Balloon sinuplasty – noninvasive treatment for sinusitis

This noninvasive technology has revolutionised the management of sinusitis and is now increasingly being used either alone or alongside traditional sinus surgery techniques. It is now also being offered to selected patients under local anaesthetic and/or sedation, avoiding the need for a full general anaesthetic.

Please refer to the separate page on balloon sinuplasty (under procedures) for further information on this technique.

Titanium Nasal Implant

A total of eleven patients have now received the Titanium BreatheTM nasal implant in the last 6 months, and all with excellent results so far. Many more have had the implant in the UK and abroad, in all cases for the correction of a weak inner nasal valve or outer (alar) cartilage. Without exception patients have reported a much improved nasal airway, with no instances of graft migration or visibility.

Surgery for halitosis (bad breath)

Halitosis, or bad breath, may occur for several reasons, ranging from dietary factors, a blocked nose causing mouth breathing, and problems within the mouth itself. One of the commonest reasons is due to a build up of debris within the tonsils which occurs when food particles get stuck inside one or more of the deep crypts which make up the surface of the tonsils. Mouthwashes and regular rinses may help albeit only temporarily.

If the problem becomes particularly severe, your specialist may recommend either a tonsillectomy (removal of the tonsils) or tonsillotomy(reduction in the size of the tonsils). This can be performed with or without the laser. Both are performed as day case procedures under a general anaesthetic, and results are almost always excellent.

Incision-less Pinnaplasty

Incision-less pinnaplasty. In recent years, a novel technique has been developed for pinning back prominent ears without the use of any external cuts or incisions to the skin. This is achieved with the use of carefully placed sutures passed into the ear cartilage. The operation can be performed under local anaesthesia more easily than a conventional pinnaplasty, usually as a day case. The advantages of an incision-less versus conventional pinnaplasty are a shorter operation, no need for external incisions or cuts in the skin, fewer postoperative complications, equivalent cosmetic result with minimally invasive surgery, easier to perform under local anaesthetic, no need to wear a postoperative head bandage and same-day discharge home.

Please refer to the separate information sheet on pinnaplasty for further information and images.

Cyclops endoscope (Acclarent)

The company responsible for the highly successful balloon sinuplasty technology, (Acclarent), has recently been taken over by Johnson & Johnson. The company identity is to be retained, an alliance which should hopefully yield further improvements to the already successful design. Please see for further information.

A further development has seen the introduction of the Cyclops rotating rigid endoscope which allows for a wide field of view which can be rotated through 10 to 90 degrees using the same endoscope. This formally was only possible by changing the endoscope each time a different angle is required.

Gaviscon AdvanceTM

Now licensed for use in laryngopharyngeal acid reflux. Gaviscon Advance TM, by Reckitt-Benckiser, is widely known as an effective treatment of indigestion and symptoms of gastric acid reflux, including burning behind the chest and pains in the upper part of the abdomen. It works by acting as a protective barrier within the stomach, preventing naturally occurring episodes of acid reflux from entering the oesophagus. The acid stays in the stomach where it causes fewer symptoms.

In some patients, acid or other substances including the enzyme pepsin reflux into the upper oesophagus and larynx, causing symptoms of burning in the throat, sore throat, hoarseness and a feeling of something stuck in the throat (also known as globus pharyngeus). These symptoms can occur even in the absence of the usual symptoms of gastric acid reflux. This condition is known as laryngopharyngeal reflux (LPR). Up to now, Gaviscon AdvanceTM has been used in patients with LPR to good effect although its use has not been formally licensed until recently. This is good news for the many sufferers of this condition as Gaviscon AdvanceTM has minimal side effects and is effective in the majority of patients, either alone or in combination with other treatments.