Sinus: Chronic Sinusitis and Surgery

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Guest: Dr. Rodney J. Schlosser - Otolaryngology - Head and Neck Surgery (ENT)

Host: Dr. Linda Austin – Psychiatrist


Dr. Linda Austin: I am Dr. Linda Austin. I am interviewing Dr. Rodney Schlosser, who is Associate Professor of ENT and Director of the Sinus Surgery Clinic here at MUSC. Dr. Schlosser, a lot of people talk a lot about having sinusitis. It’s a really common problem, how often does this become a chronic problem?


Dr. Rodney Schlosser: Chronic sinusitis probably affects about 15% of the US population.


Dr. Linda Austin: Well, that’s a lot of people and of those, about what fraction need to go on to surgery?


Dr. Rodney Schlosser: If you treat patients with chronic sinusitis with aggressive and appropriate medical therapy, really it should probably be less than 5% that need to go on to surgical treatment.


Dr. Linda Austin: Now you said that need to go on, what percentage actually do go on?


Dr. Rodney Schlosser: The numbers vary, but it’s probably higher than that, but in my practice, I say that most patients should be treated with medical therapy alone.


Dr. Linda Austin: So, what you are implying then is that it’s a wise idea to go as far as you can with the medication treatment before resorting to sinus surgery?


Dr. Rodney Schlosser: Yes, sinusitis is usually a quality of life issue. In rare circumstances, there can be complications affecting the eye or the brain. So, most of the time if you can get patient’s symptoms under better control with medical therapy, I think that’s the route that you should follow and really safe surgery is the last resort.


Dr. Linda Austin: When you say surgery, are you talking about traditional surgery, an open procedure or this is endoscopic?


Dr. Rodney Schlosser: Endoscopic surgery really is now the norm meaning that there are no incisions anywhere on the face and the surgery is all done through the nostrils with small telescopes that provide visualization and they are smaller than a pencil.


Dr. Linda Austin: What do you in surgery?


Dr. Rodney Schlosser: Well, the surgery is done with small endoscopes and what we do is we remove polyps or inflamed tissue, bacterial, or fungal debris. We actually open up the sinuses so that instead of having small narrow channels, there are now larger openings into the sinuses and the bone that is removed is actually very small as like eggshell thin-type bones. We reach in with small little instruments and open up those bony partitions, so that the sinuses can drain and we can then have access to them to clean out the infection that may be there.


Dr. Linda Austin: That sounds like very delicate surgery.


Dr. Rodney Schlosser: It is very delicate, but with the newer techniques now, patients actually in a majority take nothing other than Tylenol for pain. The risk should be very minimal. It is done as an outpatient surgery with really no packing and patients are really back on their feet within a few days.


Dr. Linda Austin: How long does that surgery actually take you to perform?


Dr. Rodney Schlosser: It depends on how many sinuses are being addressed, but really to do a nice meticulous job takes typically about three to four hours.


Dr. Linda Austin: That’s pretty long for you as a surgeon.


Dr. Rodney Schlosser: I think it benefits to take a little bit longer in the operating room so that the patients heal more rapidly. We preserve more normal structures and they generally are going to do better postoperatively.


Dr. Linda Austin: Dr. Schlosser, thank you so much for joining us today.


Dr. Rodney Schlosser: Thank you.


Announcer: If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection at (843) 792-1414.

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