The Nasal Sinus Center
James A. Stankiewicz,
MD, Director
The Nasal Sinus Center of Loyola University Medical Center, Maywood, Illinois, is committed to offering complete evaluation, education and treatment of nasal and sinus disorders with an emphasis on providing the newest technologies and services in the safest manner.
The Nasal Sinus Center
Over 30 million Americans suffer from some form of sinus or nasal disorder.
These disorders include: allergic rhinitis, nasal polyp disorder, chronic
sinusitis, inverted papilloma, and Wegener’s granulomatosis. The vast
array and frequency of these disorders requires accurate diagnosis and a
cooperative treatment. All initial evaluations at the Nasal Sinus Center
are dedicated to providing accurate diagnoses and educating the patient
of the treatment options.
Treatment
Treatment of nasal and sinus disorders can require medical and/or surgical
intervention. Medical options include the use of topical nasal sprays, antibiotics
and often an allergy evaluation. Surgical options are explained in detail,
with the Loyola Nasal Sinus Center being dedicated to provide the latest
in technological advances. The state of the art techniques that are currently
available include: endoscopic sinus surgery, computer guided sinus surgery,
and balloon sinuplasty.
Faculty
The faculty of the Loyola Nasal Sinus Center includes Dr.
James A. Stankiewicz, professor and chairman. Dr. Stankiewicz
is considered one of the pioneers of endoscopic sinus surgery and is famous
within the field of otolaryngology, head and neck surgery for his early
discussions regarding performing safe sinus surgery and avoiding complications.
With a strong core faculty, the latest in technology and services and a commitment to excellence, the Loyola Nasal Sinus Center aims provide the best available care for patients suffering from the any nasal or sinus disorder.
Typical Disorders Treated at the Loyola Nasal Sinus Center
- Allergic rhinitis
- Nasal polyps
- Chronic sinusitis including frontal sinus disease, fungal sinusitis, and mucoceles
- Nasal Obstruction/Deviated Nasal Septum
- Sinus and nasal tumors including inverted papilloma, osteomas or other sinus tumors
- Connective tissue disorders including Wegener’s granulomatosis
- CSF leak
- Nose bleeds
Typical Procedures Done at Loyola Nasal Sinus Center
- Endoscopic Sinus Surgery
- Revision Sinus Surgery
- Computer image guided sinus surgery
- Balloon Sinuplasty
- Septoplasty
- Turbinate surgery
Allergic Rhinitis
Affecting more than 30 million Americans per year, allergic rhinitis represents
a common disease that causes symptoms of a runny nose, post nasal drip,
and watery or itchy eyes. Diagnosis of allergic rhinitis relies upon a thorough
history and may require allergy screening or testing. The treatment of allergic
rhinitis is typically requires the use of topical nasal sprays, occasionally
oral anti-allergy pills and for some individuals allergy shots known as
immunotherapy.
Nasal Polyps
Nasal polyps represent a polyp formation within the nose; these polyps form
for an unknown reason but can be secondary to hereditary, allergic or infectious
triggers. Polyps are covered by the normal mucus membrane of the nose and
contain inflammatory tissue and excess fluid. Diagnosis of nasal polyps
is usually evident on exam, and can be associated with asthma, and aspirin
sensitivity. All patients with nasal polyps have an element of chronic sinusitis.
The treatment of nasal polyps requires the use of topical nasal sprays and
in some instances requires the use of oral steroids. Nasal polyps that do
not respond to medical therapy may require surgical removal via endoscopic
sinus surgery.
Chronic Sinusitis
Chronic sinusitis is a disease spectrum that includes persistent sinus infection,
recurrent sinus infection, and fungal sinus infection that may or may not
be associated with nasal polyps. Chronic sinusitis can be treated with a
variety of medication and usually requires the use of nasal sprays, antibiotics,
antifungal agents and occasionally oral steroids or other anti-inflammatory
medication. When medical therapy fails, endoscopic sinus surgery may be
required to help eradicate disease.
Nasal Obstruction/Deviated Nasal Septum
Difficulty with nasal breathing can often be attributed to a deviated nasal
septum or enlarged structures within the nose known as turbinates. The nasal
septum divides the nose into a right and left nasal cavity. This bony and
cartilaginous structure is often bent or curved to one side secondary to
some sort of trauma. While some nasal sprays may help improve nasal breathing,
a deviated nasal septum may require surgical repair to ultimately improve
nasal breathing. The repair of a deviated nasal septum is called a septoplasty.
Turbinates function within the nose to heat, humidify and filter the air
that one breathes. Often enlarged secondary to reactivity, these structures
can be reduced to improve nasal airflow with techniques such as somnoplasty
or turbinate reduction.
Nasal Sinus Tumors
Multiple nasal sinus tumors exist. These include inverted papilloma, osteoma,
mucosal melanoma and many other rare sinus tumors. Inverted papilloma is
the most common of the nasal sinus tumors. The cause of inverted papilloma
is unknown at this time. Treatment for inverted papilloma requires surgical
excision and can now be accomplished with endoscopic sinus surgery. Treatment
for specific nasal-sinus tumors is based upon the specific pathology of
the tumor or mass.
Wegener’s Granulomatosis
Wegener’s Granulomatosis is a rare auto-immune connective tissue disorder
that can affect the normal nasal mucosa. In a reaction that can cause inflammation
and severe crusting within the nose, Wegener’s Granulomatosis can
present with difficulty with nasal breathing, bloody nose, or a perforation
of the nasal septum. Medical therapy is essential and a co-operative treatment
plan between the rheumatology department and otolaryngology department is
usually necessary. Other connective tissue disorders of the nasal cavity
include sarcoidosis, and Churg-Strauss disease.
Cerebro-Spinal Fluid (CSF) Leak
A CSF leak represents a drainage of the fluid that normally surrounds the
brain into the nasal cavity. A CSF leak can result from a congenital abnormality,
or trauma; occssionally a CSF leak will arise spontaneously without an identifiable
cause. A CSF leak presents with either intermittent clear drainage from
the nose or a constant slow drip from the nose. Depending on the cause and
location of the CSF leak, surgical intervention may be required. Repair
is typically done with endoscopic sinus surgery.
Endoscopic Sinus Surgery
Endoscopic sinus surgery is the use of endoscopic camera equipment to perform
sinus surgery. Entering through the nostril, camera and operative equipment
are used to visualize the normal nasal structures and treat specific sinus
diseases. Over 5000 sinus cases have been done at the Loyola Nasal Sinus
Center. All sinuses, even the most diseased, can be opened with an endoscopic
technique. This includes the frontal, ethmoid, maxillary and sphenoid sinuses.
Revision Sinus Surgery
Sinus surgery may not always be successful and revision sinus surgery can
be difficult. As a tertiary referral center, Loyola Nasal Sinus Center represents
a specialty center for patients that have previously failed sinus surgery.
Often done with computer guided imagery, revision sinus surgery requires
the experience and expertise that is offered at the Loyola Nasal Sinus Center.
Computer Image Guided Sinus Surgery
Computer guided sinus surgery is the use of instrumentation that merges
a patient’s anatomy with a CT scan in 3-D. Computer guided sinus surgery
allows the surgeon to know in real-time the exact location of instrumentation
within the nose. While not used in every instance, computer guided surgery
helps in defining disease location, ultimately aiding in disease removal.
Balloon Sinuplasty
Balloon sinuplasty is a new technique that uses balloons to dilate open
the normal drainage pathways of specific sinuses. As a brand new technique,
long term results are not known. However, balloon sinuplasty appears to
represent a safe and effective method to treat specific sinus disorders
allowing for sinus drainage.
Somnoplasty/Turbinate Reduction Surgery
Nasal turbinates are structures within the nasal cavity that heat, humidify
and filter the air one breates. Somnoplasty is an office base technique
that uses heat to destroy the thick tissue of the nasal turbinates that
ultimately results in an improved nasal airway. Other techniques of nasal
turbinate reduction include out patient surgical procedures that directly
reduces the size of the nasal turbinates.
Septoplasty
Septoplasty is the repair and correction of a deviated nasal septum. Septoplasty
does not change the outward appearance of the nose. By careful manipulation
and removal of some bony or cartilaginous defects, the nasal septum can
be returned to its ideal midline position. The aim of septoplasty is to
provide for an open and normal nasal airway.
