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TUBES, TUBES, TUBES

Article source link https://theforumnews.com/article-3160-tubes-tubes-tubes_.html


A course of action for ear infections Why tubes in my kid’s ears? Well, for starters, antibiotics and other methods have failed to resolve the fluid behind the child’s eardrum. Therefore, most pediatricians are going to throw in the towel after three to four rounds of antibiotics, while your child is still sick with fever and pain, having trouble hearing, and you aren’t getting any sleep. So, how do you know when your child needs tubes? Nearly 500,000 sets of tubes are placed each year by ear, nose and throat specialists like me, for the above reasons. You may ask, why so many operations? Factors could include your child’s exposure to illnesses in a daycare setting, exposure to tobacco smoke, or even just nose, allergies, big tonsils and adenoids issues.

So, what’s the deal? The answer is the Eustachian tube; you know, that “thing” that pops when you’re on an airplane. For the above reasons, along with the anatomy of a little child’s Eustachian tube, it gets blocked from a swollen, infected, gross nose. It is the nose that causes the Eustachian tube not to work. What does the pediatrician do then? They prescribe antihistamines, decongestants, and antibiotics to the patient. If the fluid goes away, the problem is resolved, but sometimes the fluid can persist. After several rounds of the regimen, something else must be done! Thus, it’s time for tubes in your child’s ears. The fluid in your child’s ear is behind the eardrum. This fluid is removed microsurgically in the operating room with your child asleep. And, yes, anesthesia is safe, even for little children. The surgery begins in day surgery, where we sedate your child with oral medicine, no shot. I carry my babies to the operating room, where they go to sleep in my lap. If an IV is needed, it is placed after they are asleep. Then, using the operating microscope, a small 1/8 of an inch cut is made, the fluid is removed, and a tube inserted. So, what does the tube do? The tube lets air in and out of the middle ear. After placement, hearing returns. Fever, pain and late nights are relieved. My tubes usually stay in for one or two years, then they come out on their own, and the hole closes. So, if you’re tired of your child being in pain from an ear infection, ask your pediatrician about tubes. If you already have a regular ENT, great! If you do not, your pediatrician can refer you to one of us in Shreveport or Bossier. Remember, it is a safe procedure for your baby. Dr. J. William Parker Jr. is an ear, nose & throat / facial plastic and reconstructive surgery physician at Highland Clinic. He treats both children and adults and accepts most insurance plans. Dr. Parker specializes in disease and surgery in the area of the face, throat, sinuses and neck, with a specialty in chronic sinus patients. He now offers a new service known as Balloon Sinus Dilation. He is accepting new patients and can be reached at (318) 798-4565, located at 1455 East Bert Kouns Industrial Loop, Suite 207, Shreveport, LA 71105. Visit https://www.parkersinuscenter.com for more information.


DO YOU JUST SNORE, OR IS IT SLEEP APNEA?

Article source link https://theforumnews.com/article-3062-do-you-just-snore-or-is-it-sleep-apnea.html

Sleep study can determine course of action

Does your bed partner elbow you during the night to wake you up and tell you to turn over? Do you wake up after eight hours of sleep feeling as tired as when you went to bed? Is it just snoring that is your problem, or is your snoring so bad that you quit breathing? I’m asked this question in my ear, nose and throat practice almost every day.

The symptoms of sleep apnea, noted by many non-snoring bed partners, include the following: loud and frequent snoring, periods of no breathing, and choking or gasping sounds repeatedly throughout the night.

Twenty-five million people are diagnosed with obstructive sleep apnea every year. How many of you out there who snore have the symptoms but may not be diagnosed with OSA? The symptoms that patients notice are daytime sleepiness, fatigue and unrefreshing sleep. Others may have morning headaches.

The results of sleep apnea include high blood pressure, heart irregularities, heart attack, stroke, diabetes, chronic headache, congestive heart failure and depression. So, when I’m asked a question, “Is it just snoring, or is it sleep apnea?” this is my usual response. There is this spectrum of snoring. On one end of the spectrum, you have a social problem in bed at night with your snoring. On the other end, you have a patient who snores so badly that they have a medical problem: OSA.

So how in the world do you know where you stand in that spectrum of snoring patients? You get a sleep study. I order mine at Well Necessities on Line Avenue, as I have for over 30 years. While it sounds scary, it is not. It’s a friendly environment. Your blood pressure, pulse, EKG and oxygen saturation are measured while you sleep. Also measured are airflow and brain activity and leg jerks or movement. So, what now? If you have apnea, that’s where I come in.

My job as an ear, nose and throat specialist is to determine the level, or levels, and/ or areas where the obstruction to breathing occurs. It can be at one or all of three levels.

It can be in the nasal cavity or the oral cavity, or deeper in the throat. Anything that stops up the nose creates obstructed breathing at this level. For instance, allergies, polyps, deviations in the anatomy and swelling from sinus infection can all be the culprit. In the oral cavity, large tonsils and large tongue, long palate and long uvula are the usual offenders. Below the oral cavity is where the tongue hooks up with the throat. This is the overweight level. I then must determine which level(s) of obstruction each patient has.

When the sleep study shows sleep apnea, something must be done! Every patient has two options. One is to use a form of nasal CPAP, which stands for controlled positive air pressure. This treatment blows air through the nose, or nose and mouth, to keep the tissues from collapsing, thereby preventing the patient from having apnea periods. The second is to remove the obstruction or fix the obstruction surgically. While surgical results are usually effective, CPAP is 100 percent. When I operate on this type of patient, it’s after they have failed at the use of the CPAP.

Well Necessities obtains the equipment for you and will help you with any fitting or other issues you may have. I personally have friends that swore that they would never be able to wear the CPAP mask, but now swear by it. Wherever they travel, their CPAP equipment travels with them.

So, if you think you may have it, you must do something. See me. See your doctor. See someone who can order you a sleep study. It’s not scary. It’s not painful, and it may save your life. Get tested for OSA! Both you and your family will be glad you did.

Dr. J. William Parker, Jr., is an ear, nose & throat / facial plastic and reconstructive surgery physician at Highland Clinic. He treats both children and adults and accepts most insurance plans. Dr. Parker specializes in disease and surgery in the area of the face, throat, sinuses and neck, with a specialty in chronic sinus patients. He now offers a new service known as Balloon Sinus Dilation. He is accepting new patients and can be reached at (318) 798-4565, located at 1455 East Bert Kouns Industrial Loop, Suite 207, Shreveport, LA 71105. Visit http://www.parkersinuscenter.com for more information.


SINUS SURGERY

Article source link https://theforumnews.com/article-2927-sinus-surgery.html

New instrument reduces complications

“Picture if you will,” as Rod Serling would say. Driving the streets of downtown Shreveport, there are no street signs, no stop lights and no names on buildings! You are driving on a dark and confusing trip; but this time you are trying to navigate through your patient’s sinus passages, and obstacles mar your drive. The patient’s sinus roadmap has changed secondary to polyps, infection and deviations that you hadn’t planned for. Besides that, venturing too far over the edge could result in dire consequences.

Feeling your way is the only alternative. While searching this complicated and dangerous driving situation is unlikely to occur, sinus surgeons have been forced for years to navigate the sinuses using only their knowledge of the anatomy. Sinus surgery was once a complicated task for doctors who had to guide their instruments by feeling their way through the maze of hair chambers known as the sinuses. Now, there is a breakthrough in sinus surgery. The Fiagon, a new, computerguided instrument, provides surgeons with an inside view of the sinuses that makes surgery safer and reduces complications!

More than 30 million Americans suffer from sinus disease, experiencing symptoms such as facial pain, feeling of fullness in the face, difficulty breathing through the nose, persistent bad smell in the nose, postnasal discharge and headaches. How many of these sinus problems can be successfully treated with antibiotics? And about 5,000 sinus surgeries are still necessary each year. Doctors recommend sinus surgery for people who have an infection or inflammation that will not respond to treatment without antibiotics, nose spray and other pills to reduce inflammation. These patients return over and over with the above complaints. For many, sinus surgery using the Fiagon Surgical Navigation System allows a more accurate removal of disease tissues and less removal of normal tissue. This translates to more gentle operation for the patient. I can do this surgery on an outpatient basis without the necessity of long-term or short-term packing. Certainly, a more gentle sinus operation for my patients.

Christus Highland Medical Center and Parker Sinus Center have become the first health-care providers in the Ark-La-Tex to utilize a state-of-the-art computer system designed for pinpoint accuracy and minimal complications during sinus surgery. The Fiagon system allows the surgeon to see the exact position of his instruments and their movement in the sinuses on the computer video screen. Dr. J. William Parker Jr., MD FACS, brought the breakthrough technology to Highland in 2017. Fiagon Navigation System is now available for the entire ENT community.

Using the patient’s CT scan made prior to the procedure, the patient’s anatomy is calibrated as they are asleep in the operating room to an accuracy of .25 mm. The new Fiagon system produces a threedimensional computer model of the patient’s sinuses. The scans are a perfect match to the patient’s anatomy. In the operating room, the computer displays the video view from the endoscopic camera, as well as the axial sagittal and coronal CT views of the sinuses. Size and location of the doctor’s instruments in these areas are indicated by crosshairs on the screen to ensure accuracy. I tell my patients that it is like having a GPS in your sinuses during surgery. The system gives the surgeon confidence and a safety mechanism for difficult or revision cases. Many patients face the possibility of additional procedures no matter how well the preceding surgery was done, simply because of the nature of the ailment. I believe with difficult operations or revision operations you can lose your landmarks because of scar tissue or recurrent polyps. The Fiagon System is a momentous breakthrough for Shreveport-Bossier and surrounding Ark-La-Tex. “In many cases, sinus disease surrounds the eye and lies up against the brain,” says Dr. Bill Parker. “This system allows the surgeon to work more thoroughly and closer to the edge of the senses to remove as much of the diseased tissue as possible. Also, the Fiagon System reduces time for certain sinus procedures by as much as 25 percent.

This technology is becoming the gold standard for sinus surgery. It is being taught by leading medical schools to try and future ENT surgeons. “It’s the best way to have an operation on your sinuses,” says Parker.

Parker Sinus Center is located within the Highland Clinic.

Dr. J. William Parker Jr. is an ear, nose & throat / facial plastic and reconstructive surgery physician at Highland Clinic. He treats both children and adults and accepts most insurance plans. Dr. Parker specializes in disease and surgery in the area of the face, throat, sinuses and neck, with a specialty in chronic sinus patients. He now offers a new service known as Balloon Sinus Dilation. He is accepting new patients and can be reached at (318) 798-4565, located at 1455 East Bert Kouns Industrial Loop, Suite 207, Shreveport, LA 71105. Visit http://www.parkersinuscenter.com for more information.


ZZZZZing All Night Long

Snoring Can Indicate a Serious Condition

If you snore, it’s likely you are familiar with the nightly jabs in the ribs, grumbling from your bed partner, and maybe even separate bedrooms. Snoring happens when air cannot flow freely through the passage in your throat. As you probably know, the resulting rasps and rattles and disrupt the sleep of those around you. What you may not know, however, is that snoring can disrupt your own sleep and may be a sign of a serious condition called sleep apnea.

Signs and Signals

When a person has sleep apnea, the throat becomes blocked at night, stopping breathing for short periods of time. If you have sleep apnea, your partner may hear you alternate between snoring very loudly and being very quiet. You may not even gasp or snort in your sleep. Other symptoms of sleep apnea include

  • Waking up tired, even after a full night’s sleep,
  • Waking up with a headache,
  • Feeling very sleepy or falling asleep at inappropriate times (for instance, at work or while driving),
  • Irritability and short temperedness,
  • Problems with concentration or memory.

Nose problems make things worse and may even cause snoring or sleep apnea. If the dividing wall in your nose is crooked (a deviated septum) or if you have allergies or polyps, the airflow can be blocked and contribute to the obstruction.

Not only can sleep apnea leave you constantly tired, but it is also associated with health problems such as high blood pressure, heart attack, and stroke.

Your physician can help. Snoring and sleep apnea rarely go away on their own, but they are treatable. Your physician can evaluate you and recommend a treatment plan to help you sleep quietly and breathe freely. This plan may include changes that you make yourself, medical devices, or surgery that your physician prescribes.

Every Breath You Take

Breathing often seems like the easiest thing in the world. Most of the time, you don’t even think about it. However, if you have ever had a stuffy nose, you know the feeling of breathing through a very narrow passageway.

This constriction is what happens in your throat when you snore. While you sleep, structures in your throat partially block your air passage, making it narrow and hard to breathe through. If the entire passage becomes blocked and you can not breathe at all, you have sleep apnea.

When you breathe in, air passes through your nose and throat on its way to your lungs. Your nose warms, filters, and humidifies the air that goes to your lungs. The air travels past soft, flexible structures in the throat, such as the soft palate, uvula, tonsils, and tongue. The soft palate is the tissue at the back of the roof of your mouth. It helps block off your nose when you swallow. The uvula is the long flap of tissue that hangs from the soft palate. Tonsils are the balls of tissue that rest in the sides of your throat. The tongue helps you swallow, talk, and chew.

Simple Solutions

Whether or not your have sleep apnea, your snoring may get better by making a few simple changes in your sleeping habits. These changes may be all that is necessary to improve or even cure your snoring or sleep apnea. Some of these changes include

  • Not sleeping on your back (sleep on either side instead),
  • Avoiding alcohol and certain medication that may cause sedation,
  • Losing weight,
  • Exercising regularly, and
  • Unblocking your nose with either medicine or surgery.

Nose problems make things word and may even cause snoring or sleep apnea. If the dividing wall in your nose is crooked (a deviated septum) or if you have allergies or polyps, the airflow can be blocked and contribute to the obstruction.

So if snoring is a problem in your house, you should check with your physician. He or she may be able to help or refer you to a specialist to diagnose why you snore or if you have possibly have sleep apnea. Until then, have a good night’s sleep!

*This article first appeared in Vol. 2, Issue 6 of Highland Clinic Today

Sinus TV

The Highland Clinic and Christus Highland Medical Center have become the first health care provider in the Shreveport area to utilize a state-of-the-art Medtronic Fusion System that allows the surgeon to see the exact position of his instruments and their movements through the sinuses on a video screen.

The Highland Clinic and Christus Highland Medical Center have become the first health care provider in the Shreveport area to utilize a state-of-the-art Medtronic Fusion System that allows the surgeon to see the exact position of his instruments and their movements through the sinuses on a video screen.

The Medtronic Fusion System gives surgeons a picture-perfect view of the sinus.

Picture this scenario – you’re driving on a dark and winding road. You cannot see the road or any signs, but your map indicates that the path ahead is filled with twists and turns. Obstacles mar the road, and the lines have been rubbed away, due to years of use. Besides that, venturing too far over to the edge could result in some dire consequences. Feeling your way is the only alternative. While such a complicated and dangerous driving situation is unlikely to occur, sinus surgeons have been forced for years to navigate sinuses using only their knowledge of anatomy. Sinus surgery once was a complicated task for doctors who had to guide their instruments by feeling their way through he maze of air chambers known as the sinus. Now, a breakthrough in guided sinus surgery, the Medtronic Fusion System, provides surgeons with an inside view of the sinuses that makes surgery safer and reduces complications.

More than 30 million Americans suffer from sinus disease, experiencing symptoms such as facial pain or a feeling of fullness in the face, difficulty breathing through the nose, a persistent bad smell in the nose, post nasal discharge and headaches. While many of these sinus problems can be successfully treated with antibiotics or other medications, about 400,000 sinus surgeries are still necessary each year. Doctors recommend sinus surgery for people who have an infection or inflammation that will not respond to treatment with antibiotics or if the infection repeatedly returns after the course of antibiotics is completed. For many, endoscopic sinus surgery allows a more accurate removal of diseased tissues as well as less removal of normal tissues. Often, this surgery can be performed on an outpatient basis without the necessity of long-term nasal packing. After surgery, two or three follow-up visits are required.

The Highland Clinic and Christus Highland Medical Center have become the first health-care providers in the Shreveport area to utilize a state-of-the-art computer system designed for pinpoint accuracy and to minimize complications during sinus surgery. The Medtronic Fusion System allows the surgeon to see the exact position of his instruments and their movements through the sinuses on a video screen. Dr. J. William Parker, Jr., M.D., FACS, brought the breakthrough Medtronic Fusion technology to the Highland Clinic and Christus Highland Medical Center after exploring many different systems. He says that 97 percent of the ENTs in the worldwide market choose this system. “Surgical navigation has been used in other surgical disciplines for years. The technology has just now become available in the ENT community,” he explains.

January 18, 2001 was a landmark day for otolaryngologist Dr. Parker as he performed surgery using their new Medtronic Fusion System for the first time. Using CT scans made prior to the procedure plus a specialized headset placed on the patient, the new system produces a three-dimensional computerized model of the patient’s skull. The CT scans are positioned and synchronized to perfectly match the anatomy of each patient’s skull.

The Medtronic Fusion System is a momentous breakthrough. In many cases sinus disease surrounds the eye and lies up against the brain.
-Dr. J. William Parker

In the operating room, the computer surgeon displays four views for the surgeon – the video view from the endoscopic instrument actually in the skull as well as the axial, sagittal, and coronal views of the skull. The precise location of the doctor’s instruments in these areas is indicated by cross hairs on the screen to ensure accuracy. The endoscope performs as a miniature telescope to illuminate the surgeon’s view of the sinuses and provides a detailed view of the immediate surface area. “It’s like a GPS in your head,” explains Dr. Parker and adds that the system gives both the patient and the doctor confidence and a safety mechanism for difficult or revision cases. Many patients face the possibility of additional procedures no matter how well the preceding surgery was done, simply because of the nature of the ailments. “After the second time, you begin to lose your landmarks,” notes Parker, due to scar tissue and the condition of the sinus tissue.

The Medtronic Fusion System is a momentous breakthrough. “In many cases sinus disease surrounds the eye and lies up against the brain,” says Parker. “This system makes the surgery much safer.” The system allows the doctor to work more thoroughly and closer to the edge of the sinuses to remove as much as the diseased tissue as possible. Also, the system reduces time for certain sinus procedures by as much as 25 percent.

Although this new type of equipment is still considered optional, Parker feels that it will quickly become the gold standard. The majority of leading medical schools are using the technology to train future ENT surgeons. As training centers train residents to use this system, it will become more prevalent in sinus surgeries.

Parker notes that Medtronic Fusion increases precision. “It shows both my instrument and where it is in the sinus,” Parker says. “You can get lost in there if you can’t see anything. This is the best way to have an operation on your sinuses.”

For more information or to find out if you are a candidate for Medtronic Fusion, call (318) 798-4500.

*This article first appeared in Vol. 1, Issue 1 of Highland Clinic Today

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