Ballooning For A Solution

Royal Bahrain Hospital is now offering Balloon Sinuplasty. This procedure focuses on the sinuses and helps to relieve people who suffer from Chronic Sinusitis.

Basically, sinuses are air-filled pockets behind the facial bones surrounding the nose. Each sinus has an opening through which mucus drains, and this drainage keeps the sinuses working well and the person healthy. However, anything obstructing that flow may cause a buildup of mucus in the sinuses, which may lead to infection and inflammation of the sinuses.

Thus, sinusitis occurs when the lining of your nose, sinuses and throat become inflamed, possibly from a pre-existing cold or allergies. Chronic sinusitis is when this inflammation lasts three months or more. Common symptoms include: facial pain, pressure, congestion or fullness. Difficulty breathing through the nose; discharge of yellow or green mucus from the nose; teeth pain; loss of the sense of smell or taste; headache, fatigue; sore throat; bad breath.

There is a solution to this though. Although typical treatment for sinusitis begins with medication prescribed by your doctor, sadly a majority of chronic sinusitis sufferers don’t get relief with medication. For these patients, a surgical procedure may be recommended, which is called Balloon Sinuplasty. This procedure is safe and minimally invasive, whereby the sinus passages are opened. Doctors thread a soft-tipped guide wire equipped with a tiny balloon into the nostrils and up to the area of blockage. They then inflate the balloon just enough to open the passageway. Finally, fluid is sprayed into the infected sinus to flush out the pus and mucus.

This surgery is a perfect option for chronic sinusitis sufferers. It is a safe procedure which relieves the pain and pressure associated with chronic sinusitis without cutting and removing the natural structures in the nose. The recovery time is very short for this procedure (although it varies between each patient). Finally, it is a proven procedure, whereby tens of thousands of patients have experienced long term improvement in their quality of life after a Balloon Sinuplasty procedure.

This procedure is performed at Royal Bahrain Hospital by Dr. Shalabh Sharma [Senior Consultant ENT] and Dr. Avneesh Kumar [Senior Specialist ENT]. To book your appointment, schedule a consultation with Dr. Avneesh Kumar by calling 17246800.

Cure for a Sniff

Although many would brush off a sniffly nose as a cold, many don’t realize that it could be a sinus infection. Dr. Avneesh Kumar, specialist ENT and Head Neck Surgery, explains how to properly treat a sinus infection, and what to do if it lasts longer than normal.

According to Dr. Avneesh, the aim of the treatment is to restore the ability of the sinus openings to ventilate and drain the sinuses. The antibiotics, while important in certain cases, do not provide relief as they do not reach a concentration high enough to kill the bacteria within the stagnant mucous in the blocked sinuses.

The most important way of opening the sinuses is the use of steroid nasal spray. These sprays are cortisone but they do not get absorbed into the bloodstream and do not cause any of the side effects of cortisone.

The cortisone nasal sprays do not work immediately and require 5 to 10 days to show any effect. They also do not work unless if they are used continuously whether symptoms are present or not. These sprays are different from over the counter decongestant nasal sprays that open up the nose temporarily.

However, Dr. Avneesh warns that there are cases where medical treatments have failed and the CAT scan has shown severe obstruction which requires surgery. This is usually performed through the endoscope with the help of special instruments such as a shaver (a rotating knife) that opens up the tubes connecting the sinuses to the nose. The sinus surgery in most cases is combined with straightening of the nasal septum and reduction of the nasal turbinates (which are enlarged soft tissues on inner side wall of the nose) which are done using laser. Royal Bahrain Hospital is equipped with these modern facilities. The sinus surgeries are routinely done with the aid of latest shaver system from Stryker (A German make) and Holmium- Yag laser which has superior delivery system than other lasers especially for ENT applications.

Dr. Avneesh assures readers that this surgery does not involve making any cuts in the skin and the sinuses are approached through the nose. After the surgery the patient experiences blockage of the nose and mild pressure sensation around the eyes for few days. The patient usually goes home on the very next morning. There are no packs placed in the nose after the surgery.

Dr. Avneesh Kumar, specialist ENT and Head Neck Surgery, has vast experience in sinus and laser surgeries. He is trained at the apex institutes in this field and has attended numerous sinus workshops and specializes in use of shaver systems and laser for all nose and sinus surgeries.

For further information or an appointment with Dr. Avneesh Kumar at Royal Bahrain Hospital, please call 17246800/246811

Behind the Nose

Although many presume to know what the sinus is, Dr. Avneesh Kumar, specialist ENT and Head Neck Surgery, clarifies many of the surrounding questions and sheds some light on sinusitis diagnosis.

The doctor explains that sinuses are air filled cavities located around the nose and the eyes and connected to the inside of the nose by way of small openings. These openings help in ventilation and drainage of the sinuses. In the event of a viral infection or allergy or a reaction to environmental irritants, these sinus openings get blocked due to inflammation and swelling which leads to accumulation of secretions within the sinus and this acts as a perfect culture for bacteria to grow. The bacterial infection in turn leads to more swelling and inflammation and further closure of these openings. If not adequately treated it will turn into a chronic low-grade infection causing symptoms which may persist from a few months to a few years.

He says that usual symptoms of sinusitis are nose block, nose discharge, pain over the face and around the eyes, headache and frequent sore throat due to post nasal discharge of infected secretions. 

The diagnosis of sinusitis could be based on the patient description of the symptoms and simple office examination. This is usually done in cases where the condition is new and had been there for a few days. If the condition had lasted for a few months, and it did not respond to the initial treatment, or if the diagnosis is in question, then more studies are needed. The traditional simple sinus X- rays are not useful.

There are two important tests. The first is an examination of the inside of the nose using a small endoscope (a long flexible tube) that is inserted into the nose in the clinic to examine the openings connecting the sinuses to the nose. This examination at our hospital is carried out with video camera attachment and the same is recorded and saved in the patient’s e-file for future reference. The other important test is a CAT scan of the sinuses which shows clearly the micro-anatomy of the sinus, its openings and the nose cavities.

Dr. Avneesh Kumar, specialist ENT and Head Neck Surgery, has vast experience in sinus and laser surgeries. He is trained at the apex institutes in this field and has attended numerous sinus workshops and specializes in use of shaver systems and laser for all nose and sinus surgeries.

For further information or an appointment with Dr. Avneesh Kumar at Royal Bahrain Hospital, please call 17246800/246811

Have You Heard?

Dr. Avneesh Kumar, ENT Specialist at Royal Bahrain Hospital, reveals that “facility-wise, the set-up at the Royal Bahrain Hospital is phenomenal, as it comes with the latest technology and state-of-the-art equipment, especially so for the ENT department."

He continues to explain that "patients undergo comprehensive video examination of their ear, nose and throat. Video-endoscopic examination is viewed live by the patients and is simultaneously recorded into their hospital e-file for future reference. For example, if a patient is suffering from a blocked ear, the equipment allows us to look inside the ear on a magnified scale with no discomfort felt by the patient. The operative procedures are recorded and the patients are given a copy if they desire.”

Dr. Avneesh moves on to shed some light on common infection affecting children, called “Glue Ears”.

It is a common childhood condition, often missed as small children cannot articulate their symptoms. If a child cries frequently, has recurrent colds and frequently pointed out by the school teacher of being inattentive, he may be having “glue ears” and therefore reduced hearing.

This condition usually arises due to large adenoids (tonsils at the back of the nose) which affect the normal functioning of the Eustachian tube (tube that connects the ears to the back of the nose). Blocked Eustachian tubes fail to ventilate and drain the middle ears and lead to glue like collection behind the ear drum.

Video endoscopy of the ear clearly reveals a magnified view of the typical “Dull look” of the ear drum due to glue collected behind it. Sometimes air bubbles can also be seen through the ear drum.

A simple procedure at the right time is therefore required which is to drain the glue and ventilate the middle ear directly by fixing a ventilation tube (grommet) to the ear drum. It is a miniature tube which causes no discomfort to the patient and it extrudes by itself in one year time.

Dr. Avneesh considers Bahrain his second home, where he completed his primary education at the Indian School, before doing his MBBS and then MS (Master’s in ENT) in India at the prestigious Manipal University. For more information or to book your appointment call Royal Bahrain Hospital on 1724 6800 or our toll-free number 8000 1090

Knowing Your Nose

Dr. Avneesh Kumar, ENT Specialist at Royal Bahrain Hospital, reveals that “facility-wise, the set-up at the Royal Bahrain Hospital is phenomenal, as it comes with the latest technology and state-of-the-art equipment, especially so for the ENT department.

Patients undergo comprehensive video examination of their ear, nose and throat. Video-endoscopic examination is viewed live by the patients and is simultaneously recorded into their hospital e-file for future reference. For example, if a patient complains of hoarseness, we can examine and video-record the vocal cords to pinpoint where the problem lies. If suffering from a runny or blocked nose, the equipment allows us to look inside the nostrils on a magnified scale with no discomfort felt by the patient. The operative procedures are recorded and the patients are given a copy if they desire.”

Dr. Avneesh moves on to shed some light on common infections affecting our noses.

Nasal allergies, recurrent attacks of flu and sinusitis are quite prevalent in Bahrain. Most nasal allergies can be controlled with simple medication; however some patients are more prone to sinusitis due to abnormal anatomy of the nose and sinuses.

Sinuses are air containing chambers located around the eyes which are connected to the nose by their natural openings, allowing for ventilation as well as aiding drainage. A blockage at these openings leads to collection of sinus secretions and subsequent infections.

If the medical treatment fails, a video-endoscopy of the nose is done to illustrate on a magnified screen the small sinus draining areas (middle meatus) and to look for any anatomical abnormality. The pathologies within the deeper sinuses can be picked up on CT scan.

These abnormalities can be corrected by Video-endoscopic Sinus Surgery. Both pre and post-surgery videos are done and a copy of the same is given to the patient.

Dr.Avneesh considers Bahrain his second home, where he completed his primary education at the Indian School, before doing his MBBS and then MS (Master’s in ENT) in India at the prestigious Manipal University. For more information or to book your appointment call 1724 6800.