Archive November 2016 XVII, No. 11

5 Trends to Watch in ENT Technology

Advances in technology are leading to better outcomes and more-satisfied patients.

Allan Allphin

Allan Allphin, MD, FACS, FAAP

BIO

Category: Outpatient Surgery > ENT
balloon sinuplasty INFLATING VALUE Balloon sinuplasty is a step forward in functional endoscopic sinus surgery (FESS), gently opening sinus cavities to allow better drainage and aeration.

Improved patient monitoring, less invasive procedures, higher-quality implants, better visualization and new frontiers in ear surgery are just some of the trends delivering better outcomes and improved patient satisfaction for ENT physicians. Let's take a closer look at some of the breakthroughs that we're delivering to our patients.

1. Nerve-monitoring systems. The monitors available in today's market continue to be updated and improved, letting us be more precise and confident during several types of surgery. Time was when we did salivary gland, ear or thyroid surgery, we had to try to follow the nerve and watch for any twitching on the patient's part. The twitching indicated that we were making contact with a nerve and risking temporary, or even permanent, damage.

The nerves that go to the vocal cords, for example, are very fragile. Bump them too much during thyroid surgery and they may not recover. Other nerves are less fragile, but if, say, I'm dissecting out the facial nerve for a parotidectomy, and I bang too much on the nerve, that's going to cause some post-operative weakness. And naturally, we'd prefer not to see any weakness after surgery.

Monitoring has been shown to decrease the risk of immediate post-operative facial nerve weakness during parotidectomy (osmag.net/Job4ZC) and it's easy to see why. By putting special electrodes on the distribution of the nerves, we know when we're getting close — we hear it on the monitor well before we'd ever see a twitch. The same with thyroid surgery. We use a special endotracheal tube, so we always know when we're getting close to the nerve.

2. Sinus treatments. Minimally invasive functional endoscopic sinus surgery (FESS) revolutionized sinus procedures, and has ultimately become the standard for the current generation of ENT specialists. But we're now finding ways to be even less invasive. Enter balloon sinuplasty, the nasal equivalent of using angioplasty to open blood vessels. Using a guide catheter and a flexible guide wire, we can access the targeted sinus and then advance a balloon catheter into it. 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.

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