BEFORE & AFTER
WHY DO WE SHOW CASE STUDIES & CT SCANS BEFORE AND AFTER SINUS SURGERY OR BALLOON SINUPLASTY?
Simply because very few sinus surgeons do so and by publicly sharing the CT scans before and after surgery, the benefits of the procedure are documented for anyone who is considering these procedures. We have chosen to be transparent. Sinuses normally contain air and appear black on CT scans. When they have infection or tumor, these sinuses then look gray. So, after surgery, if the disease has been cured or improves, the sinuses once again should look black.
CASE STUDY #1
IN-OFFICE BALLOON SINUPLASTY IN PANSINUSITIS
Mrs A presented to us with 3-4 months of severe sinus problems and cough with stuffy nose and sinus pressure despite a prolonged course of antibiotics. She had an In-Office Balloon Sinuplasty of all six sinuses performed with ethmoid surgery under local anesthesia and some oral sedation. In the previous years this procedure would have been performed in the hospital under general anesthesia.
RESULTS FROM TWO MONTHS POST-PROCEDURE!
FRONTAL & MAXILLARY
BEFORE AFTER
RIGHT FRONTAL
BEFORE AFTER
LEFT FRONTAL
BEFORE AFTER
ETHMOID & SPHENOID
BEFORE AFTER
CASE STUDY #2
IN OFFICE BALLOON SINUPLASTY WITH ETHMOIDECTOMY
(SEVERE SINUSITIS)
Mrs G presented to us with many year history of moderate to severe stuffy nose, sinuses feeling blocked, sinus headache and decreased smell, fatigue and body pain despite many antibiotics and nasal sprays. In Office Balloon Sinuplasty of the frontal, maxillary and sphenoid sinuses performed with ethmoidectomy. She is very pleased with the results. CT scans show remarkable improvement 3 weeks after surgery.
RESULTS FROM THREE WEEKS POST-PROCEDURE!
LEFT FRONTAL
BEFORE AFTER
ETHMOID & MAXILLARY
BEFORE AFTER
BOTH FRONTAL SINUSES
BEFORE AFTER
CASE STUDY #3
CHILD WITH SINUSITIS
(STANDARD FUNCTIONAL ENDOSCOPIC SINUS SURGERY)
Ms F, an 11 yr old child with severe sinusitis symptoms and headache, failed to respond to antibiotics. CT scan before surgery shows severe bilateral sphenoid sinusitis. CT scan after endoscopic sinus surgery shows beautifully open ethmoid and sphenoid sinuses with complete resolution of symptoms.
ETHMOID & SPHENOID
BEFORE AFTER
CASE STUDY #4
SEVERE ALLERGIC FUNGAL SINUSITIS
(EXTENSIVE SINUS SURGERY)
Mr S presented to us with severe nasal congestion, sinus pressure, headaches, dirty green nasal discharge and poor smell despite two previous surgeries by another specialist. Nasal examination showed polyps and a CT scan of the sinuses revealed extensive sinusitis with polyps and destruction of bony walls between the sinuses and the brain, eye and the carotid artery. He was at risk for meningitis, brain abscess or eye complications. He underwent surgery over two days, the first extensive endoscopic sinus surgery and the second with external incision also called Modified External Lothrop Procedure (or MELP). He has done amazingly well since then.
RESULTS FROM 6 MONTHS POST-PROCEDURE!
FRONTAL & ETHMOID
BEFORE AFTER
ETHMOID & SPHENOID
BEFORE AFTER
CASE STUDY #5
PATIENT WITH FUNGAL SINUS BALLS
(ENDOSCOPIC SINUS SURGERY)
Both these adult patients had balls of fungus in the sinuses. They both underwent standard endoscopic sinus surgery through the nose. CT scans show complete clearance of the sinuses after surgery.
MAXILLARY
BEFORE AFTER
SPHENOID
BEFORE AFTER
CASE STUDY #6
ESTHESIONEUROBLASTOMA
(OF RIGHT NASAL PASSAGE)
Mr C presented to us with nasal congestion of the right side for years. CT showed a polyp in the right nasal passage arising from the smell receptor area also called the cribriform plate. He underwent endoscopic sinus surgery with complete clearance of tumor and preservation of the cribriform plate followed by radiation treatment. He is now 6 years out and has done very well without evidence of recurrence.
The gray thin long mass on the left side as you face the images is the tumor. Post-procedure, no traces of the tumor!
ETHMOID & MAXILLARY
BEFORE AFTER
ETHMOID & MAXILLARY
BEFORE AFTER
CASE STUDY #7
BALLOON SINUPLASTY
(ENDOSCOPE VIEW)
After Balloon Sinuplasty in the office, an endoscope was passed into the sinus 3 weeks after surgery. The frontal or forehead sinuses are nicely lit up showing that the sinus openings are beautifully open after surgery. Normally it would be impossible to pass the endoscope into the frontal sinus.
ENDOSCOPE
LEFT RIGHT
CASE STUDY #8
BILATERAL SILENT SINUS SYNDORME
(CONGENITAL MAXILARY HYPOLASIA)
An individual with a rare condition of bilateral silent sinus syndrome, also called congenital maxillary hypoplasia. In this condition, the cheek or maxillary sinus is shrunken compared to a normal sinus resulting in some lowering of the eyeball or retrusion of the eyeball making the eyes look smaller. Here the CT scan shows before and after surgery results.
ETHMOID & MAXILLARY
BEFORE AFTER
CASE STUDY #9
BILATERAL SILENT SINUS SYNDORME
(CONGENITAL MAXILARY HYPOLASIA)
Mr. K had diffuse chronic sinusitis with nasal polyps for a very long time causing nasal congestion, reduced smell, and headaches with post nasal drip. He also had allergies as well. In addition, there was a suspicion that one of the bones called fovea ethmoidalis or the roof of the ethmoid sinus (a thin piece of bone separating the sinus from the brain lining) was destroyed by the polyp on the right side. Despite this suspicion, we elected to do an in-office balloon sinuplasty with surgery on his ethmoid sinus (total ethmoidectomy) using a microdebrider. Dr. Khetarpal is one of few surgeons in this country performing six sinus balloon sinuplasty and total or near-total ethmoidectomy in the office. We show in this CT scan that not only can this type of surgery be performed safely in the office but can yield excellent results. The CT scan results of before and eight months after surgery are shown.
ETHMOID & SPHENOID
BEFORE AFTER
ETHMOID
BEFORE AFTER