Center of Excellence - Sinus Center
Dr. Smith explains post-operative care for nasal and sinus surgery
Control of chronic sinusitis requires unique knowledge of the complex interaction between the anatomy of the sinuses and the physiology of the lining of the nose. Dr. Smith was among the first in the nation back in the 1990s to begin to understand the role of allergy – particularly mold allergy, in the pathogenesis of chronic sinus disease. Now Dr. Smith, along with many other sinus surgeons, is convinced that the majority of chronic sinus disease stems from a complex interaction between mold antigens and protective allergy cells in the nose.
Utilizing specialized mold allergy testing, video endoscopy, and fine cut CT scanning (available with the Mini-CAT Scanner) within the Institute, enables our doctors to form customized treatments for each patient. The use of custom compounded natural mold removal sprays, allergy and environmental treatments, and advanced endoscopic sinus surgery form the basis to successfully treat many patients with refractory sinus disease.
Many patients who come to the Sinus Center in the Institute are referred as “failures” of surgery done other places. Although most patients come thinking their only hope is for another sinus surgery, many are delighted that our first priority to is to attempt to clear the problem with aggressive medical and allergy treatment. This often includes the use of specially compounded medication or herbal topical nasal sprays. Evaluation and control of allergens (especially mold) is another key to effective relief for many patients suffering with chronic sinus disease.
The Institute partners with Oklahoma Natural Environmental Specialists (ONES) to offer complete building evaluation and chemical-free natural treatment of mold infested buildings. Dr. Smith helped found ONES in Lawton in 2006, as part of a search for effective and safe treatments for mold in homes and commercial buildings. The Institute offers comprehensive mold testing for the patient’s environment as a key part of our evaluation of chronic sinusitis. Our experience has shown that remediation of mold within the patient’s indoor environment is paramount to control of chronic sinus disease, especially allergic fungal sinusitis with associated nasal and sinus polyps.
Many of the patients we treat are children attending schools with flat roofs that leak and have mold in the classroom. Since nearly 20% of the population is allergic to mold, many children and teachers suffer from chronic sinusitis and asthma as a result of this long-term exposure. Although school budgets generally don’t allow these classrooms to be professionally remediated, we offer specialized mold filter systems (available in the Allergy Store of the Institute) that are very helpful in reducing the mold counts and improving sinus and asthma symptoms.
Being treated by surgeons who also understand and practice aggressive allergy avoidance and treatment, allows many chronic sinus suffers to avoid surgery all together. When surgery is recommended to augment overall treatment, most of the sinus surgery is done as an out-patient at the Surgery Center of Lawton, avoiding costly hospitalization. Dr. Smith differs from most other sinus surgeons in the area by specializing in advanced endoscopic sinus techniques (Functional Endoscopic Sinus Surgery or FESS) using “no packing” procedures for almost all patients.
The use of general specialized anesthesia techniques and various medical treatments have nearly eliminated the need for nasal packing after surgery. Both of these adjuncts were pioneered by Dr. Smith over the last 20 years as he sought for a method to do nasal surgery without the painful packing still used by most other surgeons. Based on surveys of our patients, most use nothing for post-op pain except OTC Tylenol. With no packing, our patients are able to breathe easily through their noses immediately after surgery. This is just one of the reasons our surgeons do the majority of all nasal and sinus surgery in this part of the State of Oklahoma. Less pain, no packing, and excellent results lead many doctors and patients alike to refer to the Institute for help with chronic sinus problems.
For some patients with difficult anatomy, prior surgeries, or massive polyps specialized guidance systems can be very helpful to preserve safety in sinus surgery. This system, known as CT-image guidance, uses CT images collected by the Mini-Cat CT scanner in the Institute and digitally loads them into a special scanner for use in surgery. This allows our surgeons to “see” the surgical instruments on the x-ray images as they guide them to the diseased areas of the sinuses during endoscopic surgery. Dr. Smith was the first in Lawton to utilize CT-image guidance for sinus surgery and currently uses technology developed by Brain Lab.
For patients with minimal disease or to reduce scarring in certain sensitive areas of the nose, our surgeons also offers Balloon Sinuplasty. This technique uses tiny balloons that dilate, instead of removing tissue,to open the sinus outflow tracts. This system is still quite new and long-term results are still being evaluated nationally, but our surgeons offer this cutting-edge procedure today in Lawton.
Our comprehensive evaluation of chronic sinus disease followed by intense medical and allergy treatment certainly has reduced the number of sinus surgeries that are needed today compared with 10-15 years ago. For that we and our patients are thankful. With improved techniques, the surgery that is needed is less extensive and less uncomfortable. Most patients can return to work or school within 2-3 days and our commitment to allergy treatment before and after the procedure, allows most of our patients a life-time of improvement in sinus symptoms.
Services We Provide
- Functional Endoscopic Sinus Surgery
- Septoplasty (nasal septal surgery)
- Sinus irrigations
- Coblation of nasal tissues
- Balloon Sinuplasty
- Image Guidance Technology
- Migraine
- PROPEL® Sinus Implant