Procedures

Cerumen (Ear Wax) Removal

Under ideal circumstances, the ear canals should never have to be cleaned.  However, that isn't always the case. The ears should be cleaned when enough earwax accumulates to cause symptoms or to prevent a needed examination of the ear by your doctor.  This condition is called cerumen impaction, and may cause symptoms such as earache, pressure in the ear, partial hearing loss, tinnitus, itching, discharge or coughing. When at home cleaning recommendations do not work, the providers at Cass Street E.N.T. can help. Removal of earwax can be done using suction, special miniature instruments, and a microscope to magnify the ear canal.  Although irrigations may also be effective, manual removal is preferred if your ear canal is narrow, the ear drum has a perforation or tube, other methods have failed, or you have diabetes or a weakened immune system.

Balloon Sinuplasty

Sinusitis occurs when the linings of the sinuses become inflamed, possibly from a pre-existing cold or allergies.  If you experience frequent bouts of sinusitis, or your symptoms are continuous for three months or more, you may have chronic sinusitis. For patients suffering from chronic sinusitis, symptoms may include facial pressure or pain, nasal congestion, discolored nasal drainage, loss of smell and fatigue.  Standard of care begins with medical treatment such as antibiotics and steroids.  If medical therapy has been attempted and your symptoms fail to improve, you may be a candidate for Balloon Sinuplasty. Balloon Sinuplasty is a procedure that is used to widen the drainage pathways of the sinuses. For many patients, the procedure can be performed in the office under only local anesthesia.  A small flexible balloon catheter is placed into the nose to stretch the sinus openings and facilitate drainage of the mucus that builds up in patients that suffer from chronic sinusitis. Additional Reading: balloonsinuplasty.com  watch an animated in office balloon sinuplasty procedure here.

Turbinate Radiofrequency Ablation (RFA)

Patients who have enlarged nasal turbinates resulting in nasal congestion may benefit from RFA.  This simple in office technique uses low temperature radiofrequency energy to reduce the size of the turbinate tissue.  The treated turbinate tissue is absorbed naturally by the body over a period of 3-8 weeks, reducing the tissue volume and improving the ability to breathe through the nose.

Lugol Cautery

Lugol cautery is a treatment used for sinus pain and drainage.  The procedure uses multiple nasal sprays to superficially cauterize (burn) the nasal passages.  This procedure is very helpful in controlling a chronic runny nose, bothersome post nasal drainage, and preventing sinus headaches.  Many patients note an improvement in their symptoms within days.  Treatments have a cumulative effect, often decreasing the need for other nasal medications.  Symptoms may, however, reappear before the next treatment.   The treatment is repeated monthly for a total of three (3) applications.  It may be repeated as needed after that time, typically 3-4 times per year.

Restech pH Probe System

When Acid Reflux is a concern, your doctor may suggest a simple diagnostic test with the Restech pH System, which measures acid levels in your airway.  A small, soft tube is placed through your nose until the tip is positioned in the back of the throat.  Patients tend to forget the probe is even in place, as it does not interfere with talking, eating, or drinking.  During the test period, less than 24 hours, patients are encouraged to go about their day as usual (eat normal meals, go to work, and even exercise) while the Restech pH System tracks the frequency and severity of reflux episodes. A detailed report will help your doctor determine the best treatment plan, personalized for you. Relevant links: https://www.restech.com/pharyngeal-ph-testing-how-it-works-and-how-its-different/

Vivaer

Nasal congestion is a sensation of decreased airflow through the nose. It is often the result of inflammation of the membranes of the nasal passages. Structural changes in the nose may also contribute, including a deviated septum, enlarged turbinates and nasal valve collapse. Nasal congestion is commonly treated with medication or surgery, depending on the underlying cause. A new option now available to our patients is Vivaer. This in office procedure, performed under local anesthesia, uses low energy radiofrequency to remodel the nasal tissues and improve your breathing. For some patients, Vivaer is a reasonable alternative to surgery. Ask your doctor if Vivaer is right for you. Relevant links: https://aerinmedical.com/for-patients/vivaer-nasal-obstruction-treatment/

Sinuva

Chronic sinusitis is an inflammatory condition of the sinuses that is diagnosed when symptoms are present for at least three months. Symptoms include nasal congestion, thickened nasal discharge, facial pain or pressure and loss of sense of smell. For many patients the treatment of chronic sinusitis, with or without nasal polyps, involves surgery. However, even with surgery, medical treatment is necessary to control the underlying inflammation and to help prevent recurrent symptoms and polyps. The primary treatment for inflammation is steroid medication, in the form of a topical nasal spray or rinse, or a pill taken by mouth. When taken by mouth steroids can have significant short and long term side effects. Patients that suffer from recurrent nasal polyps after sinus surgery now have another option for treatment. Sinuva is an absorbable sinus stent coated with a steroid medication that is slowly released to the sinus tissue. Sinuva can be placed into the ethmoid sinus cavities (those between the eyes) in the office using only a topical anesthetic. Typically left in place for up to three months, Sinuva can produce results similar to those of oral steroid pills, without the common systemic side effects. Relevant links: https://www.sinuva.com/

Surgical Services

Surgeries are performed at Munson Medical Center or the Northwest Michigan Surgery Center. Some ENT surgical services include but are not limited to the following:

• Tonsillectomy
• Adenoidectomy
• Myringotomy / Tubes
• Septoplasty
• Sinus Surgery
• Nasal fracture
• Rhinoplasty
• Lymph Node removal
• Frenulectomy
• Tympanoplasty
• Parotidectomy
• Thyroidectomy
• Removal of Head and Neck Cancers