It’s all in your head

Dec 14, 2015 at 03:28 pm by steve

Scott Elledge, MD

New advances in treating sinus problems provide welcome relief to chronic sufferers

According to the CDC’s National Center for Health Statistics, over 28 million adults have been diagnosed with sinusitis, and in a year’s time, nearly eight million lost work days can be attributed to chronic sinusitis. So clearly, sinus problems make a huge impact on the day-to-day lives of Americans.

But recent advances in treatment and technology are helping to ease the discomfort associated with ailing sinuses, and physicians like Scott Elledge, MD of ENT Associates in Birmingham are combining the latest methods with tried-and-true treatments to give their patients relief.

“When you’re talking about sinusitis, you’re talking about problems with the nose,” Elledge said. “There are several things you do about these problems, some of them kind of new and some of them a little bit older, but they’re all coming together to make the management a lot more efficient and cost effective.”

Sinuses are often difficult to treat due to an almost gel-like goo called biofilm. Created by bacteria, biofilm’s consistency renders it nearly impervious to oral antibiotics, so medicating the underlying problem is difficult at best. But doctors have discovered that “washing” the sinuses clears away the goo and allows the medication do its job.

“There’s been a lot of new research about using irrigations where you take a bottle or atomizer of saline, mix in an antibiotic or a steroid and use it to get rid of the goo,” Elledge said. “You can also add anti-fungal products if you’re treating a fungal infection.”

Another helpful development is that instead of having to wait a few days or weeks for the bacteria collected on a swab to grow in a Petrie dish, labs can now take the swab and break down the proteins, thus giving them the ability to report back in a day or two.

“They give us a report on all kinds of things,” he said. “The turnaround time allows us to treat the patient quicker, as well as more accurately. It makes the efficiency of treating someone so much better.”

Elledge also finds an in-office CAT scanner that does a panoramic scan of the sinuses is helpful in decreasing turnaround time on diagnoses.

“We can get a scan that day, and by the end of the day, we’ve already got a really good plan from one office visit,” Elledge said. “It’s increasing our efficiency and keeping patients from having to come back for another office visit and pay another co-pay.”

Used in conjunction with an endoscope (old technology), the scan becomes an even more valuable tool for understanding the anatomy. But new technology helps even more.

“You can also put your disk of the CAT scan and put it into a surgical navigation machine, and it becomes a GPS for the sinuses,” Elledge said. “It’s like driving a car. You can get there, but it’s nice to have some navigation. It doesn’t take the place of the old technology, but it makes it better.”

In his practice, Elledge also makes frequent use of a lighted balloon sinuplasty device, a tool that can be used to open closed-off passages in the sinuses. The light helps guide the surgeon to the right place where the balloon device can then stretch the closed-off passage.

“We’ve been doing this procedure for years, but this tool changes how we do it,” he said. “It makes it easier to get into narrow places, and we’re finding that it leaves the tissue less inflamed compared to techniques in which we’d take an instrument and kind of bite away the tissue. It makes a nice, smooth opening.”

A final development concerns the turbinate, a spongy bone in the nose that stick down to the side of the nose when the sinuses become infected. A stent loaded with steroids is now available that can be inserted into the affected area. It is slid into the sinus, where it spreads the area open, and then slowly releases steroid into the tissue. It completely dissolves in 30 days

“People hardly ever notice it was there,” Elledge said. “We think that down the road, we’ll be able to load these things up with antibiotics or other drugs, slide them in, and they’ll slowly release the medicine. The technology is there. We’ve just got to keep expanding it to make it more useful.

I think we do a better job than we did five years ago taking care of people. We’re getting more accurate, and our patients are experiencing better results. This is an exciting time to be an ENT.”




January 2023

Jan 14, 2023 at 02:48 pm by kbarrettalley

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