Sinusitis & Treatments
Sinusitis is an infection of the paranasal sinuses, which are air-filled spaces surrounding the nasal cavity. When a sinus infection occurs, these spaces become filled with thick, discolored mucus, which blocks breathing and causes facial pain and pressure. Sinusitis is usually caused by nasal infection, viruses, allergies, molds and asthma. It is a common ailment that affects 37 million Americans each year.
At his New York office, Dr. Charles Kimmelman diagnoses sinusitis with careful examination of the nose and sinuses aided by fiberoptic technology. CT scans and cultures for invading organisms can further help determine the severity and cause of the infection. Treatments for sinusitis depend on the cause: antibiotics for bacterial infection are usually necessary. In more severe cases balloon sinuplasty, an innovation that enlarges narrow sinus openings and opens blocked sinus tissue, can successfully reduce recurrent infections.
Deviated Nasal Septum
The nasal septum is the bone and cartilage within in the nose that separates the two nasal passages. The septum should be fairly straight for optimal air flow. When the nasal septum is significantly deflected to one side or the other, air flow through the nose is obstructed and can lead to nasal blockage, reduced sense of smell, nose bleeds and snoring with sleep apnea.
Dr. Kimmelman evaluates and treats patients with a deviated septum at his NYC office with a procedure known as Septoplasty. In this procedure the septum is reshaped so that the nasal passageways become even. The procedure takes about an hour and does not affect the external portion of the nose. Typical healing time is between two to four weeks.
Sleep Disorders: Snoring and Sleep Apnea
Snoring occurs when the breathing passages of the nose and throat become narrowed, leading to turbulent flow of air in the throat. Snorers often are unaware of their snoring. Snoring can lead to poor sleep and daytime fatigue. Bed partners are also affected by the snoring as well.
Sleep apnea occurs when the air passage is totally blocked, resulting in frequent loud snoring punctuated by periods of apnea (stoppage of breathing). This cycle continues throughout the night. Sleep apnea not only affects quality of sleep, but may be life-threatening, causing depression, fatigue, irritability, high blood pressure, and contributing to stroke and heart attacks.
Treatments for snoring and sleep apnea can significantly improve breathing and reduce or eliminate airway obstruction. If the condition is mild to moderate, Pillar implants can be inserted in the office setting to reduce snoring and apnea. The implants are rod-like in shape and support the soft palate to open the airway and reduce vibrations of the nose and soft palate. Most patients can resume daily activities such as eating and drinking the same day. More severe cases of snoring and sleep apnea can be managed with surgical procedures, such as tonsillectomy, uvula procedures and base of tongue advancements. The goal is to open the air passages from the nose into the throat to allow normal breathing and restful sleep. Dr. Kimmelman devises a specific treatment plan based on the type and severity of your sleep disorder.
The Pillar Procedure is the first FDA-approved implant treatment for snoring. Six small implants are inserted into the roof of the mouth. The implants are rod-like in shape, measuring 18mm in length and made from a polyester woven thread. The implants stiffen and support the soft palate to assist in stabilizing the airway, minimizing vibration and shaking of the soft tissues of the nose and mouth during sleep. This greatly reduces snoring and sleep apnea.
Dr. Kimmelman performs the Pillar Procedure at his Manhattan office. It is an outpatient procedure done under local anesthesia. The procedure is minimally invasive and takes about 30 minutes to complete. Most patients can resume daily activities such as eating and drinking the same day.
Smell disorders are characterized by the reduced ability (hyposmia) or inability (anosmia) to smell odors. Some people are born without a sense of smell, but most cases of loss of smell are due to viral infections, head trauma and upper respiratory infections. A reduced sense of smell due to infection may resolves on its own. Sensory cells in the nose, mouth and throat work together to generate our sense of smell. Because of this, smell disorders affect the taste and appeal of food. They can also be dangerous as they dull our reaction to alarming odors such as gas leaks and smoke.
Before treating a smell loss, Dr. Kimmelman administers the Smell Identification Test at his NY office. Dr. Kimmelman worked with the original developers of this test during his research at the University of Pennsylvania. The test reveals the severity of the patientís smell disorder. A complete examination of the nose and sinuses is then performed. Dr. Kimmelman may order a CT or MRI scan for further evaluation of your condition. Treatment methods vary from surgical to medical according to individual cases.
Taste disorders are characterized by a reduced sense of taste, an inability to taste (although this is very rare) or a distorted sense of taste. The taste buds on our tongues allow us to detect what is sweet, sour, salty, bitter and umami. Our sense of smell is closely tied to our perception of taste, so often times a dulled sense of taste can be attributed to a smell disorder.
Taste disorders can be a secondary symptom of an illness, infection, or a sign of an underlying medical problem. Taste disorders often occur as a result of head trauma or upper respiratory infection. Dr. Kimmelman treats taste disorders at his New York City office by first evaluating the patientís medical history. He then carefully examines the ear, nose, tongue, palate and membranes under the tongue and side walls of the mouth. Taste testing can also be important. With this information, Dr. Kimmelman can decide on the most appropriate options for treatment.
Hearing & Balance
Like all of our senses, our hearing is extremely important. It allows us to communicate and listen to the world around us. Many people donít know that our sense of hearing and our sense of balance are actually connected. The anatomy of our ears is complex; it is composed of the outer ear, the middle ear and the inner ear. Sound first reaches our outer ear. The vibrations are carried into the ear canal, allowing us to interpret the sound and the direction itís coming from. The ear canal is part of the outer ear. It leads to the eardrum which leads to the middle ear. The eardrum amplifies sound. The inner ear is composed of a set of sensory organs and fluids that help us maintain balance. These sensory organs respond to the pull of gravity as well as our head and neck positions.
Hearing and balance can be thrown out of place. A person can be born with difficulty hearing, develop it due to certain events such as exposure to loud noises or infections, or accumulate it with age. Hearing loss can be sudden or gradual and is often tied with a decreased sense of balance. There is a wide range of hearing losses. Dr. Kimmelman diagnoses them in is New York office by reviewing his patientsí medical histories and conducting a series of hearing and balance tests. The treatment of hearing and balance loss also varies. Hearing loss due to an ear infection is the simplest one to treat because ear infections generally go away themselves. Antibiotics may also be prescribed to hasten the process and relieve any discomfort. For more serious cases, treatment options can vary from antibiotics, hearing aids, surgery to cochlea implants.
Voice & Swallowing
When we exhale, the lungs which propel air out of our windpipe; to speak, we narrow the tissues of the larynx (voice box), generating the movement of the vocal cords and the sound of human speech. As the vocal cords vibrate, the sound is modulated by our tongues, lips, soft palate and sinus cavities. Signs of a voice disorder include hoarseness, fatigue and difficulty when speaking, change in pitch or tone of the voice, excessive coughing and excessive clearing of the throat.
The swallowing process begins with the mouth. We chew our food to moisten and soften what we eat;as we swallow, the vocal cords close to prevent liquids and solids from entering the airway. The esophagus is a muscular organ that propels the food and drink into the stomach. If youíve ever had food ďgo down the wrong pipeĒ then youíve experienced how these two functions relate.
Tinnitus & Treatments
Tinnitus is most easily described as a ringing in the ear. The ringing does not come from any external source. Tinnitus is divided into objective and subjective. Objective tinnitus can actually be heard by others if they are close enough. Causes for objective tinnitus are usually muscular or vascular problems. The sound comes from spasms or altered blood flow inside the patientís ear. Subjective tinnitus is more degenerative and harder to relieve. Subjective tinnitus usually goes hand in hand with sensorineural hearing loss. As such, it usually develops and worsens with age. As the hearing deteriorates, the brain overcompensates by sending signals to regions of the brain that stimulate the nerves in the ear. For sufferers, this causes the ringing in their ears to be especially loud compared to the dulled sounds they perceive from the outside world.
Unfortunately, there is no clear treatment for tinnitus. Prevention in the younger ears is crucial as tinnitus develops with hearing loss. Being cautious with the sounds we are exposed to can help in tinnitus prevention. Lowering the volume in our earphones and wearing earplugs when exposed to loud working environments are both essential.
For sufferers who already have tinnitus, Dr. Kimmelman does have methods to relieve the pain and annoyance in his New York office. Often times the ringing in the ears becomes louder and louder to the sufferer and harder to ignore as the tinnitus progresses. One technique that has proven to be successful is training the brain to focus on something other than the ringing. This can be achieved through biofeedback, yoga, meditation and anxiety reducing drugs. Another technique is to use another form of noise to take the focus away from the ringing. This noise can be white noise, static or the sound of a fan. A noisemaker shaped much like a hearing aid can also be placed in the ear to counteract the ringing.