ear, nose & throat

Ear, Nose & Throat - Head & Neck Surgery

download patient documents

1. Skin Cancer Surgery of the Head & Neck
2. Endoscopic Sinus Surgery
3. Septoplasty
4. Ear Tubes
5. Tympanoplasty
6. Stapedectomy
7. Turbinate Reduction Surgery
8. Snoring
9. Sleep Apnea Surgery
10. Allergy Evaluation and Treatment

Ear Tubes

Placing tubes in the ears has become one of the most commonly performed operations in the United States. A tiny tube, with a collar on both ends, is slipped through a tiny incision in the eardrum. This pressure-equalization (PE) tube provides a temporary alternate avenue for equalization of pressure in the middle ear and to allow bacteria and fluid to drain out. This procedure is of great benefit to nearly all children and some adults who suffer from recurring ear infections, fluid retention or poor Eustachian tube function.

Tympanoplasty

The tympanic membrane, or ear drum, is made of tissue similar to thin skin. Perforations of the ear drum occur by infection or some type of trauma, such as a puncture by a cotton-tipped applicator, or a slap injury. Most heal spontaneously in much the same way a cut on an arm would heal. When a perforation persists, the middle ear is unprotected from the environment and vulnerable to infection. When a perforation is present, the ear canal must be kept dry. Repair of a perforation restores the protective barrier to the middle ear, and in most cases improves hearing.

Stapedectomy

Patients with otosclerosis and significant hearing loss are candidates for a stapedectomy. During a stapedectomy, an incision is made in the skin of the ear canal, the skin and eardrum are lifted to expose the stapes bone, and the stapes bone is removed. Through an incision above the ear, tissue is removed to be used to cover the opening created by the stapes bone removal. A prosthesis is placed where the stapes bone had been and the eardrum laid back in place.

Septoplasty

Septoplasty is an operation that corrects defects or deformities of the nasal septum, the wall between the two nostrils. The goal of the surgery is to straighten the septum and relieve obstructions or other problems related to septal deviation. Surgery is performed via the nostril hence no external incisions are necessary. Septoplasty is highly successful at improving a poor nasal airway and mouth-breathing, and often improves recurrent sinusitis and snoring

Turbinate Reduction Surgery

Turbinates are internal folds or corrugations on each side of the nasal vault. The nose is analogous to an air conditioning panel. Enlarged turbinates are often the cause of chronic nasal congestion. Even after the underlying problem is addressed, such as chronic infection or allergy, the enlargement may remain. There are varying ways to reduce turbinate size, from radiofrequency ablation done in the office under local anesthesia (no down time for the patient), to surgical reduction done in the operating room as an outpatient. Each treatment option has advantages and disadvantages. The best approach for each individual is discussed at the office visit.

Endoscopic Sinus Surgery

Endoscopic sinus surgery is used to increase the amount of air flowing through the sinuses and allow mucus to drain properly. The procedure can relieve nasal blockages, improve breathing, improve the sense of smell and taste and relieve facial pain. The endoscope, which utilizes fiberoptic technology, allows Dr. Snow to see inside the sinuses via the nostril, without incisions on the face, and makes it possible to see parts of the sinuses that were formerly difficult to reach.

Snoring

You may have been told that you snore by a partner, roommate, or other person who sleeps nearby. Snoring is very common and usually is not an indication of an underlying disorder.

Sometimes, however, snoring can be a sign of a serious sleep disorder called sleep apnea. This means you have periods when you are not breathing for more than 10 seconds while you sleep. Periods of "apnea" are indicated by a long silence following a pause in your snoring. Apnea ends with a sudden snort or gasp when breathing resumes. Then, snoring starts all over again. If you have sleep apnea, this cycle generally happens several times a night.

The major risk from this condition is stroke due to the multiple episodes when your brain is not getting enough oxygen. If sleep apnea is suspected, a sleep specialist can test you for it with a sleep study. In some people the cause of snoring remains unknown.

In some people snoring is caused by:

• Too much alcohol or sedation at bedtime (like sleeping pills or antihistamines)
• Nasal congestion from colds or allergies, especially if the congestion lasts a long time
• Enlarged adenoids and tonsils that block the airway
• Sleep apnea
• Being overweight, which leads to excessive neck tissue that puts pressure on the airway
• Last month of pregnancy

The following practices can reduce snoring:

• Lose weight if you are overweight.
• Cut down or eliminate alcohol and other sedatives at bedtime.
• Avoid sleeping flat on your back. Sleep on your side if possible. Sew a golf or tennis ball into the back of your night clothes, then, if you roll onto your back, you are reminded to stay on your side because of the discomfort. Eventually, sleeping on your side becomes a habit and you don't need to be reminded.

Sleep Apnea Surgery

For mild cases of obstructive sleep apnea, treatment often consists of methods to avoid sleeping on one's back. For people with significant nasal congestion, a decongestant therapy may be prescribed. Patients with apnea should avoid central nervous system depressants such as alcoholic beverages, sedatives and narcotics. Weight loss, diet control and physical activity are encouraged for overweight patients.

Many serious cases of obstructive sleep apnea can be relieved by continuous positive airway pressure (nasal CPAP). Nasal CPAP uses a mask-like device and pump to keep the airway open with air pressure during each inspiration. For those who cannot tolerate nasal CPAP, surgical options include Uvulopalatopharyngoplasty (UPPP), surgical shortening of a drooping soft palate, tonsillectomy and elimination of lax excess tissue from the throat. If this does not "cure" the problem, then procedures to move the tongue forward such as genioglossis advancement or maxillomandibular osteotomy can be done. Some doctors also believe that radiofrequency ablation of the tongue base can help. So far laser surgery of the palate has not been shown to help significant sleep apnea.

Skin Cancer Surgery of the Head & Neck

The two most common kinds of skin cancer are basal cell carcinoma and squamous cell carcinoma. Basal cell carcinoma accounts for more than 90 percent of all skin cancers in the United States. It is slow-growing and seldom spreads to other parts of the body. Squamous cell carcinoma spreads infrequently, but it does so more often than basal cell carcinoma. It is important that skin cancers be found and treated early because they can invade and destroy nearby tissue and structures.

Basal cell carcinoma and squamous cell carcinoma are sometimes called nonmelanoma skin cancer. Another type of cancer that occurs in the skin is melanoma, which begins in the melanocytes.

Most head and neck cancers begin in the squamous cells that line the structures found in the head and neck. Because of this, head and neck cancers are often referred to as squamous cell carcinomas. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.

Cancers of the head and neck are further identified by the area in which they begin:

Oral cavity —The oral cavity includes the lips, the front two-thirds of the tongue, the gums (gingiva), the lining inside the cheeks and lips (buccal mucosa), the bottom (floor) of the mouth under the tongue, the bony top of the mouth (hard palate), and the small area behind the wisdom teeth.

Salivary glands —The salivary glands are in several places: under the tongue, in front of the ears, and under the jawbone, as well as in other parts of the upper digestive tract.

Paranasal sinuses and nasal cavity —The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.

Pharynx —The pharynx is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus (the tube that goes to the stomach) and the trachea (the tube that goes to the lungs).

Allergy Evaluation and Treatment

Allergy symptoms can include respiratory symptoms, such as itchy eyes, nose, or throat; nasal congestion, runny nose, watery eyes, chest congestion or wheezing. Skin symptoms are hives or generalized itchiness. Another symptom may be abdominal such as stomach cramps or diarrhea following specific foods.

Generally, inhaled allergens such as dust mites, tree, grass or weed pollens will produce respiratory symptoms and ingested (food) allergies will produce skin and/or gastrointestinal symptoms or anaphylaxis but both types of allergens (ingested and inhaled) can produce the spectrum of allergy symptoms.

Treatment for inhalant allergies begins with avoidance whenever possible (such as not exposing oneself to cat or dog dander if you react to them). The use of mattress and pillow casements to minimize dust and dust mite exposure during the night may also be beneficial. Using air conditioning early in the season to as late in the season as possible allows de-pollination of the house to further reduce exposure. When this is not enough, medications such as antihistamines, decongestants, intranasal steroid sprays and anti-inflammatory agents can be used to suppress symptoms. When this fails, allergy testing and shots may be successful.

Call us today to learn more or schedule an appointment or consultation and Awaken The Beauty Within.

Mon -Fri 8:00 am to 5:00 pm

Snow Facial Plastics
and Laser Aesthetics
119 West Logan Street ,
Suite A
Caldwell, Idaho 83605

Get Directions

Cosmetic Patient Documents:

• Adult Patient Registration
• Cosmetic Medical History
• Skin Type Matrix
• Payment Policy