Posts for tag: Allergy
I may be correct in saying that nobody ever really WANTS to have surgery. It involves IVs, anesthesia, uncertainty, and it HURTS. That being said, surgery is often the solution to a medical problem that is not fixed by medication. Sinus surgery has changed tremendously over the last few decades. This blog is intended to dispel myths that often frighten people about it and/or cause them to postpone treatment and prolong suffering.
Sinusitis is inflammation of the sinuses-these are air filled cavities in the face-the exact purpose of which is unknown. However, we think the sinuses humidify the air we breathe, lighten the skull, and resonate the voice. That being said, they can fill with infection, lead to pain, drainage, fatigue, and infect surrounding structures. For acute sinusitis (less than 4 weeks), an antibiotic with a nasal steroid and sinus rinse will usually fix the problem. Occasionally, this doesn’t work and the infection becomes chronic (lasting 12 weeks or more). Often, a prolonged course of antibiotics (3 weeks!), nasal and oral steroids, and a sinus rinse will solve the problem. When this does not do the trick and we see evidence of persistent disease on a CT scan, we will recommend surgery. Obviously, this is an oversimplification-but-you get the point.
When surgery is the “next step,” we often hear the following questions/concerns:
Q: “MY (insert relative here) had sinus surgery 20 years ago and they PACKED his nose-He said it was the WORST thing in the world…do you pack the nose?”
A: No, we do not pack the nose. This is something that surgeons used to do quite frequently after surgery to prevent bleeding or scar tissue growth. Today, we have absorbable packing and ointments we can place in the nose to prevent bleeding, and our surgical techniques have changes to minimize risk of scarring
Q: “Do you SCRAPE the sinuses??”
A: No, we do not scrape the sinuses. The point of surgery is widen the opening where the sinuses naturally drain, and to avoid damage to the mucosa (tissue lining the sinuses) as much as possible. We can irrigate the sinuses and remove inflamed growths such as polyps. But, no scraping.
Q: “Will sinus surgery prevent me from ever having another sinus infection?”
A: Unfortunately, no. The purpose is to open the sinuses up and remove diseased tissue. You can still get sinus infections in the future, but we may treat them with “topical” antibiotics and steroids (in the sinus rinse) which will reach the cavities better because they are more open. Your risk of developing future problems depends on why you had this in the first place (severe allergies, polyps, fungus, etc.)
Q: “I had sinus surgery 10 years ago, and now I am having problems again. What are you going to do differently?”
A: You may have recurrent disease for a number of reasons; however, our goal in surgery is the same. Because you had surgery before, things may scar certain ways that predispose you to infection again-Often, we will use “image guidance” which is a new technology that helps us identify structures in the nose during surgery to ensure good drainage (and correct identification of infected areas).
Q: “Are you going to use balloons on me?”
A: Balloon sinuplasty is a new technology that uses a balloon to widen the natural opening of the sinuses. It can be a helpful tool in sinus surgery (especially the frontal sinus) or used alone. Not all doctors offer this procedure, and some patients are not good candidates for this technology, so this will need to be a discussion between you and your physician.
Michael Jackson really didn’t sing that one. But we do sing the Central Texas blues around the end of every year due to the clouds of “cedar” pollen billowing up from those trees. Ash Juniper, Cedar’s real name, is not a native Texas species. It was imported to provide wind breaks for the prairie houses of early settlers. Unfortunately for those of us who are allergic, those trees took off and now dominate the landscape in some places. Dense clouds of yellow Cedar pollen and millions of dollars of health care dollars are the result.
Treatment is usually an over-the-counter affair. Antihistamines, particularly the non-sedating ones like loratidine (Claritin®), cetirizine (Zyrtec®), and fexofenadine (Allegra®), are very effective. Anti-itch eye drops (ketotifin) are also available to can keep that symptom at bay. Don’t forget nasal saline irrigation. A Neti-Pot or sinus rinse system can go a long way in controlling your nasal symptoms. However, there are times when these meds are not enough and a trip to your doctor is in order.
At Great Hills ENT, we frequently see people in the throes of cedar agony. Treatments are available to stop the symptoms and the complications of severe allergy. Nasal steroids, nasal antihistamines, combo nasal sprays, prescription eye drops, and steroids are usually successful additions to your over-the-counter. We also partner with many allergists in town if testing and desensitization is on your agenda.
Make an appointment see us if Cedar is making your life miserable. We can help!
Mark T. Brown, MD, FACS
Dr. Mark Brown is an Otolaryngologist (Ear, Nose and Throat) specialist at Great Hills ENT in Austin, TX. Dr. Brown is Board Certified in both Otolaryngology, Head and Neck Surgery as well as Sleep Medicine. 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.