D. Scott Fortune
Over the past 10 years, Rhinology has seen a revolution in site of service for treatment of several common conditions: Chronic Rhinosinusitis, Chronic Rhinitis, Eustachian Tube Dysfunction, and Lateral Wall Insufficiency (Nasal Valve Stenosis). Increasingly, these services can be delivered in an office based setting creating significant advantages for the patient such as quicker recovery, minimal downtime, less cost, less lost productivity, and equivalent results when patients and disease severity are chosen appropriately. In this presentation, Dr. Fortune will cover several important aspects of office based rhinology procedures. Anesthesia is first and foremost in the office setting and the first portion of the presentation will cover anesthesia protocols which work for the patient, attending consultant, and nursing staff. The second portion of the presentation will focus on the various procedures that are described in the literature using a disease based classification. Examples include balloon catheter dilation of paranasal sinuses, drug eluting stents, sinus irrigation, ablation procedures for hyperactive sphenopalatine nerves, balloon catheter dilation of Eustachian Tubes, repair of nasal valve collapse with polymer implants, as well as radiofrequency ablation of redundant soft tissue over the lower lateral cartilages. Dr. Fortune will then review some of the technology options for carrying out office based rhinology procedures. Finally, the talk will cover some of the relevant medical literature regarding pertaining to the office based rhinology literature emphasizing outcomes based symptom scores. Dr. Fortune will include videos and still photos from his own work demonstrating these techniques. With continual advances in endoscopic instrumentation and technology, recent years have witnessed significant expansion in office-based rhinology. The advent of specialized equipment and novel therapies specifically designed for use in the clinical setting has enabled an increasing number of rhinologic procedures to be effectively performed in the office without the need for general anesthesia.