Island ENT Key West
What is sinusitis and endoscopic sinus surgery? The sinuses are bony hollows in the head. When the lining of the nose and sinuses becomes swollen with allergies or infections, the sinuses can become obstructed. If they stay obstructed long enough, the mucus in the sinuses can become infected. When this occurs, patients typically experience facial pain in the distribution of the sinuses, as well as thickened, often yellow or green, nasal discharge, as well as nasal congestion.
CT scanning of the sinuses after medical management may be recommended for patients with chronic symptoms to allow documentation of chronic sinusitis. CT is also a valuable tool for planning when surgery is warranted.
Patients may require sinus surgery if all medical management has failed – typically endoscopic sinus surgery. With endoscopic surgery, the doctor can examine and make repairs to the nasal cavity through a nasal telescope, without external incisions.
Often regarded humorously, snoring can be a difficult problem – both for patients and their bed partners. It is the sound made by the soft palate and uvula during inhalation. It occurs during sleep because of the way the throat muscles relax. Although snoring does come from the mouth, it can be made worse with nasal obstruction as this limits inward airflow.
Patients are at risk if their oral cavity is small and crowded, if their uvula and palate are long, if they have large tonsils, or are obese. Depending on the amount of redundant tissue, the throat may actually close during sleep, rather than just reverberate with snoring. We call this obstructive sleep apnea. In obstructive sleep apnea, oxygen levels fall. This can lead to significant strain on the lungs and heart, and may generate heart arrhythmias.
Typically, during surgery for snoring and obstructive sleep apnea, any areas of nasal obstruction are corrected at the same time. In select patients, mandibular procedures may be included to increase the chance of surgical cure. Generally these procedures are well tolerated, but involve a sore throat that lasts for typically seven to 10 days after surgery.
Nodules within the thyroid gland are very frequent in the adult population. Some studies suggest up to 50 percent of the adult population have thyroid nodules. They are commonly benign but may represent thyroid cancers.
The risk of thyroid cancer is higher in the elderly, and is higher with a past history of radiation therapy. The larger the nodule, the higher the risk of cancer. Thyroid nodules may be identified during routine physical exams by general medical physicians, or may be identified by the patient during a shower or during shaving. When large enough they can also be sensed as a lump in the neck, especially noticeable during swallowing.
At Island ENT,, surgery of the thyroid and parathyroid glands Eye and Ear Infirmary is performed with an advanced recurrent laryngeal nerve monitoring system. This new technology allows real-time vocal cord monitoring to help in identification and preservation of this important nerve during thyroid surgery. The system may decrease the rate of vocal cord nerve injury and may reduce the incidence of voice and swallowing problems after thyroid surgery.
A complete head and neck exam is essential to view the entire upper airway and digestive tract. It is important to assess a history of smoking in a patient with a neck nodule. During the ENT office exam, the location of the nodule can often given a clue as to its identity. CT and MRI scanning and other imaging evaluation is sometimes necessary.
Fine needle aspiration and biopsy is an important test and usually provides a definitive diagnosis without surgery.
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