New Drug to Treat Nasal Polyps - Dupilumab (Dupixent)

Patients who suffer from nasal polyps suffer from significant nasal obstruction, smell loss, and congestion. This condition is not normally "curable" and requires medical management for long-term symptom control. Traditional treatment includes surgical removal , leukotriene inhibitor (ie, singulair ), intranasal steroids , allergy shots (if applicable), and oral steroids. In the majority of patients, this treatment management usually controls nasal polyp recurrence/growth such t…

7/18/2019 0

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Video of Nasal Packing for Severe Nosebleed Control

Although the vast majority of nosebleeds are more annoying than life-threatening, some are so severe that an ER visit is required. At other times, nosebleeds occur not unexpectedly after sinus surgery, rhinoplasty, or some other type of nasal surgery.  The video above demonstrates how such severe nosebleeds are typically controlled with nasal packing. This procedure is most commonly performed in the ER, operating room, or ENT office. Special shout-out to Nick Gallo of Physical Therapy 101…

7/04/2018 0

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Steps a Patient with Chronic Sinusitis Goes Thru

For the vast majority of patients with sinus infections , a trip to the primary care doctor's office and a prescription for antibiotics is all that is required. However, for the unfortunate few, several courses of oral antibiotics do not seem to help as much as it should. In such cases, these patients eventually end up at an ENT office for further evaluation and management. ASSUMING the patient has bona fide chronic or recurrent sinus infections and not some other medical problem conf…

12/08/2017 0

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Blood Thinner Use and Sino-Nasal Surgery (Septum and Sinus Surgery)

Cross-Section showing relationship of septum, sinus, eye, and brain There is an active abhorrence between blood thinner medications and ENT surgeons. Not only do blood thinners markedly increase risk of nosebleeds which often require nasal packing   (even without surgery), but it can complicate any type of sino-nasal surgery, particularly septoplasty and sinus surgery . With septoplasty or sinus surgery (collectively called sino-nasal surgery), not only is the nasal mucosa actively c…

7/04/2017 0

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When is Sinus Surgery Appropriate for Recurrent or Chronic Sinus Infections?

Normal CT Sinus Scan When a patient suffers from chronic or recurrent sinus infections , sinus surgery is an option to consider especially when medical management has failed. There are the obvious candidates where any reasonable ENT would agree sinus surgery is required, but as with much of medicine, there are times when a patient may get several diametrically opposite opinions whether sinus surgery is recommended or not. Such opposing recommendations at its core occur due to what a CT …

5/24/2017 0

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Local ENT Surgeon Missed Rare Sinus Pathology on CT Scan

Ditto in right maxillary sinus cavity. A well-respected ENT surgeon in Warrenton, VA created an uproar in the medical community when it was discovered that he failed to detect a rare sinus pathology on a CT sinus scan. This parasitic growth was easily discovered by the patient's teenage son within seconds of looking at the CT scan in spite of still being in high school. It's called a " Ditto " claimed John Smith, 14, son of the patient who suffered from this missed patho…

7/24/2016 0

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Big Bang Theory TV Star Kaley Cuoco Undergoes Sinus Surgery

On Dec 26, 2014, Kaley Cuoco of Big Bang Theory fame posted on instagram pictures of herself after undergoing sinus surgery . Apparently the need for sinus surgery was present for over one year. Given Kaley has been suffering from some kind of sinus problem for over one year, what could those possibly be? She may have suffered from recurrent sinus infections or even nasal polyps which would lead to persistent nasal congestion , sino-nasal pain/pressure, and/or need for repeated cours…

1/04/2015 0

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Dr. Chang Featured in Regional Newspaper Regarding Balloon Sinuplasty

Dr. Chang was recently featured inside a regional quarterly newspaper regarding balloon sinuplasty  in the treatment of chronic sinusitis . Sinus surgery  has come a long way compared to even just 5-10 years ago and great patient experiences after this type of surgery is not uncommon now. A few key features of  sinus surgery  of the 21st century that is provided at  Fauquier ENT  include: • Nasal packing rarely occurs • Most patients are surprised by how little pain there is •…

1/04/2013 0

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Guns n' Roses Rocker Duff McKagan Underwent Sinus Surgery

Duff McKagan , the bassist of Guns n' Roses, apparently underwent sinus surgery  back in December 2010. According to media reports , his sinus cavities developed significant scar tissue due to years of cocaine abuse. Sinus surgery due to scar tissue is a relatively rare indication for surgery, but required if they block sinus cavities leading to recurrent sinus infections. Cocaine abuse more typically causes other sino-nasal abnormalities especially septal perforation. Exactly w…

7/01/2012 0

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Northern Virginia Balloon Sinuplasty for Chronic Sinusitis

In the past month, local residents of Northern Virginia may have received a magazine newsletter from Prince William Hospital (Manassas, Virginia) that contained a feature story about sinus surgery and about balloon sinuplasty specifically. It was a great story about how far sinus surgery has come compared to even just 5-10 years ago and great patient experiences after this type of surgery is not uncommon now. A few key features of sinus surgery of the 21st century that is provid…

1/22/2012 0

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Nasonex Sinus Implant for Chronic Sinusitis

The FDA on August 15, 2011 approved of a novel dissolvable sinus implant that slowly releases mometasone furoate steroid (same active ingredient as Nasonex steroid nasal spray) directly onto the sinus mucosa. The spring-like implant is placed at the time of sinus surgery and automatically expands and conforms to the sinus cavity regardless of size and shape. The theory is that by continuously delivering a low dose steroid directly to the sinus cavity, sinus inflammation will decrease an…

8/30/2011 0

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"Sinus Lift" Procedure - The Return of Intra-Oral Sinus Surgery

I saw a patient today who informed me that she underwent a " sinus lift " procedure in the past. This statement made me realize that though ENTs are generally considered the sinus surgery experts, dentists and oral surgeons perform some sinus surgery as well like the "sinus lift" procedure. As far as I know, there is no ENT surgeon that does that specific sinus operation. In essence, the "sinus lift" procedure is when the floor of the maxillary (cheek) sinus c…

11/23/2010 0

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Recurrent Chronic Sinusitis Often Due to Allergies

A 2009 research paper lends credence that allergies may be a VERY important player in patients who suffer from recurrent sinus infections . Such patients will improve with antibiotics only to have their sinus infection symptoms recur shortly after completing the antibiotics. The research described how allergy exposure to patients resulted in a rapid and radiographically significant response of sinus disease including mucosal thickening and/or opacification. How fast? Within 60 MINUTES!!! …

12/24/2009 4

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