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[MUSIC]
My name is Douglas Reh, I'm an endoscopic sinus surgeon.
I treat patients with chronic nasal and sinus issues.
Sinusitis and nasal complaints are one of
the most common complaints that patients have.
These patients are debilitated.
They have significant impediments of their quality of life.
They can't breath, they can't smell.
And it becomes A real burden to them.
Johns Hopkins offers a unique range of services offered by super-specialized,
fellowship-trained physicians, including rhinologists, allergists, endoscopic
sinus surgeons and facial plastic surgeons.
Patients with nasal and sinus issues, typically complain of or present with
symptoms that include obstructed nasal breathing, nasal congestion.
They often have reduced sense of smell,
they have nasal discharge and post nasal drip.
They may often have allergy symptoms, such
as frequent sneezing, itchy, watery eyes, itchy ears.
They can also complain intermittently of facial pressure and pain as well.
When I think about the causes of nasal and
sinus problems, I separate them into two main categories.
The first is anatomic, anatomic causes can range from deviated septum, enlarged nasal
turbinates nasal deformities such as twisted nose
or nasal collapse from previous tra, trauma.
The other causes are inflammatory.
Inflammatory causes can be caused by allergy or chronic inflammatory sinusitis.
Typical patient with sinus or nasal problems will
undergo a complete history and a focus physical exam.
Part of that physical exam involves a nasal
endoscopy which is a short, relatively painless procedure.
The patient is given a topical anesthetic
and decongestant, and then the physician uses a
small rigid endoscope to examine the nasal
passage in the areas of the sinus drainage.
The procedure lasts for about five minutes.
There is a myriad of available therapies for patients with
sinus and nasal problems, both over the counter and prescribed.
Sinus physicians such as myself typically prescribe
antihistamines such as oral and topical antihistamines
as well as anti inflammatory medications such
as nasal steroids We also often use therapeutic
nasal irrigations to allow for distribution of
topical medications as well as saline rinses, which
are quite homeopathic and seem to help
patients quite a lot with their nasal symptoms.
[MUSIC]
>> Sinus surgery is typically indicated
after a patient fails maximum medical therapy.
And that medical therapy may involve prolonged
use of antibiotics or oral or nasal antihistamines.
Some patients have specific anatomic issues that are amenable to surgery.
And so they, those patients will be
offered surgery Early on in the treatment process.
[MUSIC]
Sinuplasty is a procedure in which we, under endoscopic
visualization, insert a guide wire into an affected sinus.
A catheter with a balloon is then placed over the guide wire and inflated.
As a way of atraumatically enlarging the sinuses.
Sinuplasty is not indicated for all patients, but it
can be particularly helpful for patients with specific sinus issues.
It can also be done either in the operating room
or in the office for patients that meet those criteria.
[MUSIC]