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 thy-
roid 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 weak-
ness. 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 ulti-
mately become the standard for the current generation of ENT spe-
cialists. 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.
5 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 6
Balloon sinuplasty is extraordinarily safe,
can be done comfortably under local anesthesia
and delivers consistent, lasting improvement.
