Otolaryngology

MEDICAL TREATMENTS

Allergy Treatment 

Options include daily medical therapy - such as sprays, eye drops, and pills - and behavioral modifications and environmental controls. Allergy shots (immunotherapy) and sublingual immunotherapy are offered in collaboration with the allergists at UI Health.
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Aspirin Desensitization 

This is a treatment option for Aspirin-exacerbated Respiratory Disease, which requires having three specific conditions: nasal polyps, asthma, and sensitivity to aspirin/aspirin-containing medications or non-steroid anti-inflammatory drugs (NSAIDs). This is pursued for appropriate patients in collaboration with the UI Health Allergy Program. 
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Biologic Therapy (biologics)

These are newer medications, such as dupilumab (DUPIXENT®), that target specific components of the inflammatory pathway responsible for sinus infections (sinusitis). Biologics may be offered to appropriate patients in collaboration with the in collaboration with the UI Health Allergy Program.
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Nasal & Sinus Irrigations, Rinses 

Washes can be done with saltwater alone, in addition to steroid and antibiotic additives. High-volume and positive-pressure methods work the best. They have been demonstrated to be safe, beneficial, and well-tolerated, for the treatment of sinus infections (sinusitis).
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Systemic Antibiotics & Steroids

Often in oral form, antibiotics and steroids are initial treatments for chronic sinusitis (sinus infection), with surgery reserved for refractory cases. 
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SURGICAL TREATMENT

Cerebrospinal Fluid (CSF) Leak Repair

 Once it is confirmed that clear drainage from the nose is cerebrospinal fluid (CSF), it is important to determine the cause. In some cases, the underlying cause can be treated, and this is critical to optimize success. If surgical repair is indicated, the defect site can be repaired from either the brain side or nasal/sinus side. More recently, the repair has been performed from the nasal/sinus side, as this is done via a minimally invasive endoscopic approach that avoids any external incisions and significantly speeds up recovery time. The placement of a lumbar drain also may be used to resolve this issue. 
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Endoscopic Resection of Sinonasal Tumors & Skull Base Tumors

Endoscopic resection involves the use of telescopes and cameras through the nose to reach the tumor and remove it. This type of surgery is used to avoid external skin incisions to remove the tumor. The Skull Base Program at UI Health is dedicated to the use of minimally invasive procedures to treat sinonasal and skull base tumors. When you are seen, we may schedule you to undergo radiographic studies such as an MRI or CT scan. You may also be seen by other specialties, such as Neurosurgery, Ophthalmology, Endocrinology, Radiation Oncology, or Medical Oncology, for further workup of the tumor. Once we have the information we need, we will devise a treatment plan best suited to you.  
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Endoscopic Sinus Surgery

 Functional endoscopic sinus surgery is the use of telescopes and cameras through the nose to reach, open, and clear out the sinuses. Sometimes, it is beneficial to widen this opening to aid in the long-term function of the sinus, in addition to removing remove disease and secretions from the sinus. There are no external facial cuts in this type of surgery - no change in the external appearance of the face, faster recovery, and less pain. As a result, there is less morbidity associated with this type of surgery as compared to surgical approaches to the sinuses with external facial cuts.

In our practice, we emphasize the importance of postoperative care and long-term follow-up with ongoing endoscopic surveillance of the sinus and nasal cavities. In general, medical therapy with antibiotics and nasal saline irrigations, and sometimes oral steroids, are used in the postoperative period along with weekly or bi-weekly endoscopic surveillance and adjustment of medications as sinus inflammation resolves. Afterward, we follow patients with periodic nasal endoscopic exams. So, in addition to discussing the pros and cons of the treatment for your condition, we emphasize long-term follow-up for continued management of your chronic sinusitis.
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Image-Guided Surgery 

During image-guided surgery, a computer helps the surgeon known the precise location of his or her instruments within the sinuses in real-time. The patient's imaging (CT scan, MRI) is used by the computer to create a map of the patient's sinuses. This technology has the potential to make procedures safer and more complete. Our practice has image-guidance capabilities for all nasal and sinus procedures. 
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Orbital Decompression

 This surgery is performed to relieve swelling of the tissue in the orbit, creating bulging of the eyes, such as in thyroid eye disease. It creates more space by removing one or more of the bony walls surrounding the eye. It is typically recommended when symptoms of eye pain, eye irritation, or vision changes/loss become severe. The endoscopic approach does not involve cutting through the skin, as it is performed entirely through the nostrils, in contrast to the conventional open approach. Therefore, the endoscopic approach also avoids bruising and swelling associated with the conventional open approach. 
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Revision Sinus Surgery

For some patients, sinus surgery may not have achieved the desired results. There are many reasons that sinus surgery may not have been successful, including severe chronic sinusitis (sinus infection); development of scare tissue; inadequate tissue removal; and Inadequate sinus drainage. This type of surgery involves removing inflamed tissue that was left behind from the previous surgery, with the goal of opening all of the sinuses as wide as possible .
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Septoplasty and Functional Septorhinoplasty

Problems with nasal breathing may be due to anatomic obstruction of the nasal passages, such as a deviated septum. A septoplasty is a procedure that removes the deviated portion of the septum to improve nasal airway breathing.

In addition to the septum, the nasal skeleton is made up of nasal bones, upper lateral cartilages, and lower lateral cartilages. If any of these portions of the nasal skeleton are crooked or broken, they may obstruct the nasal passages and lead to complaints of nasal obstruction or difficulty breathing through the nose. A functional septorhinoplasty addresses the structure of the nasal skeleton to improve nasal breathing.
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Tear Duct Surgery

 The purpose of the surgery, endoscopic dacryocystorhinostomy (DCR), is to correct tearing caused by obstruction of the tear duct. The endoscopic approach leaves no scars on the face in contrast to conventional open DCR. In comparison to the conventional open approach, the endoscopic approach also allows concurrent addressing of intranasal issues that may lead to complications or failure, such as a deviated septum or enlarged middle turbinate. When you are seen, we may schedule you to undergo radiographic studies such as an MRI or CT scan. You may also be seen by other specialties, such as Neurosurgery, Ophthalmology, Endocrinology, Radiation Oncology, or Medical Oncology, for further workup of the tumor. Once we have the information we need, we will devise a treatment plan best suited to you.
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Turbinate Reduction

Turbinates are on each side of the nose and humidify the air as it moves through the nose. Turbinate reduction surgery can reduce their size, increasing the size of the nasal passageway and improving nasal breathing. The turbinates also can be enlarged (turbinate hypertrophy).
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