A deviated septum is a bend in the wall that separates the two sides of the nose. In some people this can cause nasal obstruction, facial pain, or sinus pressure. This condition can be treated with certain nasal sprays or in some cases with outpatient surgery to correct the deviation permanently. Traditional nasal packing following surgery is rarely needed.
Many patients in this part of the country suffer with sinus problems. Acute sinusitis symptoms are associated with facial pain or pressure, headache, nasal discharge and post nasal drip. This condition is often associated with a bacterial infection. We perform cultures of the nasal cavity in the office to ensure you are on the proper antibiotic. Chronic sinusitis refers to patients who have a longstanding, persistent infection that is resistant to many courses of antibiotics. These patients need to be evaluated with a CT scan of the sinuses in many instances. Treatments range from long-term medical intervention to surgery. Evaluating for allergies can also be very helpful in managing patients with chronic sinusitis.
Recently new advances have been made in the surgical treatment of sinusitis including Balloon Sinuplasty. This is a new less invasive surgical treatment of chronic sinusitis which allows for shorter recovery time after surgery. In many cases this procedure can be done in the office under local anesthesia. In addition, new absorbable stenting material is now available which can keep sinuses open longer with less scarring.
These polyps are benign growths in the nasal or sinus cavities. Some people develop nasal or sinus polyps for reasons we do not fully understand. Research suggests the cause may be a defect or alteration in the immune system of these people. Polyps can be treated with oral medication, nasal spray, and in some cases surgery to physically remove the polyps from the nasal and sinus cavities. Polyps can cause nasal obstruction, chronic sinusitis, and loss of or changes in sense of smell.
Inhalant and food allergies can be major contributors to many medical conditions including sinusitis, asthma, etc. Most allergies, particularly inhalant allergies, can be successfully treated with medications. Many people assume that all sinus or nasal symptoms are allergy related, which is not necessarily the case. A comprehensive allergy evaluation is necessary to rule out inhalant allergies. Therefore, we offer blood allergy testing to ensure that allergies are the cause of the patient s symptoms. Our practice uses the newer form of allergy testing called Immunocap, which can evaluate for virtually any allergen. Standard allergy panels are used for initial screening. Allergy shots may be indicated in patients who do not respond to conventional medical therapy. We work closely with local allergists who can provide this service if necessary.
Fractures of the face and nose should be evaluated within 5-6 days of injury, unless an eye injury is suspected. If an injury to the eye or eye socket is suspected, the patient should be evaluated in an Emergency Room within 24 hours. Dr. Paolini surgically corrects mid-facial fractures, eye socket fractures and nasal fractures. He does not repair jaw fractures.
Wax in the external ear canal is a natural process and a certain amount of wax is normal. Sometimes, however the wax can build up due to multiple factors including a narrow ear canal, excessively dry or oily wax, or Q-tip use. Q-tip use in the ear canal is the number one cause of wax impaction. Wax can be safely removed by people who do not have a tympanic membrane perforation or tympanostomy tubes, by using a bulb syringe and warm water to irrigate the ear. Ear wash kits are also available at most pharmacies.
Sometimes, despite the best efforts of our patients, they are unable to remove the wax at home and this can be performed in an office setting. Depending upon the wax and the shape and size of the ear canal, wax can be removed using various techniques including direct removal with a loop, the use of other instrumentation, or irrigation.
Hearing loss occurs naturally with the aging process. Signs of hearing loss can include a ringing or buzzing in the ears. This condition is called tinnitus. Noise exposure from a person's place of employment or from military exposure can predispose people to experience premature hearing loss.
Hearing loss or tinnitus should be evaluated with definitive audiological testing. We offer on-site audiological testing which is done on the same day of service.
- Audiological Exams
- VNG (videonystagmography)
- ABR ( auditory brainstem response)
- OtoAcoustic Emissions (OAE) - Hearing Aids
We also offer implantable hearing aids for patients who meet the criteria. These are becoming increasingly popular with patients with these types of hearing loss. In most cases the implantable hearing aids (BAHA) are covered by insurance.
Hearing loss occurs naturally with the aging process. Signs of hearing loss can include a ringing or buzzing in the ears. This condition is called tinnitus. Noise exposure from a person's place of employment or from military exposure can predispose people to experience premature hearing loss. An abnormal sound in the ears or tinnitus can present as a ringing, buzzing, and "ocean like" sound or even other abnormal sounds. Usually this is a sign of hearing loss; however, other conditions can also cause these abnormal sounds. Tinnitus should always be evaluated by an Otolaryngologist or Ear, Nose and Throat specialist to rule out hearing loss or other serious conditions. In particular, if the tinnitus is unilateral or one sided, this should be evaluated.
Ear pain can be caused by many factors, many of which are not even related to the actual ear itself.
External ear infections, otherwise known as swimmers, and middle ear infections, can cause severe ear pain and hearing loss. However each of these ear conditions is treated differently.
Ear pain can also be caused by problems in and around the TMJ joint, where the jaw articulates with the skull.
Ear pain can also be caused by an abnormality in the throat. This is called referred ear pain and can be seen in serious conditions including infections of the throat or cancer. Ear pain should always be evaluated as this can be a potentially serious condition.
Ear infections and eustachian tube dysfunction are normally associated with blockage or narrowing of the eustachian tube which connects the middle ear with the nose. This can be caused by viruses, bacteria, or can be congenital. Watchful waiting, nose sprays, antibiotics and eventually tympanostomy tubes are the treatments commonly utilized. However, we now have a NEW option called Eustachian Tube Balloon Dilation, which uses a small balloon inserted into the nose and then into the eustachian tube to unblock the obstruction. This is a new, recently FDA cleared procedure. Results very promising based on current research.
Often times, dizziness and balance disorders are caused by conditions of the ear or inner ear. We offer a full range of services that can fully evaluate patients with dizzy related complaints. Dizziness and balance disorders can also be caused by factors other than ear disorders. These include disorders of the brain, blood pressure abnormalities, metabolic abnormalities, and cardiac arrhythmias. All of these conditions can be evaluated as needed.
Throat pain can be caused by many factors including viruses, bacterial infections, acid reflux disease, or more serious conditions such as carcinoma of the larynx. We offer a full evaluation for these complaints, including laryngeal endoscopy using flexible laryngoscopes if necessary to evaluate these complaints.
Patients oftentimes become hoarse or have a weak voice during and following an upper respiratory tract infection. This usually improves after several weeks.
Hoarseness or vocal fatigue which persists for one month should be evaluated by an otolaryngologist. This condition can be caused by sinus conditions, postnasal drip, nodules or masses of the vocal cords, paralysis of the vocal cords, acid reflux disease.
Swallowing disorders can be caused by many factors including, but not limited to, degeneration of the spine as a patient ages, acid reflux, thyroid abnormalities, and narrowing of the esophagus.
Acid reflux or GERD is an increasingly common phenomenon as people live longer and as the average weight of Americans increases over time. Poor eating habits can also contribute to this condition along with anatomical changes in the stomach and esophagus over time. Silent reflux can cause many ear, nose and throat problems without the patient even being aware that they have reflux. Patients are oftentimes confused and surprised to find out that they have silent reflux. Silent reflux causes many symptoms which may present as a tickle in the throat, postnasal drip, chronic throat clearing, throat pain, or chronic cough. Reflux may also cause mild swallowing problems or a "lump" sensation in the throat.
In most cases, tonsil and adenoid disease is a condition in children causing snoring, sleep apnea, sinusitis, and recurrent tonsillitis. These conditions can also be seen in adults. Signs and symptoms of tonsil or adenoidal hypertrophy may include chronic mouth breathing, halitosis, snoring or sleep apnea, recurring upper respiratory infections. Oftentimes adults will complain of white spots on their tonsils which cause bad breath or a funny feeling in the throat. These are caused by a chronic low-grade tonsil infection.
Women are much more prone to thyroid abnormalities than men. A family history of thyroid problems is also a risk factor. Hypothyroid disease can be associated with fatigue, hair loss, weight gain, low libido, cold intolerance and depression. Hyperthyroidism or a high thyroid level can be associated with symptoms such as heat intolerance, an inability to gain weight, high blood pressure, nervousness. Thyroid disorders can be evaluated by obtaining thyroid function tests and or thyroid ultrasound. Physical examination is also very important in diagnosing thyroid disorders. The vast majority of thyroid problems can be treated medically, however at times surgery is indicated.
Lumps or bumps in the head and neck should always be evaluated if they persist for greater than one month. Rapidly enlarging or painful masses in the head or neck should be evaluated immediately. Radiological (x-ray) testing and blood work are oftentimes needed along with a full head and neck examination.
Soft tissue, skin lesions or masses of head and neck should always be evaluated by a physician. While many are benign, all should be evaluated and a biopsy can be performed if necessary.
Sleep apnea is a serious condition caused by a collapse of the upper airway during sleep. Sleep apnea can be caused by a variety of factors including weight gain, enlarged tonsils, an elongated palate, and nasal or sinus conditions causing nasal obstruction.
CPAP, or continuous positive airway pressure, is the mainstay of treatment for sleep apnea. However, certain patients cannot tolerate CPAP.
Daytime fatigue, morning headache, poor sleep patterns, and snoring can be associated with sleep apnea and should be evaluated. Surgical and nonsurgical options for the evaluation and treatment of sleep apnea are available.