A New York City ENT doctor deals with a variety of different conditions from performing sinus surgeries to diagnosing ear, nose & throat problems.
Posts tagged sinus infection surgery
Insomnia and Brain Communication Network Damage
6 years ago
It can be exhausting trying to fall asleep sometimes. No matter how much you try, insomnia can keep you awake during all hours of the night. While the condition may seem like a minor frustration, it could be an underlying sign of something worse. A recent study was performed by the Department of Medical Imaging, Guangdong No. 2 Provincial People’s Hospital, Guangzhou, China. The study found a link between insomnia and damage to the brain’s communications networks.
The Troubling Case of Insomnia
Insomnia is a sleep disorder, where patients often have trouble falling asleep or staying asleep throughout the night. Most often it is associated with daytime fatigue, mood disruptions and cognitive impairment. The condition can be a sign or symptom of several disorders, including depression, pain, or obstructive sleep apnea.
Damage to the Brain’s Communication Network
“Insomnia is a remarkably prevalent disorder,” said researcher Shumei Li, M.S., from the Department of Medical Imaging. He goes on to mention that it is difficult to nail down the key to what causes the disorder.
Looking for answers to this challenging question, Dr. Li’s team investigated the white matter tracts in insomnia patients. He said, “White matter tracts are bundles of axons—or long fibers of nerve cells—that connect one part of the brain to another. If white matter tracts are impaired, communication between brain regions is disrupted.”
Researchers tested 23 patients with insomnia and 30 healthy patients without the disorder, measuring mental status and sleep patterns. Using a MRI with a specialized technique called diffusion tensor imaging, the researchers were able to monitor the patients’ brains and the pattern of water movement along the white matter tracts. With the goal of identifying a loss of tract integrity, scientist found telling results.
Insomnia patients had considerably reduced integrity of the white matter in several right-brain regions and the thalamus when compared to the patients without the disorder. These areas of the brain control consciousness, sleep and alertness. “These impaired white matter tracts are mainly involved in the regulation of sleep and wakefulness, cognitive function and sensorimotor function,” Dr. Li said.
More research needs to be done to find a definitive relationship between insomnia and the brain’s functions. However, you may want to consult your physician if you are having trouble sleeping. Sleep apnea is common among millions of Americans and also one of the causes of insomnia. Your doctor might be able to help you find a solution before the problem becomes worse.
Azithromycin and Chronic Sinusitis
6 years ago
A new study shows treatment with long-term low-dose azithromycin in combination with the conventional therapy can reduce the recurrence rate of chronic sinusitis symptoms after functional endoscopic sinus surgery, but there was no sufficient evidence to support clinical significance of azithromycin at the investigated dose.
The aim of clinical trial was to evaluate the efficacy of long–term consumption of low–dose azithromycin after a successful endoscopic sinus surgery.
Chronic sinusitis is recognized as a common disease that imposes a huge burden on the healthcare system worldwide. About 37 million Americans suffer from at least one episode of sinusitis each year. Besides the burden on the healthcare system, there is a huge burden on the individual due to missed workdays and reduced productivity that the condition causes. This study is needed because when it comes to conventional therapies, other less invasive surgeries should be considered such as balloon sinuplasty.
Method of Research
Sixty-six patients were randomly divided into intervention and control groups. The subjects received the standard conventional treatment (fluticasone nasal spray plus normal saline solution irrigation) or the conventional treatment plus 250 mg of azithromycin on a daily basis for 3 months. Evaluation was made based on the 22-item Sino-Nasal Outcome Test (SNOT-22) immediately before surgery and 3 months after surgery.
Results
The intervention group showed a significant improvement in SNOT-22 scores after the treatment and a higher percentage change after 3 months of therapy compared to the control group. Also the researchers found a significant correlation between the percentage change of SNOT-22 scores and smoking in the placebo group.
Conclusion in relation to chronic sinusitis
Treatment with long-term low-dose azithromycin in combination with the conventional therapy could statistically reduce the recurrence rate of chronic sinusitis symptoms after functional endoscopic sinus surgery. However, more evidence is needed to support clinically significant conclusion of azithromycin at the investigated dose. Thus a larger scale trial and a longer follow-up period are warranted to evaluate the effectiveness of the therapy.
Take the Taste Test: To Aid in Sinusitis Surgery Treatment Selection
6 years ago
A new study proves that your taste buds may predict post-surgery results for sinusitis surgery patients, according to a Penn study.
Taste buds pickup what is called biomarkers, that is, the existence of a certain biological state or condition, such as bitter or salt. The researchers from Penn Medicine and the Monell Chemical Senses Center reported their findings in International Forum of Allergy & Rhinology.
It might sound strange but the team discovered that a genetic biomarker—the receptor for bitter taste—could better predict post-surgery results for patients who underwent surgery for chronic sinusitis. Remember that this seasonal-related condition afflicts around 37 million Americans each year. The condition reduces daily productivity in lost worktime, and is associated with a lower quality of life. In the US, sinus infections cost more than $13 billion in lost productivity each year.
The study found people sensitive to a certain bitter compound reported breathing more easily through their nose, having fewer subsequent infections, and sleeping with ease six months after surgery than those less sensitive to the bitter compound.
Bitter taste receptors are proteins that are found in taste cells of the tongue, where they protect against the ingestion of toxic plant and bacterial products. The collaborative Penn Medicine/Monell team had earlier identified these cells lining the passages of the nose and sinuses and contributing to the natural defenses against certain bacteria.
For the study, patients were asked to taste a specific bitter chemical and report their sensations. Those more sensitive to the bitter chemical than those who were not proved to better fight off certain types of respiratory infections. This specific genetic difference correlates to how much one group is able to combat infection following surgery. Thus, the study suggests those more sensitive to certain bitter tastes fight off upper respiratory infections better, and if they do get sick enough to require surgery, they improve more than people with less sensitive systems.
The researchers warn that there is still much research to do because of the diverse functions of taste receptors, but for now, once an easy test kit is produced, ENT specialists will be better able inform and chose a treatment for their patients.
This is welcome news for otolaryngologists who can correlate surgical outcomes to bitter taste tests in order to forecast postoperative complications and results, and thus choose the best sinusitis surgery options.
Citations
Other Penn authors are Douglas Farquhar; James N. Palmer, MD; David W. Kennedy, MD; Laurel Doghramji, RN; Shane A. Morris; David Owens; and Robert J. Lee, PhD.
Other authors are Corrine Mansfield, Anna Lysenko; Beverly J. Cowart PhD; and Danielle R. Reed, PhD, all from the Monell Chemical Senses Center in Philadelphia.
Can Sinus Surgery Improve Allergies, Asthma and Sinusitis?
7 years ago
A growing body of research has pointed to some common problems found among western societies: That allergies, asthma and chronic sinus problems are increasing. Although the research is not conclusive, some researchers suspect one main reason for these growing problems is the “hygiene hypothesis,” also called the “cleanliness hypothesis.” This theory states that a lack of early childhood exposure to infectious organisms such as those found in gut flora, probiotics or common parasites increases the chances of allergic diseases because the immune system is naturally suppressed. In other words, the immune system’s tolerance is weakened because it hasn’t been exposed to certain bacteria and parasites that it should have at an earlier age.
Some of the microorganisms that many allergy and asthma suffers have not adapted to are allergens. People who are not routinely exposed to some allergens can develop allergies, particularly as children. When they are later exposed to an allergen, the body misidentifies the foreign substance as dangerous and then reacts with hives or other allergy symptoms.
There are many detractors of this hypothesis. But did you know that allergies and asthma are uncommon in developing or underdeveloped countries yet are increasing in developed countries?
Furthermore on increased allergies, research has shown that severe allergies are connected to chronic sinus problems and asthma. The connection to all these conditions has to do with the inflammation in the airways, which is similar in the nose and sinuses or in the lungs.
What can we do to prevent these conditions from progressing or causing greater severity in the other conditions? There is growing evidence that early management of allergies or sinus inflammation can reduce the risk of developing asthma. Immunotherapy (allergy shots, or now sublingual drops or tablets) in allergic and asthma-prone children has been shown in a couple of studies to reduce developing asthma and reducing asthma attacks.
According to Dr. Michael S. Benninger, “Sinus surgery may also be preventative in some people.” In a recently presented paper at the American Rhinologic Society’s spring meeting, researchers suggested people who underwent sinus surgery had lowered the severity of and even prevented their asthma from occurring.
Other interesting results from the paper include:
- Allergy patients with chronic sinusitis were at a higher risk of developing asthma than those with no allergies.
- Early surgical treatment (less than two years after a sinusitis diagnosis) resulted in less long-term asthma than in those who had surgery later (four to five years after a sinusitis diagnosis).
Sinuses affect the lungs and vice versa. What may cause inflammation in the sinuses may do so also in the lungs, especially for those with allergies. For those with allergies and chronic sinusitis, keeping the sinuses under control helps the lungs, and keeping the lungs under control helps the sinuses. Aggressive treatment, whether with allergy immunotherapy or sinus surgery, may help reduce the risk of developing a worse airway disease, like asthma.
What all this means is that we might be recommending surgery and immunotherapy earlier in order to relieve later symptoms.
One final though before you slather your children’s hands in antimicrobial gel: sometimes a little dirt is good for a little while. Of course, this doesn’t mean they should wash their hands regularly; it means we don’t have to be overly cautious with a little dirt sometimes because it might reduce the development of asthma and severe sinus problems.
Endoscopic Sinus Surgery
8 years ago
Endoscopic Sinus Surgery: Good News for People With Chronic Sinusitis
Endoscopic sinus surgery is a minimally invasive procedure that offers new hope for sufferers of chronic sinusitis. Advancements are quickly being made when it comes to surgery, and endoscopic surgery, in particular, now boasts a number of benefits. In fact, the changes made in how sinus surgery is performed may allow many people who have chronic sinusitis find relief. The changes have certainly made this an exciting treatment option and the least invasive surgical procedure for the condition now available.
One of the benefits to this new method is it requires much less time to perform. Because of this, the amount of time a patient needs to be under anesthesia is also reduced. Moreover, the surgery can be mapped out prior to the operation, which also helps reduce time. The cumulative effect of these time-savings means there is no need to stay overnight at the hospital. In fact, patients are normally sent home a few hours post-surgery. Recovery is also very quick, adding to the overall appeal, and people are well enough to return to work within a few days.
The real breakthrough, however, is with the incision, or, more precisely, the lack of incision. Previously, surgery for this condition required a long incision on the face with the concurrent chance of scarring. The new procedure is done through the nasal passage so, cosmetically, the patient is unscathed.
Not only are surgery times shortened, and appearances greatly improved, but the accuracy is exceptional as well. Using the endoscopic probe means that a precise view of nasal passages and problem areas are readily available. ENT’s can treat the problem in a manner so meticulous that healthy tissue remains intact and untouched. This provides better overall results, making the treatment even more effective. One last benefit is that the pinpoint nature of endoscopic sinus surgery results in much less bruising and swelling, too. Thus, after the surgery, the patient will look as good as they now feel.
Information on Balloon Sinuplasty
8 years ago
There is a health condition that afflicts more Americans annually than common conditions like asthma and heart disease. It’s called a sinus infection, or sinusitis. Perhaps you have been plagued by this affliction. A person suffering from sinusitis will experience stuffiness, headaches, pain in the temples and cheeks, a colored nasal discharge, difficulty breathing through the nose and perhaps even a fever. These symptoms may persist. While the common prescription for sinusitis is an antibiotic, as many as one in five of those afflicted do not respond to the treatment and experience recurring sinus infections. What can be done?
A recurring sinus infection is called chronic sinusitis. It may be corrected with a surgery that is very minimally invasive. This surgery is called Balloon Sinuplasty. It uses balloon-like devices to gently alter the size and shape of the sinus cavities, thus providing relief from sinusitis symptoms and helping to prevent recurrence of the disease.
Balloon Sinuplasty involves the placement of an FDA approved catheter type devices into the sinus areas to keep them open. They are inflated gradually (hence the term balloon) and gently move the bones and tissue that would be removed in traditional sinus surgery. The open sinuses don’t retain as much material that can become infected and result in sinusitis. This is usually an outpatient surgery and is performed in less than one hour.
You ear, nose and throat doctor (otolaryngologist) can receive specialized training to learn how to perform such a surgery. It is vital for someone suffering from chronic sinusitis to see such a specialist. If antibiotics have not provided relief from your sinus infections, be sure to ask your doctor to recommend an otolaryngologist for you to see.