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Posts Tagged ‘turbinate reduction’

Awarded Again as Best Doctors in Dallas by D Magazine 2015!

Tuesday, September 29th, 2015

Dallas ENT Group provides comprehensive, quality otolaryngology care to adult and pediatric patients.

Drs. Andy Chung and Thomas Hung also offer their patients full audiology services, as well
as the latest advanced technology at Medical City Dallas Hospital, Forest Park Medical Center, and
Baylor Surgicare at North Dallas.

As former chief of ENT at Medical City and Medical City Children’s Hospitals in Dallas and
director of surgical oncology with the Dallas ENT Group, Dr. Andy Chung’s specialized training
and extensive experience affords adult and pediatric patients the luxury of one-stop, unsurpassed
care for even the most complicated ENT cases. He has clinical expertise in all aspects of ENT with
special interest in the treatment of sinus, cancer, sleep apnea, and thyroid disorders using the latest
minimally invasive techniques, such as balloon sinuplasty, radio-frequency tongue base reduction,
and transoral laser microsurgery.

Dr. Chung is board certified by the American Board of Otolaryngology and completed his
otolaryngology residency at Duke University and an advanced head and neck cancer fellowship at
Washington University in St. Louis. He is a member of the American Academy of Otolaryngology,
American College of Surgeons, Texas Medical Association, and Dallas Academy of Otolaryngology.
Double board certified by the American Board of Otolaryngology and the American Board of
Facial Plastic and Reconstructive Surgery, Dr. Hung completed his surgical internship at Massachusetts
General Hospital and his otolaryngology residency and fellowship at Duke University
Hospital. Striving for the best outcomes while minimizing recovery time in his adult and pediatric
patients, Dr. Hung incorporates state-of-the-art technology specializing in minimal invasive office
procedures, including balloon sinuplasty.

Along with their associate Dr. Arun Badi, the physicians of Dallas ENT Group provide superior
care to their adult and pediatric patients.

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All about Sinus infection/Sinusitis

Thursday, May 30th, 2013

Sinus Infection Diagnosis | Dallas ENT Group | Dallas, TX

This is the time of year when many people are getting sick with a cold or flu and then develop nasal congestion and pressure. How do you know when you have a sinus infection? Do you need to see a doctor? This will attempt to help answer those questions.

Sinusitis: Swelling of the lining of the sinuses and nose. The sinuses are the hollow areas within the facial bones that are connected to the nasal openings. The sinuses are lined with mucous membranes, similar to the inside of the nose.

Symptoms: Nasal congestion, purulent discharge, dental pain, facial pain, especially if it’s worse when bending forward. Other signs include fever, fatigue, cough, ear pressure/fullness, bad breath and headache.

When to get help immediately: High fever > 102.5, sudden severe pain in the face or head, double vision or difficulty seeing, confusion or difficulty thinking clearly, swelling or redness around one or both eyes, stiff neck or shortness of breath.

Diagnosis: Highly predictive symptoms of a sinus infection include purulent rhinorrhea and nasal congestion with facial pressure/pain. The diagnosis is supported by the sensation of ear fullness, cough, difficulty smelling and headache. Symptoms that may suggest a bacterial sinus infection include: worsening of symptoms after initial improvement of symptoms. It is generally not possible to distinguish between viral and bacterial sinus infections in the first 10 days of illness even based on history, examination or radiology studies.

Most of the time radiologic tests such as x-rays or CT/Cat scans are not indicated for acute sinus infections. These radiological tests may show sinus fluid levels in both viral and bacterial sinus infections but it cannot distinguish between the two.

In general acute rhinosinusitis (ARS) is the most common type that we see in the medical clinic. It is a symptomatic inflammation of the nasal passages and paranasal sinuses lasting less than 4 weeks.

There are different classifications of sinusitis that are based on the length of symptoms.

1) Acute rhinosinusitis: symtpoms for less than 4 weeks

2) Subacute rhinosinusitis: symptoms for 4-12 weeks

3) Chronic rhinosinusitis: symptoms persist greater than 12 weeks

4) Recurrent acute rhinosinusitis: 4 or more episodes of ARS per year with resolution of symptoms in-between these episodes.

A sinus infection can be either viral or bacterial. Viral sinus infections usually last 7-10 days and most sinus infections are this type. Bacterial sinus infections usually (75%) go away on their own as well, but can take a month or more. In rare cases, patients with a bacterial sinus infection can develop a complication called orbital cellulitis.

It is very challenging for the doctor to determine whether a sinus infection is viral (like a common cold) or bacterial. Antibiotics may be helpful for the bacterial kind of sinus infection but won’t help the viral infection. Even though about most of the sinus infections are viral, 85-98% of the patients with sinus infections in the US are prescribed an antibiotic when seen in the clinic.

Acute bacterial infection occurs in only 0.5 to 2.0 percent of patients with sinus infections and virus is causing the symptoms 98-99.5% of the time.

How do you get a sinus infection? Viral sinusitis begins with direct contact of the virus into the eyes or nasal mucosa by respiratory droplets from someone else. Symptoms usually develop within the next day after exposure from someone else. Bacterial sinus infections occur when bacteria secondarily infect the inflamed sinus cavity. Most of the time this is a complication of a viral sinus infection but can also be a complication from with allergies, mechanical obstruction of the nose, swimming, intranasal cocaine use, impaired mucociliary clearance due to cystic fibrosis, or immunodeficiency.

You are more likely to develop a sinus infection if you smoke or you already have an impaired respiratory tract such as in cystic fibrosis.

Treatment: Since viral sinus infections usually resolve within 10 days, most of the time we use medications to treat symptoms with these symptoms without the use of antibiotics. An exception would be in the case of a patient who is getting worse after initial improvement or patients with severe symptoms are who are clearly worsening or are immunocompromised. For viral sinusitis, treatment aims to relieve the symptoms of nasal pressure/obstruction and runny nose. The medications do not shorten the duration of the illness in viral infections.

Options for treatment include:

1) Analgesics such as ibuprofen, naproxen or Tylenol

2) Topical steroid nasal spray such as Flonase, Rhinocort or Nasonex

3) Oral decongestant such as Sudafed or anti-inflammatory medication such as prednisone

4) Antihistamines such as Benadryl, Zyrtec, Allegra or Claritin

5) Zinc preparations have been used, but if sprayed in the nose they way cause difficulty with smell are not recommended.

6) Nasal saline rinses

Treatment of bacterial sinus infections may include antibiotics, however 40-60% of patients with bacterial sinus infections will clear their infection without antibiotics.

Antibiotics: Studies have shown nearly identical results in adults with the use of amoxicillin, Bactrim or erythromycin compared to other antibiotics. Most of the time we use Amoxicillin, either 875mg twice a day or 500mg three times a day for 10-14 days. If someone has an allergy to penicillin, Bactrim, doxycycline or other antibiotics might be chosen. There are some strains of S. pneumonia bacteria that are becoming resistant to amoxicillin.

This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.

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Sports Endurance/ Nasal Airway

Thursday, March 21st, 2013

The ability to continue exercise during high-intensity sports such as cycling is dependent on both physiologic factors and the perception of fatigue.

Sports Endurance/ Nasal Airway | Dallas ENT Group | Dallas, TX

In 2008 Ansley, et al (1) showed that head cooling significantly decreased the perception of fatigue and increased the exercise time to fatigue by 51%. Not only were athletes able to exercise dramatically longer with head cooling, but their production of a stress hormone thought to be involved in feeling fatigue, prolactin, was nearly eliminated.

In 1995 White and Cabanac found that this head cooling is achieved by the body during exercise via increased blood flow to the nose (2) and that improving nasal airflow increases cooling (3).

Taken together, these studies suggest that improving the nasal airway in athletes will dramatically improve their endurance. Its important to point out that there have been many misleading claims made over the years about how this works and attempts by not-so-reputable groups to sell useless products based on this information. A better nasal airway does not improve an athlete’s VO2 max (maximum exercise capacity of heart and lungs) or his/her oxygen intake. A better nasal airway does improve an athlete’s ability to continue exercise under conditions of heat and fatigue by measurably decreasing both.

So how can you achieve a “Better Nasal Airway”? One simple solution is Breathe Right Strips. They have been shown in studies to increase the internal cross-sectional area of the nose. However, if you have significant allergies, a deviated septum, or other nasal abnormalities these strips may have limited effectiveness. In that case, treating the allergies or nasal obstruction will give you a Better Nasal Airway.

With improvements in both allergy treatments (such as Sublingual Immunotherapy or Allergy Drops) and minimally invasive nasal surgery (turbinate reduction, septoplasty, nasal valve augmentation), a Better Nasal Airway can be achieved with little effort, downtime or discomfort. Visit our website for more information or an appointment; www.dallasentgroup.com.

1) Ansley L, Marvin G, Sharma A, Kendall MJ, Jones DA, Bridge MW The effects of head cooling on endurance and neuroendocrine responses to exercise in warm conditions. Physiol Res. 2008;57(6):863-72. Epub 2007 Nov 30.

2) White MD, Cabanac M. Eur J Appl Physiol Occup Physiol. Nasal mucosal vasodilatation in response to passive hyperthermia in humans. 1995;70(3):207-12.

3) White, M. D. and Cabanac, M. (1995). Physical dilation of the nostrils lowers the thermal strain of exercising humans. European Journal of Applied Physiology, 70, 200-206.

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