Nasal and Sinus Center

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Sinusitis refers to inflammation of the lining of the sinus cavities. It is a common condition affecting more than 37 million Americans per year.

The sinuses are air-filled spaces in the bones of the face and skull. There are 4 sets of sinuses.

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The maxillary sinuses are located in the cheek region, frontal sinuses are found in the forehead, ethmoid sinuses are located between the eyes and sphenoid sinuses are deep behind the nose. The sinuses are lined with a mucous membrane which constantly secretes mucus. The mucus is continuously swept out of the sinuses through small drainage hole into the nasal passages by microscopic hairs called cilia lining the mucosa. The nasal passages are also lined with cilia that transmit mucus toward the back of the nose and into the throat to be swallowed. Sinusitis results from conditions that block the drainage of the sinus cavities and interfere with ciliary function. Thus, mucus accumulates in the nose and sinuses causing congestion and pressure and may become infected by bacteria.

These conditions include:

  • Upper respiratory infection (cold)
  • Allergies (hayfever, dry air, cigarette smoke, pollutants)
  • Obstruction in the nasal or sinus cavity (sinonasal polyps, septal deviation, sinonasal tumors)

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Symptoms and signs of sinusitis

  • Nasal stuffiness
  • Thick, often discolored mucus draining down the back of the throat or from the front of the nose
  • Facial pain or pressure, toothache and headache
  • Decreased sense of smell and taste
  • Cough
  • Ear pressure
  • Fever
  • Fatigue

Diagnosis should be confirmed with in-office nasal endoscopy and/or CT scan of the sinuses.

Our philosophy is to take a comprehensive disease management approach to treating sinusitis. The dry climate in the valley have resulted in a large number of individuals suffering from chronic sinusitis. We believe that the treatment for chronic sinusitis is primarily non-surgical and requires identification and treatment of underlying causes of continued sinus infection. Surgery does play a role in management of chronic sinusitis if medical therapy has failed to improve patient’s symptoms. Medical therapy is continued after the surgery to help prevent recurrence of symptoms.

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Medical treatment

Your nasal and sinus complaints will be carefully evaluated during your office visit. The latest technology and medical therapy will be used to diagnose and manage your nasal and sinus condition. Your visit will include a full ear, nose, throat, head and neck examination. If necessary, nasal endoscopy will be performed. Cultures are often obtained for chronic or resistant infections.

Your treatment regimen may include:

  • Oral antibiotics, oral or topical decongestants, oral or nasal steroids, mucolytics, and nasal saline irrigations, antihistamines, leukotriene modifiers and allergy immunotherapy.
  • In some cases of chronic or recurrent infection, minimally invasive endoscopic sinus surgery may be necessary to improve sinus drainage and resolve infection.
  • Endoscopic Sinus Surgery

Sinus surgery is recommended after appropriate medical therapy has failed to provide long-term control of inflammation and relief of symptoms. Historically, sinus surgeries required an incision under the upper lip or through the face to access the sinus cavities. With advances in technology, most sinus surgery now is accomplished through the nose, without external incisions.

Endoscopic sinus surgery is performed with the patient asleep (under general anesthesia). A pre-operative CT scan is obtained and used as a guide in surgery. In some cases, an image guidance system is used to navigate the sinuses during surgery. The surgeon uses an endoscope to visualize and magnify the nasal and sinus cavities. Using delicate endoscopic sinus instruments, the surgeon will open or dilate the sinus drainage pathways and remove diseased mucosa. Every attempt is made to preserve as much healthy tissue as possible, allowing sinuses to recover normal function.

The procedure generally takes one to three hours and most patients go home the same day. The procedure usually does not cause facial swelling or bruising and is not associated with severe post-operative sinus pain. Some bloody nasal drainage is common for several days after surgery.

Patients typically return to work within three to four days after surgery. Periodic office visits are necessary to examine and clean the sinus cavities to promote healing.

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Balloon Sinuplasty™

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Balloon Sinuplasty™ technology is an FDA-cleared, endoscopic, catheter-based system for patients suffering from sinusitis. This technology utilizes a small, flexible, sinus balloon catheter to open up blocked sinus passageways, restoring normal sinus drainage and function. When the balloon is inflated, it gently restructures and widens the walls of the passageway, while maintaining the integrity of the sinus lining.

Drs. Weingarten has been trained in this technique.

Steps in using Balloon Sinuplasty™

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  1. Using the Balloon Sinuplasty™ system, your physician gently places a sinus guide catheter and a flexible sinus guidewire through the nostril to access the target sinus.
  2. The sinus balloon catheter is advanced over the sinus guidewire and positioned across the blocked sinus drainage passageway. The balloon is gradually inflated to open the blockage.
  3. The Balloon Sinuplasty™ system is removed, leaving an open sinus passageway and restoring normal drainage and function.

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