We then inflate the balloon to try to open the sinus cavity and allow
better drainage and aeration. Since it's a relatively gentle procedure, it
doesn't create more scar tissue.
Balloon sinuplasty is also extraordinarily safe, can be done comfort-
ably under local anesthesia and delivers consistent, lasting improve-
ment. We're able to do most of ours on an outpatient basis.
Impregnated stents are another innovation for sinuses. They're
made from a net-like material that slowly releases steroids over a peri-
od of 6 to 8 weeks and can be used to treat patients with recurrent
nasal polyps. They can also help reduce inflammation in patients who
have chronic sinusitis, obviating the need for steroid nose sprays,
which rely on patient compliance and which simply aren't as effective
as having something that exudes the drug. I suspect this is just the
beginning, that we'll see this concept advance over time, leading to
slow-release antibiotics and other therapies.
3. Better implants for laryngoplasty. This is an area that's
really evolved in recent years, with manufactures now creating newer
and better implants that are ready to go when we need them.
Because the nerve to the left vocal cord reaches down near the arch
of the aorta, it's often inadvertently scratched or damaged during tho-
racic procedures. In other patients, tumors can push on that nerve
and create vocal cord paralysis. In either case, patients can end up
breathy, because they can't get their vocal cords together. To treat the
damaged nerve, we need to stiffen the paralyzed cord so the other
vocal cord can hit against it and create a more normal-sounding voice.
We do it by making a little window behind the vocal cord, and
inserting an implant. Patients are under mild IV sedation and we have
them vocalize for us while we try different sizes, trying to get the ideal
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