Get the Facts - Read our ENT Blog!

Fall in the Omaha and Bellevue area means that the trees will turn beautiful shades of yellow, orange, and red. It signifies Husker football, cooler days and nights, and that annual trip to Vala’s Pumpkin Patch or the Bellevue Berry Farm. But the fall is a pretty miserable time for many Nebraskans and Iowans because of hay fever or fall allergies.

 

Symptoms of allergies…

Often mistaken as a semi-annual cold or sinus infection, allergies most commonly happen in the spring and fall and have many of the same symptoms of a cold or sinus infection such as congestion, runny nose, facial pressure or pain, post nasal drip, and cough. The problem comes when people do not adequately treat their allergies causing the swelling in the nose to get out of control and the drainage to back up. Trapped mucus is a breeding ground for bacteria, and that is when we see allergies turn into a sinus infection.

 

How do I know when my allergies have turned into a sinus infection?

We tell our patients that if you have over 5-7 days of yellow or green, thick nasal drainage despite using a saline nasal rinse (such as the Neilmed Sinus Rinse Kit or NetiPot), you now have a sinus infection. Prior to the 5-7 days, we cannot know if your issue is just stagnant allergy secretions or a viral infection like a cold or flu. It is at this point that we recommend that you either see your primary care physician or your ENT specialist for an antibiotic. If you have this sort of infected drainage for over 3 months or have had to be on antibiotics for sinus infections 3-4 times or more, then you likely have developed chronic sinusitis and should see an ENT doctor to see if there is infection that is trapped and needs drained surgically. Many times, chronic sinusitis starts out as allergies that have gotten out of control, and your ENT will likely discuss a necessary daily regimen to try to manage this underlying condition to help prevent future infections and even surgery.

 

How do I treat my allergies so that I don’t get a sinus infection?

If you are looking for things to do at home that have been clinically proven, then you are in luck! Most of our good prescription allergy treatments have gone over the counter and are available for the general public. We recommend combining an oral antihistamine with a nasal steroid while also rinsing your nose daily with a saline rinse for best coverage. Many people are turned off by the idea of a nasal rinse, but as Dr. Medaris always says, “Dilution is the solution to pollution!” So giving it a good college try is worth the benefits! If you do not like the idea of daily medication, it is worth mentioning that local honey and essential oils (also technically “medicines”) are not well studied, and there is no sound scientific evidence of the effectiveness of these treatments.  We also do not recommend nasal or oral decongestants such as Sudafed, pseudoephedrine, oxymetazoline (Afrin), neosynephrine, or Vicks inhalers, as these drugs have side effects that can affect blood pressure, heart beat/rate, and also can cause rebound or worsening nasal congestion.

Oral Antihistamines & Nasal Steroid Sprays Available Over the Counter That We Recommend: (store brands and generics are just as effective)

***ALL OF THESE MEDICATIONS COME IN DOSING FOR CHILDREN AS WELL AS ADULTS!

***FLONASE AND FLONASE SENSIMIST COME IN DOSING FOR CHILDREN AS WELL AS ADULTS!

 

    

            

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

When the allergy treatment fails…

If you are treating your allergies, or your children’s allergies, and still get a sinus infection, you need to be seen and evaluated, as there are other prescription medications that can be tried. We also offer allergy testing and allergy treatment to help desensitize you to the things that are causing you to be sick in the first place. Or if the problem is severe enough, surgery may be an option; however, we can never really cut out allergies or infection.

The bottom line here, is that you do not have to suffer! We are the Omaha and Bellevue area’s one-stop sinus and allergy shop, and we are here to help you get your life back so that you can cheer on your favorite football team, take that trip with your kids through the corn maze, enjoy a night by the campfire with friends, or do whatever fall activities you have been missing out due sinus and allergy. Call us today for your evaluation 402-778-5250 or request an appointment online!

 

September 14, 2017
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Nasal Congestion? A New Easy Procedure Will Have You Breathing Easier!

While nasal congestion can be caused by allergies and chronic sinusitis (less likely), most of the patients that we see with complaints of nasal congestion, stuffy nose, nasal obstruction or trouble breathing through their nose have fixable anatomical problem or problems. These folks often struggle with trouble sleeping and issues with nasal breathing especially during exercise or exertion. There is now a quicker, safer, and less invasive way for the 20+ million Americans with these issues to gain relief! Sounds like a cheesy sales pitch, right? Well, it’s actually not! We don’t need to convince you to buy anything here, but we are excited that we have two experienced ENT surgeons (Dr. Hansen and Dr. Medaris) that can offer our patients and future patients relief – and that is worth spreading the word about!

What causes nasal congestion?

Deviated Septum:

The cartilage wall between the nostrils can bend and block the nasal passage. How can fixing a deviated septum improve your life?

Turbinate Hypertrophy:

Ridges of bone and tissue inside your nose can limit airflow when the enlarge. First line of treatment for this issue is usually medication, but if that fails a simple procedure to make the turbinates smaller while still maintaining their lining and function in the nose can be performed.

Nasal Valve Collapse:

Weak or excessively flexible upper/lower cartilage in the outer nasal wall may cause it to collapse inward when a person inhales.

While surgeries to correct the septum and turbinates are common place at our office, it’s the surgery to fix nasal valve collapse that has radically taken a turn for the better. It used to be that if a person nasal valve collapse, we would leave it alone, unless it was severe, because our only option was a rhinoplasty surgery that had some major risks, longer recovery, and patients were not always happy with the cosmetic outcome. However, we now have the Latera implant that is a safer, quicker, easier procedure to address nasal congestion caused by nasal valve collapse. Dr. Hansen and Dr. Medaris have recently trained and are now performing this procedure, often in conjuncture with other nasal procedures to help people find relief and live richer and fuller lives.

How does Latera work?

Latera is an absorbable nasal implant used to support the upper and lower lateral cartilages of the nose. It is placed under the skin in the side wall of the nose and helps reduce nasal airway obstruction by stenting open the nostrils. And because seeing is believing…

Latera Video Demonstration

 

What are patient’s saying about their nasal congestion after Latera?

9 out of 10 Latera patients in clinical studies…

  • Were satisfied with the procedure.
  • Were satisfied with their breathing after the procedure.
  • Were satisfied with their appearance after the procedure.
  • Would recommend the procedure to friends and family.

“Now that I can breathe, it’s an amazing difference. It’s really made a difference for me in every aspect of my life from sleeping to waking up and working out.” – Marcus, Latera Patient

"I immediately noticed a difference right after surgery. I could breathe. I noticed immediately that I had increased airflow...It seems like such a simple device has had great impact." - Nancy, Latera Patient

“The most appealing thing about Latera to me was my appearance wouldn’t really change…The very next day I went out and saw people that I know, and nobody noticed anything different.” – Candace, Latera Patient

 

So, is nasal congestion making your life miserable, trouble sleeping, or causing you to have trouble breathing while exercising? If so, remember that we are not trying to sell you some gimmick or trendy-wendy procedure, but a relatively simple, clinically proven, minimally invasive solution to what was once a more complicated issue. Think this might help you? Then give us a call and set up your consultation today with Dr. Jessica Moran-Hansen or Dr. Samuel Medaris at 402-778-5250!

 

References

San Nicolo, et. Al. 2017. Absorbable Implant to Treat Nasal Valve Collapse. Facial Plast Surg, 32:233-240.

August 31, 2017
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What Voodoo Should You Do (or Not Do) During Allergy Season

Everyone is looking for the magic cure during this time of year for their seasonal allergies, and we hear a lot of crazy ideas that people have read online or found on Pinterest (the worse place on the planet to gain any form of medical advice). So it can seem daunting on what is legit and what is just downright hokum, and I guess our official answer would be – do you – as long as it isn’t harmful to you or anyone else and makes you feel better.

First of all, for all of those people out there who are not keen on taking “medicine,” it is important to understand that the definition of medicine is any substance or substances used in treating disease or illness; medicament; remedy and is not mutually exclusive to commercially prepared drugs. Furthermore, just because something is “all natural” does not mean that it is better for you than something that is not labelled as “all natural.” For example, Arsenic is found naturally in soil and plants but you wouldn’t take it as a medication.

So, given these facts, lets pick apart some of the internet’s and Pinterest’s most popular allergy medicines – did you see that, I used “medicine” when actually what I meant is hocus pocus.

 

1.    Local Honey

Can honey lessen seasonal allergy symptoms?

Probably not. While there is one study out there that was done in Malaysia and published in 2013 that showed some marginal improvement over the control group with VERY LARGE doses and only after 8 weeks of continual treatment, these study results have failed to be consistently duplicated1. So at this point, and until these results can be consistently duplicated, local honey is just a really sweet placebo.

What ENT doctors and Allergists like about the idea of local honey is the idea of giving the body a little bit of what it is allergic to so as to train the body to not be allergic anymore. However, the issue with honey is that we cannot really know what pollens are incorporated in its making and at what concentrations. So if this idea appeals to you, you should consider seeing a provider at our clinic or an Allergist about sublingual immunotherapy, which is a clinically proven, daily oral therapy, where you take measured concentrations of the pollens or antigens that you have shown to be allergic to in testing. Sublingual immunotherapy patients show significant improvements in quality of life and allergy symptoms in studies and also this quality of life appears to be maintained and even increases with some even decreasing their need for other medical therapies such as nasal steroid use2.

 

2.    Essential Oils or Aromatherapy

Can aromatherapy with essential oils help with my seasonal allergies?

Probably not. While research on this subject is also limited, some studies have shown that essential oils might have health benefits for people suffering from anxiety and depression, improved sleep, and general improved quality of life. Smaller studies on lavender oil show reduced pain for people with osteoarthritis of the knee, improved quality of life with dementia, and reduced pain for people with kidney stones. As far as allergies are concerned, there was a study done in Korea in 2016 that showed that patients that inhaled an essential oil containing sandalwood, geranium and Ravensara for 5 minutes a day twice daily for 7 days did show some improvement in symptoms with most participants noting an improvement in fatigue3. Again, these results have not been consistently duplicated and thus essential oils have not been accepted by the scientific community as an effective form of treatment for allergies. Furthermore, placing certain oils on the skin can cause allergic reactions and ingesting them may interact with other medications and substances, so there is concern that using essential oils in these ways as a form of medicine may actually be doing more harm than good.

 

3.    Saline rinses and Nettipots

Yes, yes, a thousand times yes! This is the only holistic, “all natural,” non-medicine medicine for allergies that allergy and sinus experts agree on, and why, because there are literally hundreds of studies out there all saying the same thing – dilution is the solution to pollution studies too numerous to site. Pollution being unwanted antigens or pollens in your nose. The only caveat to this is you should use bottled or distilled water in your rinse mixture to make sure that you are not adding anything more harmful to your body, such as bacteria or amoebas.

 

 

So what voodoo should you do or not do based on the info delivered in this blog? Again, if it is not harming you or anyone else, do you, but realize that the fallacy behind the arguments as to why you choose a certain “medication” might make you just say hocus pocus for a more proven and reliable allergy treatment. And if you decide to stop listening to the experts of Pinterest, let us know, because we would be happy to give you a clinically proven, effective treatment plan for your allergies.

 

References

1 Asha’ari ZA et al. Ingestion of honey improves the symptoms of allergic rhinitis: evidence from a randomized placebo-controlled trial in the East coast of Peninsular Malaysia. Ann Saudi Med. 2013 Sep-Oct; 33(5):469-75. doi: 10.5144/0256-4947.2013.469.

2 Woody, J et al. Clinical improvement after escalation for sublingual immunotherapy (SLIT). Ear, Nose & Throat Journal. 2011 Sep 21.

3 Choi SY and Park K. Effect of inhalation of aromatherapy oil on patients with perennial allergic rhinitis: a randomized controlled trial. Evid Based Complement Alternat Med. 2016; 2016: 2103616. doi: 10.1155/2016/7896081.

July 28, 2017
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Why You Should NEVER Use Q-Tips (or Any Other Objects) in Your EarWhy You Should NEVER Use Q-Tips (or Any Other Objects) in Your Ear

Reason 1: Risk of Injury

Most ear cleaning attempts merely push ear wax deeper into the ear canal, causing further blockage at the very least. At the worst, a Q-tip can puncture the ear drum. Other injuries that are caused by Q-tips include injuries to the ear canal. Over-aggressive cleaning can scratch and bruise the very thin and sensitive canal walls this can lead to swelling and infection, which can be very painful.

 

Reason 2: You NEED Ear Wax

The skin of the ear canal has special glands that produce ear wax to trap dust, dirt, loose hairs and insects and keep these things away from your eardrum. The ears are almost always SELF-CLEANING and should not require cleaning at all.

 

What should I do if I think my ears are blocked with wax?

If your ears feel full, they itch, or you have decreased hearing, your ears may be impacted with cerumen or ear wax. If you tend to have dry wax, you can try mineral oil, baby oil, or olive oil at bedtime into the ear canals to emulsify the substance. If you tend to have wet wax, we recommend you try a 50/50 mixture of white vinegar and rubbing alcohol to try to dissolve the wax so that it will come out on its own. If trying these fails you, we would recommend seeing an ENT who can clean your ears under a microscope using special tools so that they can see the small structures of the ear and safely remove any impaction. We DO NOT recommend irrigating the ears (see Reason 1). If you or someone you know suffers from ear wax impactions, please do not hesitate to contact us for an appointment! While this is certainly not considered emergent, we do try our best to get patients in a soon as possible!

Identifying the Risks of Head & Neck Cancer.

90% of Head & Neck Cancers occur from prolonged exposure to specific risk factors. Oftentimes, these factors are 100% preventable. The most severe offender is the use of tobacco. Tobacco in the form of cigarettes, cigars, snuff, and chewing tobacco are the worst offenders and are associated with a majority of these types of cancer. This is especially true when coupled with heavy alcohol use. In adults that do not smoke or drink, cancer of the throat can occur as a result of HPV (human papilloma virus). Prolonged exposure to sunlight is linked with cancer of lip and skin cancers of the head and neck region.

 

Symptoms of Head & Neck Cancer.

1. Lump or lumps in the neck that do not go away, last more than 2 weeks, or continue to enlarge should be checked by your doctor. Not all lumps are cancer.

2. Change in voice that persists longer than two weeks should be evaluated with a laryngoscopy. While most voice changes are not cancer, you shouldn't take the chance.

3. A growth in the mouth, ESPECIALLY IF IT IS PAINLESS! If the area of concern is present more than a week, it may need to be biopsied.

4. Bringing up blood. Some tumors do bleed, but not always. However, bleeding of any kind is not normal and should be checked out irregardless. 

5. Swallowing problems. If you have trouble almost every time you swallow something, you should be examined by a physician to rule out cancer or another reason for the issue. Throat cancers and esophageal cancers often make themselves known with a symptom of difficulty swallowing foods and sometimes liquids.

6. Persistent ear pain. Many areas of the face, head and neck refer to the ear. If ear pain is also associated with hoarseness, difficulty swallowing, or a lump in the neck, it is even more concerning for a tumor. All ear pain should be evaluated by an ENT to rule out throat or neck cancer.

7. Changes to the skin. Skin cancers of the face/neck region are common because this is the areas most exposed to the sun. Any patchy skin, raised areas, or concerning moles should be evaluated.

 

What Should I Do If I Think I Might Have Head & Neck Cancer.

SEE YOUR DOCTOR! Many of the above listed symptoms and signs can occur with no cancer present, and most often this is the case, but you cannot be certain without an examination! When found early, most cancers of the head and neck can be cured with few side effects! Also, we encourage you to practice healthy lifestyle habits and choices which will help prevent these diseases.

If you are interested in seeing one of our providers to be evaluated for one of the symptoms described above, please feel free to call us at 402-778-5250 or Appointment Request online.





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