Real Answers, Science Based Solutions, Healthier Sleep. Dr. Brown treats sinusitis, nasal congestion, nasal fractures, dizziness/vertigo, ear infections, tonsilitis, sleep apnea and insomnia for both adults and pediatrics. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, dizziness/vertigo and sleep disorders.


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