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Why It’s Dangerous To Leave Your Sleep Apnea Unchecked

Many people have heard of sleep apnea and associate it with annoying problems like snoring and tiredness. But what about other side effects of this condition? And, more importantly, is sleep apnea dangerous?

A Quick Explanation of Sleep Apnea

Obstructive sleep apnea is the most common type of sleep apnea. It happens when there’s a blockage somewhere in your airway while you’re trying to sleep.

Muscle tone is much lower when you’re asleep than when you’re awake. Even the muscles of your airway relax. This relaxation can cause the tongue and tonsils to fall back and block off your airway. For people with larger bodies, fatty tissue in the neck can also put pressure on the airway.

An obstructed airway keeps your lungs from getting the airflow they need to function properly. It can also cause your heart to work overtime as it attempts to make up for the lack of oxygen from your lungs.

is sleep apnea dangerous

Is Sleep Apnea Dangerous?

Many people don’t view sleep apnea as being dangerous, but over time, the effects can be devastating. Obstructive sleep apnea poses two levels of danger: short-term and long-term.

Short-Term Consequences of Sleep Apnea

The short-term consequences of sleep apnea occur immediately, rather than building up over time. “Short-term” doesn’t mean they go away, however. Unfortunately, these symptoms remain until you receive effective treatment for your sleep apnea.

Sleep Deprivation

Sleep apnea can leave you feeling exhausted. Even if you’re in bed for a full eight or nine hours, you may only get twenty minutes of true, restful sleep. Hitting the snooze button doesn’t make you feel any better, and your exhaustion follows you throughout the day.

You may notice you drink more and more coffee just to function normally, feel miserable during the workday, or nod off at inopportune times. This level of sleep deprivation isn’t the same as missing an hour of rest here or there.

Car Accidents

Any kind of sleepiness can affect your operating of heavy machinery, including your car. People experiencing sleep deprivation are six times more likely to be involved in a vehicle collision than their well-rested counterparts.

Loss of Focus

It’s much harder to focus on the task in front of you when you’re not well-rested. You may find yourself asking coworkers to repeat themselves multiple times or zoning out as you try to read an email. Tasks that normally take little effort suddenly become huge chores because you just can’t concentrate. Sleep deprivation that leads to poor concentration can seriously impact your performance at work.

Lowered Immune Function

Even your immune system is compromised when you don’t get enough sleep. You don’t heal as easily without enough rest, and you’re more susceptible to illnesses. It’s also harder to get healthy and stay healthy when you’re too tired to exercise or cook a healthy meal.

Relationship Problems

Lack of sleep impacts your relationships, and it can lead to depression, anxiety and other mental health problems. And since sleep apnea usually leads to loud snoring, it can also make your partner miserable!

Long-Term Consequences of Sleep Apnea

The short-term consequences of sleep apnea can compound to cause further problems, of course. For example, if your body doesn’t heal well, a common cold or flu can more easily turn into something else, like pneumonia. But sleep apnea also causes other, more serious long-term problems when left untreated.

Damage to Organs

Because sleep apnea keeps you from breathing properly while you sleep, your body is repeatedly oxygen-deprived throughout the night. A lack of oxygen to any part of the body is bad news, but this takes a particular toll on your heart and lungs.

High Blood Pressure

People with untreated sleep apnea are four times more likely to have high blood pressure, also called hypertension. Hypertension can eventually lead to heart failure as well as other complications.

Heart Attack

Severe sleep apnea sufferers are twice as likely to have a heart attack as others.


Those with severe sleep apnea are 1.8 times more likely to have a stroke.

Where Do I Start if I Think I Might Have Sleep Apnea?

The first step in getting evaluated for sleep apnea is to visit your doctor and tell them your concerns. Your doctor will then order a sleep study.

A sleep study is the only way to diagnose sleep apnea. It can be done either in your home or at a sleep lab. Although the technology used in a sleep lab may be a little more accurate, you might sleep better in your own home. Which setting you choose is up to you and your doctor.

After your test, your doctor can talk to you about your results and give recommendations for your specific situation. Together, you’ll decide on what treatment is right for you.

Some recommendations your doctor might make include:

  • weight loss
  • oral appliance therapy
  • a CPAP machine
  • Inspire

It’s difficult to make decisions when you’re exhausted. But the decision about where to get treatment for your sleep apnea doesn’t have to be difficult.

ENT Associates of Lubbock offers a number of solutions for your obstructive sleep apnea. Regardless of the age of the patient or the severity of the sleep apnea, we can help. We treat the whole family, and we look forward to meeting with you!

Book a consultation today to discuss your sleep apnea with one of our experienced ENT doctors.

What Are the Symptoms of Eustachian Tube Dysfunction?

Do you ever feel like you’re hearing the world from underwater? Or maybe your ears feel like you’ve been on an airplane and you just can’t get them to “pop.”

If so, you may be dealing with a case of eustachian tube dysfunction.

What Is the Eustachian Tube?

The eustachian tube is a tiny passage that connects the middle ear to the back of the nose.

Normally this tube stays open and helps to equalize the air pressure in the middle ear. It also allows any excess fluid from the middle ear to drain to the back of your nose and down your throat.

But when this tube becomes blocked due to inflammation or other causes, fluid builds up in the middle ear. Air can build up as well, since the eustachian tube is failing to maintain equal pressure.

This imbalance of fluid and air can lead to a group of symptoms that healthcare professionals call eustachian tube dysfunction.

What Are the Most Common Eustachian Tube Dysfunction Symptoms?

Patients with eustachian tube dysfunction often have muffled hearing, feeling like they’re hearing underwater or in a barrel. Some people can even hear water sloshing or bubbling in their middle ear!

Friends and loved ones might point out that you’re talking louder than normal. This is because when your middle ear is full, you can’t hear yourself talk as well. If you think you might be experiencing hearing loss, but it was very sudden in onset, it’s likely that the loss isn’t permanent.

Patients also often describe a feeling of fullness or pressure in their ear, though it’s not usually painful. One woman said she hadn’t felt pressure that intense since childbirth! (She even asked for an epidural.)

Trying to yawn, swallow, or chew gum to relieve the pressure will usually fail. All these methods to “pop” your ears rely on the eustachian tube functioning properly.

eustachian tube dysfunction symptoms

What Can I Do at Home To Manage My Eustachian Tube Dysfunction Symptoms?

Eustachian tube dysfunction symptoms can be very uncomfortable. If you begin to experience ear pain rather than just pressure, you should contact your ENT doctor right away. At that point you might be dealing with a middle ear infection.

But if you’re just experiencing the other symptoms mentioned above, you can try a variety of over-the-counter solutions before picking up the phone.

Antihistamines, decongestants and topical steroids can provide relief from eustachian tube dysfunction symptoms. These medications are helpful because many of the symptoms of eustachian tube dysfunction are due to swelling and congestion in the nasopharynx (the back of the nose).

A technique called autoinsufflation can also help in clearing the eustachian tube and restoring a bit of balance between the middle ear and the nasopharynx. To try this, pinch your nose and exhale gently through your mouth, but with your mouth closed. This technique can be a helpful way to release the pressure behind the eardrum.

We usually recommend first trying to decongest the nasopharynx area and seeing if that helps to improve your symptoms. If your symptoms persist after a month, or if they become more severe or painful, you’ll probably need medical help to deal with your eustachian tube dysfunction.

When Should I Call a Doctor?

If you’ve been dealing with pressure, fullness and that annoying underwater feeling for more than a month without any sign of relief, it’s time to call an ENT doctor.

Even if over-the-counter medications temporarily relieve the symptoms, if they return as soon as the medications wear off, you should still see a physician.

What Treatments Might an ENT Suggest?

It’s possible that a prescription-strength decongestant or topical steroid may solve your eustachian tube dysfunction. But some people (like children, people with allergies, or people who smoke) are more susceptible to eustachian tube dysfunction than others, and may have more persistent cases.

When the problem isn’t remedied by medications, even prescription strength, other options are available.

In cases like these, ear tube placement might help. Ear tubes open a tiny pathway between your middle ear and your outer ear. This equalizes pressure in your ear and allows any excess fluid to drain through your outer ear.

Ear tubes may not be right for everyone, or they may fall out over time. In these cases, eustachian tube balloon dilation can be a great option.

In eustachian tube balloon dilation, an ENT doctor inserts a small balloon into the eustachian tube and inflates it. This opens up the part of the tube that tends to collapse.

This short procedure involves very little risk or pain and has a high success rate. And because the balloon enters through the nose, there’s no cutting or scarring!

Dealing With Symptoms of Eustachian Tube Dysfunction?

If any of the above symptoms sound familiar and won’t respond to your go-to home remedies, call ENT Associates of Lubbock. Dr. Cuthbertson and Dr. Scolaro both have extensive experience treating eustachian tube dysfunction.

Make an appointment for a consultation to talk about your particular case and how we can best help you treat it!

Inspire for Sleep Apnea: Say Goodbye to Your CPAP Machine

CPAP machines are designed to help sleep apnea sufferers stop snoring, breathe more deeply, and get a good night’s sleep. That sounds pretty good!

And for many CPAP users, that’s how the story goes. Unfortunately, though, other patients with sleep apnea find CPAP machines difficult to use.

Transporting a CPAP machine can be inconvenient, particularly if you travel often. Sometimes the air that’s meant to help you breathe can dry out your eyes or fill up your stomach, leading to bloating and discomfort.

Some CPAP users develop a headache from having the mask strapped to their head too tightly. Others experience anxiety from wearing the CPAP mask, particularly those who suffer from claustrophobia. Some CPAP users even throw their mask on the floor without knowing it.

If you’re not a natural back-sleeper, changing your sleep position can be hard! And let’s face it; a mask and a loud machine don’t exactly set the stage for romance.

Inspire is the modern solution to sleep apnea for people who can’t tolerate a CPAP machine.

What Happens Physiologically During Sleep Apnea?

The vast majority of cases of sleep apnea are caused by an obstructed airway.

During the day, your muscles stay toned and you hold yourself upright. You can consciously compensate for any small airway blockage.

But at night when you’re reclined and sleeping, your muscles relax. Your tongue falls backwards and your tonsils fall inwards, and this can obstruct your airway. And since you’re asleep, you can’t consciously do anything to deal with this obstruction.

This is obstructive sleep apnea, which blocks the breath from entering your airway while you sleep.


Oxygen Flow to the Lungs Is Restricted

The lungs function quite differently than any other organ in the body.

When another organ is low on oxygen, its blood vessels dilate (get wider) to allow more blood — and the oxygen it carries — to enter.

Lungs, on the other hand, function in the opposite way.

Normally, blood flows through your lungs to pick up oxygen and deliver it to the rest of your body. But when some part of your lungs doesn’t get enough oxygen, the blood vessels in that area constrict (clamp down) to reduce how much blood runs through. Your body attempts to shunt that blood to a different part of the lung in an attempt to pick up more oxygen.

This efficient system usually works incredibly well for the body. But sleep apnea throws a wrench in the works.

With sleep apnea, no part of your lung is receiving enough oxygen, so all the blood vessels in your lungs start clamping down! This forces your heart to work extra hard to force blood into an area that’s trying to keep blood out.

Over time, this “battle of the blood” can lead to serious complications like pulmonary hypertension and heart failure.

How Can Inspire for Sleep Apnea Help?

The key to treating sleep apnea is to remove the obstruction that’s blocking the airflow.

So when we find a visible blockage, like swelling, congestion or enlarged tonsils, we work to eliminate those blockages first. If needed, a CPAP machine combats sleep apnea by using forced air to blow past any obstructions in the airway.

Inspire, on the other hand, attempts to recreate your body’s natural sleep state. Inspire uses your body’s own musculature and nerve signals to restore functional tone to your airway at night. This mimics the way you breathe when you’re awake and upright.

Common Patient Concerns About Inspire

As with any surgery or medical procedure, patients may have understandable apprehensions about Inspire. Let’s address some of the more common concerns we hear in our ENT practice.

How Long Has Inspire Been on the Market?

Inspire was originally approved for patient use by the FDA in April 2014.

Does Inspire Actually Work?

While it’s impossible to know with complete certainty how a specific patient will react to a procedure, Inspire has a pretty impressive track record.

After a patient gets Inspire, 90% of bed partners report no snoring or only very light snoring. Patients experience a 79% reduction in episodes of sleep apnea each hour. And 94% of patients say they would recommend Inspire to their fellow snorers.

Are There Studies That Prove That Inspire Works?

Yes, studies show that Inspire is effective. The first study of Inspire began in 2010, and the one-year results of that study were published in the New England Journal of Medicine. A five-year follow-up study was published by the American Academy of Otolaryngology: Head and Neck Surgery Foundation.

The ADHERE registry was originally established to follow Inspire patients after their surgery, both in the United States and abroad. This registry shows clinical data compatible with the studies mentioned above.

How Long Do the Effects of Inspire Last?

The battery inside the Inspire device lasts about 11 years, so your doctor will need to change it out about once a decade.

The battery change is a surgical procedure, but not as complex as the original placement. Other than this routine maintenance, Inspire works on its own to manage your sleep apnea indefinitely.

What’s the Surgery Like?

The surgery itself takes about two and a half hours. It’s an outpatient procedure, so you can expect to go home the same day. (You will need to have someone available to drive you home.)

Most patients are fully recovered within about a week after surgery.

Is There Anything Else I Should Know?

Your ENT doctor will take you through a process of informed consent, letting you know about all known risks and benefits of the Inspire procedure.

Inspire received full approval from the FDA in 2014, but it’s good to note that Inspire is not FDA-approved for an MRI of the chest or abdomen. It is approved for MRIs of the limbs and head.

Inspire at ENT Associates of Lubbock

At ENT Associates of Lubbock, we have successfully placed many Inspire devices for a wide variety of patients. The results have been the same for male and female, young and old, moderate cases to severe sleep apnea. Their quality of sleep — and life — has improved dramatically.

Whether you’re dealing with untreated sleep apnea or are tired of fighting with your CPAP machine at night, give us a call. Our ENT doctors can help you determine if Inspire is right for you!

6 Snoring Surgery Options That Could End Your Snoring

Have you ever woken yourself up with your own snoring? That can be a jarring experience! But that’s not even the most common reason patients come to our office for help with their snoring.

The top reason is actually complaints from their partner!

No one wants to go through a medical procedure. But if you (or your partner) are concerned about your snoring, it’s good to know that surgery could help.

What Should I Try Before Considering Snoring Surgery?

Anytime we have a patient complaining of snoring, we want to address the root cause, not just ease the symptom.

To start, we take a look inside your nose to identify any obvious obstructions. If you’re dealing with nasal or sinus congestion, we’ll try to address those with medications, such as decongestants. These can be over-the-counter or prescription, depending on how severe your congestion is.

If we see any other obstructions, like nasal polyps or an anatomical abnormality, we’ll discuss with you how we can correct these.

We’ll also inspect your throat to see if there’s anything that could be contributing to obstructing airflow while you sleep. For example, enlarged tonsils are a common cause of snoring, especially in children.

We might also discuss weight loss if it seems like your weight could be contributing to snoring. Fatty tissue in the neck can put pressure on the airway, leading to a noisier snooze. Losing a few pounds can sometimes have a dramatic effect on snoring!

snoring surgery

What Are the Types of Surgery for Snoring?

There are several surgeries that can help with snoring. Some specifically treat snoring, and some treat another condition and result in relief from snoring as a pleasant side effect.

Let’s look at some of these surgeries: three that we perform today, and three that we think are better left behind.


Believe it or not, years ago it was common to cut away a portion of the back of the tongue to prevent snoring. Fortunately, we don’t do this anymore. It was about as painful as it sounds!

Pillar Implant

With a pillar implant procedure, the surgeon inserts several small pillars into your soft palate (the back of the roof of your mouth). These pillars are meant to keep your soft palate from collapsing and causing airway obstruction.

Unfortunately, this is a temporary solution, and it’s not always effective. That’s why we don’t prefer to perform this surgery, or the following procedure, in our practice.


Somnoplasty is a procedure that uses radiofrequency waves to shrink the tissues in the nose and mouth. The results are also temporary and, again, not always effective.

This would likely be a last resort for someone who has tried a number of other solutions without success.

While these two procedures could theoretically offer temporary relief from snoring to a small percentage of patients, they aren’t something we offer at ENT Lubbock.


Removing the tonsils can be extremely helpful in snoring reduction for people with large tonsils. This is one of the most successful surgeries in treating children with sleep apnea and snoring. For children, the recovery is generally pretty easy.

The recovery time for an adult tonsillectomy can be more difficult. Plan to take two or three weeks to recover if you and your ENT doctor choose the tonsillectomy route for your snoring surgery.

Uvulopalatopharyngoplasty (UPPP)

This surgery first removes the tonsils if they haven’t already been removed. Several small incisions are then made in the soft palate. When the surgeon sutures these incisions, they tighten the palate, making it less likely to interfere with airflow.

A UPPP can be extremely helpful for a patient who experiences snoring because of loose tissue in the soft palate.

Despite how it looks, the most difficult part of this procedure isn’t the pronunciation. The recovery can be painful, and an overnight hospital stay for pain management is generally required.


Inspire is a small device that’s similar to a pacemaker. It includes a sensor that sits in your chest, detecting when you’re trying to take a breath. When it does, a probe sends a gentle electrical signal to the nerve that controls your tongue. Your tongue then moves out of your airway to allow you to breathe without restriction.

Inspire is well-accepted, well-documented and highly effective for stopping snoring. This little pacemaker-type device can lead to a 90% reduction in snoring, and a 100% reduction in your partner leaving the bedroom!

Inspire is an outpatient procedure and requires about a week to recover. As with any surgery or implanted device, there is also a small risk of infection.

What’s the Outlook After a Snoring Surgery?

The prognosis after these surgeries is excellent, assuming that there’s a good match between the right patient and the right procedure.

It’s important to address the root cause of your snoring, so be sure to talk to your ENT doctor about whether any of these snoring surgeries could be the right fit for you.

If your bed partner has been elbowing you at night and encouraging you to get help for your snoring, go ahead and reach out! At ENT Associates of Lubbock, we’re experts in getting you the help you need to stop snoring.

What Is Inspire for Sleep Apnea — Top Questions Answered

A continuous positive airway pressure machine (more commonly known as a CPAP machine) can seem like a dream come true at first. No more will you have to deal with the restless nights, the lack of REM sleep, and the daytime sleepiness.

But sometimes your CPAP dream can turn into a nightmare.

Your mask doesn’t fit right. The air leaks. It dries out your eyes. You’re uncomfortable. The machine is noisy, and the mask leaves grooves on your face. The air blows into your stomach, making you bloated. It dries out your mouth, so you drink more at night and have to get up to use the restroom.

On top of all that, your partner isn’t sleeping well now either because of your tossing, turning and fidgeting with this noisy machine!

How can you win the battle of the mask while still getting the sleep you need? Enter Inspire, the maskless solution for sleep apnea.

What Happens in the Body with Sleep Apnea?

There are two categories of sleep apnea.

Obstructive Sleep Apnea

The vast majority of sleep apnea cases are classified as obstructive sleep apnea. The body tries to breathe, but — as the name suggests — air can’t get to the lungs because of an obstruction in the airway. Usually, the obstruction involves the tonsils, the tongue or the soft palate (the roof of the back of the mouth) relaxing enough to block the back of the throat.

Another cause of obstructive sleep apnea is sometimes excess body weight that collapses the airway during sleep.

Central Sleep Apnea

A smaller number of people have central sleep apnea. This is caused by a problem with communication between the brain and the body. The brain simply fails to trigger the body to take a breath. Central sleep apnea is much less common than obstructive sleep apnea.

inspire sleep

Why Is Sleep Apnea a Problem?

You might be asking, “So what if I snore a little? Is it actually dangerous to my health?”

The answer is, it depends. A little bit of snoring can be harmless, but true sleep apnea is very dangerous. In the short term, untreated sleep apnea can cause inadequate sleep, decreased productivity, daytime fatigue, and poor performance at work.

It can even affect your driving. People with untreated sleep apnea are six times more likely to be involved in a car crash! When you multiply that by more than 20 million Americans affected by sleep apnea, suddenly the roads look a lot more dangerous.

The long-term effects of untreated sleep apnea are even more disturbing.

The word “apnea” means “lack of breath.” Sleep apnea restricts the flow of oxygen to every organ in the body. And since oxygen is vital to the functioning of all these organs, the stakes are high. Over time, untreated sleep apnea can lead to serious health concerns, including:

  • High blood pressure
  • Heart disease
  • Strokes
  • Diabetes
  • Memory problems
  • Weight gain

People with untreated sleep apnea also have higher levels of pulmonary hypertension, meaning their lungs undergo significant stress. These people are almost twice as likely as others to experience a stroke or heart attack, and four times as likely to deal with high blood pressure.

What Is Inspire for Sleep Apnea?

Inspire is a maskless alternative for people who can’t tolerate a CPAP machine.

Inspire works a lot like a pacemaker, but for your tongue. Unlike pacemakers, which have been safely implanted for decades, Inspire doesn’t connect to your heart. Instead, after your doctor implants the device, a sensor in your chest detects when you’re trying to take a breath, and Inspire sends a small electrical signal to the nerve that controls your tongue. This very gently tells your tongue to move out of the way, leaving your airway clear for every breath.

So where a CPAP machine pushes air into your nose and mouth continually, Inspire uses your own nerves and muscles to pull in a breath.

What Are the Pros and Cons of Inspire for Sleep Apnea?

If you’re considering a maskless alternative to CPAP, you’re likely wondering about the pros and cons of Inspire for sleep apnea.

The Pros

Inspire is much more portable than a CPAP since it’s housed inside your body! There are no tubes, masks, hoses or plugs to worry about.

Inspire doesn’t cause dry eyes and mouth, bloating or marks on the face. Inspire comes with a remote control for you to turn it on at bedtime, and you can set it to turn off at a predetermined waking time. You can also turn it off manually when you wake up in the morning.

The Cons

Since Inspire is a surgery, it comes with the risks that any surgical procedure involves. This means that though Inspire is simple to use after surgery, it is more invasive than a CPAP machine.

Additionally, any time a foreign object is implanted in the body, it carries some risk of infection. Inspire is no different.

The battery in Inspire lasts about 11 years, and then needs to be replaced. All the other parts of Inspire can remain in the body, but the pacemaker part of the device needs to be changed out about once per decade. This procedure is much simpler than the initial surgery.

Even though Inspire is FDA-approved, it is not approved for an MRI of the chest or abdomen. It is approved for an MRI of the arms or legs.

Also, if you work near an arc welding unit, the magnetic field it produces can alter the settings of your Inspire device.

Inspire is also not FDA-approved for SCUBA diving deeper than 25 meters (about 82 feet).

Is Inspire Right for Me?

If you’re interested in giving Inspire a try, you’ll need a sleep study to determine the severity and type of your sleep apnea. An ENT doctor can perform a sleep endoscopy to evaluate you while you sleep. This allows the doctor to look at the airway collapse pattern and make sure it could benefit from Inspire.

Inspire also has weight restrictions, which keep the surgery safe. Patients must have a BMI lower than either 32 or 35.

If you’re considering Inspire, ENT Associates of Lubbock has the experience and expertise you’re looking for. Book a consultation today to see if Inspire could be the maskless CPAP alternative you’ve been looking for.

Otitis Media: A Doctor’s Quick Guide to Middle Ear Infections

Having a small child sick with a cold is sad enough. But when they tell you their ear hurts, you know your plans for the day have changed.

Otitis media, or a middle ear infection, is awful no matter how old you are. How do you treat otitis media? And better yet, how can you keep it from happening in the first place?

otitis media

“File:Anatomy of the Human Ear.svg” by Lars Chittka; Axel Brockmann is licensed under CC BY 2.5

A Quick Overview of Ear Anatomy

When we think of our ears, we usually picture our outer ear, the part that’s visible. But the anatomical ear has many more parts than just what you can see in the mirror.

The External Ear

The external ear includes everything you see on the side of your head plus the ear canal. The ear canal leads to the eardrum, also called the tympanic membrane, which is a thin barrier between the outer ear and the middle ear.

An infection of the outer ear is called otitis externa, or swimmer’s ear.

The Middle Ear

The middle ear is on the other side of the eardrum. Three of the smallest bones in your whole body live here: the malleus, incus and stapes. You may also hear these called the hammer, anvil and stirrup.

A healthy middle ear is filled with air and a small amount of fluid, and it is connected to the back of the nose by a thin passage called the eustachian tube.

The eustachian tube’s job is to equalize air pressure in your middle ear and to allow excess fluid to drain to the back of your nose. But if the eustachian tube becomes blocked, the fluid can’t drain properly and builds up. Also, no air can get through to equalize the pressure.

The fluid buildup from a blocked eustachian tube causes inflammation and infection. An infection of the middle ear is called otitis media.

The Inner Ear

The inner ear contains your actual hearing organ. It’s also responsible for helping you keep your balance.

An infection in the inner ear is pretty rare, but when it happens, it’s called otitis interna, labrynthitis or vestibular neuritis.

Why Do Kids Get So Many Ear Infections?

If you’re a parent, you’re probably familiar with the heartbreaking cries of a small child with an ear infection. But why are young children are so susceptible to otitis media?

The reason is their anatomy. Children have shorter and straighter eustachian tubes than adults. Because their eustachian tubes are more horizontal, their middle ears don’t drain to the nose and down the throat very efficiently.

In fact, their eustachian tubes can even operate in reverse, sending drainage from the nose up into the middle ear!

Children who battle frequent otitis media usually grow out of it around age three or four as their eustachian tubes grow with them. But they’re so hard to console in the meantime!

For children who suffer often from ear infections, ENT doctors can put in ear tubes, or tympanostomy tubes, to help the ears ventilate. These can be removed when the child’s eustachian tubes grow wider and more vertical.

otitis media

What Are the Symptoms of Otitis Media?

Otitis media can be painful, but it doesn’t always hurt. Many patients complain of feeling pressure behind the ear or a sense of fullness.

The fluid buildup in the middle ear can also cause muffled hearing. Some patients say it sounds like listening under water.

Sometimes, people with middle ear infections can hear fluid sloshing around, or bubbling and crackling sounds in their ear!

While very young children can’t tell you what’s going on, they’ll usually be fussier than normal and they may grab at or tug their ears. This may coincide with a cough or runny nose, but not always.

If too much pressure builds up from air or fluid, the eardrum can rupture. A tear in the eardrum usually causes a few seconds of sharp pain, followed by an immediate relief of pain and pressure. The fluid buildup will usually drain out through the ear canal as well.

What’s the Best Treatment for Otitis Media?

The treatment for otitis media depends on the severity of the infection, as well as on what’s causing it. When the infection is caused by bacteria, antibiotics can clear it up pretty quickly.

Most ear infections, though, are caused by a virus and will resolve on their own after a few days.

Some people experience an ongoing accumulation of fluid in the middle ear. Since the nasal passages connect directly to the ear, treating the nose can actually help in this situation. Using antihistamines or topical steroids for a few days can decrease the swelling in the eustachian tube and help the fluid to drain.

If you have middle ear infections repeatedly, it might be time to talk to your doctor about ear tube placement.

Tube placement is a simple procedure that can be performed in your physician’s office or an outpatient surgery center, depending on the patient’s age. An ENT doctor will make a small hole in the eardrum and insert a tiny tube. The tube allows fluid to drain freely out of the middle ear. This is the same common surgery that ENT doctors perform on children with recurrent ear infections.

Because frequent ear infections in children typically resolve within a few years, ear tubes aren’t designed to remain in the body long-term. Most children only need one set of ear tubes, though some need repeat tube placement over the years, depending on their anatomy and other factors.

For adults, a newly developed procedure to consider as an alternative to repeat tube placement is called eustachian tube dilation.

In eustachian tube dilation, your ENT doctor inserts a small balloon through the nose and carefully inflates it to open your eustachian tube. This FDA-approved solution can be a reasonable alternative for adults considering ear tube placement.

How Can I Prevent Otitis Media from Recurring?

One of the most effective methods to prevent middle ear infections is to keep the nose open and clear. This can involve nasal irrigation, blowing the nose, or treating colds and allergies.

This can mean using allergy medications like Claritin and Flonase. It may also involve seeing an ENT doctor for allergy testing and allergy shots.

If you’ve tried these solutions but still suffer from repeated middle ear infections, tube placement or eustachian tube dilation could be the way to go.

Make an appointment with Dr. Scolaro or Dr. Cuthbertson to determine what option is right for you or your child. We treat the entire family, and we look forward to meeting with you!

Is Your Sore Throat Caused by COVID, or Something Else?

So you’ve woken up with a sore throat.

Even though COVID numbers are looking better lately, you’re still trying to be cautious and want to make sure you don’t spread COVID to those around you.

You know sore throats can have lots of different causes, and you wonder: is this sore throat COVID? Is it just a cold? How can you know what the cause is so you know what precautions to take?

What Are the Most Common Symptoms of COVID?

COVID generally affects the lungs more than any other organ. That’s why some of the major symptoms of COVID include a cough, shortness of breath and a fever.

But, confusingly, every case of COVID seems different. It can include many of the same symptoms as the flu, or just some of them. Many people experience some combination of the following symptoms:

  • fever
  • chills
  • body aches
  • fatigue
  • cough
  • shortness of breath
  • headache
  • nasal congestion
  • runny nose
  • sore throat

Additionally, one of the most unique symptoms of COVID can be the loss of taste and smell. Sometimes COVID also comes with gastrointestinal symptoms, like nausea, vomiting and diarrhea.

While COVID can cause a sore throat, it’s rare for this to be the first sign. Any illness that causes congestion or a runny nose can also cause a sore throat.

sore throat covid

What Else Might Be Causing My Sore Throat?

While a sore throat isn’t the most common sign of COVID, sore throats are very common with many different conditions.

Any type of postnasal drainage can cause a sore throat. Your throat becomes irritated as the excess mucus drains. It doesn’t matter whether that drainage is from allergies, a cold, the flu or COVID.

Infected tonsils can also cause a sore throat. This is usually the result of strep throat, which your doctor can diagnose with a simple throat swab.

Acid reflux can cause a sore throat as well. We usually associate reflux with heartburn, but this isn’t always the case. Laryngopharyngeal reflux, or silent reflux, doesn’t have any symptoms in the chest; it only causes burning in the throat.

Finally, some simple, everyday things can cause irritation in the throat, but these will resolve on their own. The dry West Texas climate can irritate your throat. And in the winter, running the heater can dry out the air in your home or office even more.

You may want to play it safe and get tested for COVID. But if a sore throat is your only symptom, it’s unlikely that COVID is the cause.

How Can I Soothe My Sore Throat?

To find relief from your sore throat pain, try to figure out what’s causing it. When you know the cause, you can identify the best ways to reduce your pain and to prevent more sore throats in the future.

If acid reflux is the culprit, dietary changes can help eliminate your discomfort. Spicy, greasy and acidic foods are the most common culprits in causing reflux. Experiment to see what helps your specific case, especially in the evenings. Tomato products and caffeine are a good place to start, since these often make reflux worse.

If your throat is irritated from postnasal mucus drainage, you can gargle warm salt water or make yourself a cup of hot tea. (Honey lemon tea is a good choice!)

If you have seasonal allergies, addressing those with an ENT doctor can lessen the amount of drainage you experience. This could mean getting allergy shots, but it could also just mean using topical sprays and antihistamines.

If a dry environment is causing your sore throat, try running a humidifier, especially at night. Your throat can really dry out while you’re sleeping! Be sure to stay hydrated by drinking plenty of fluids throughout the day as well.

When Should I Call a Doctor?

If you have a sore throat that just won’t go away despite treating it at home, go ahead and give your doctor a call.

If your sore throat is so painful that you have trouble functioning, you may want to call your healthcare provider sooner.

And if your throat pain is accompanied by changes to your voice, difficulty swallowing, or coughing up blood, make an appointment with an ENT doctor right away.

A sore throat accompanied by unintentional weight loss also warrants a call to your doctor. You should check in with your doctor if you have a sore throat and a history of smoking or heavy alcohol use as well.

No matter what’s causing your sore throat, ENT Associates of Lubbock can help you get to the bottom of it. Contact us to set up a consultation if you’ve had any of these concerning symptoms, or if you just want to see what’s going on with your sore throat!

How To Avoid Spreading Your Contagious Sinus Infection

The old adage, “sharing is caring,” doesn’t apply to illnesses.

But with over 30 million Americans diagnosed with sinus infections every year, how can we be sure we aren’t spreading this particular ailment to those around us?

Should we to go to work or to the grocery store with a sinus infection? Or should we call in sick and order our groceries online?

Is a sinus infection contagious? And if it is, should you stay home? Wear a mask? Or carry on as usual?

What Happens in Your Body During a Sinus Infection?

One in seven adults will be diagnosed with a sinus infection in any given year. But do we really know what our sinuses are?

Sinuses are air-filled spaces inside the skull that produce a light coating of mucus, which drains through the nose. They’re supposed to stay open and aerated, but sometimes their outflow tract can become blocked. When this happens, the mucus gets backed up and becomes trapped in the sinuses.

Are There Different Types of Sinus Infections?

You can describe sinus infections in a couple different ways.

Describing a Sinus Infection by Location

Each of your sinuses has a different name. You can describe a sinus infection according to which sinuses are affected.

For example, if your congestion is in your frontal sinuses, you have a frontal sinus infection. The frontal sinuses are directly behind the lower forehead.

You have four sets of sinuses, called paranasal sinuses, in four areas around your nose:

  • frontal sinuses — behind your lower forehead
  • maxillary sinuses — behind your cheekbones
  • ethmoid sinuses — between your eyes
  • sphenoid sinuses — deep behind your nose

A sinus infection can block any combination of these sinuses.

is a sinus infection contagious

Describing a Sinus Infection by Cause

Another way to describe a sinus infection is by what kind of germ causes it. Most sinus infections are caused by viruses, just like the common cold.

Viral sinus infections generally end on their own without any medical intervention. They usually only affect the upper respiratory system, with symptoms like runny nose, sore throat, facial pressure, congestion and headache.

But sometimes viral infections can turn into bacterial infections. Inflamed, blocked-off sinuses encourage the kind of moist, vulnerable environment where bacteria can thrive.

You might have a bacterial sinus infection if your symptoms linger beyond about a week. If your drainage turns yellow or green, that could mean your viral infection has turned bacterial.

Bacterial sinus infections typically need a little help from antibiotics to clear up.

Lastly, even though the vast majority of sinus infections are caused by viruses and bacteria, it is possible to have a sinus infection caused by a fungus. Most fungal sinus infections are caused by an allergic reaction to a fungus in the air, like black mold. This type is called “allergic fungal sinusitis.”

Another type of fungal sinus infection called “invasive fungal sinusitis” exists, but is extremely rare. People who are otherwise healthy don’t get this infection. This type of infection is possible in severely immunocompromised people, such as those going through chemotherapy or with poorly controlled diabetes.

Is a Sinus Infection Contagious?

When you have a cold, the flu or COVID, the infectious particles replicate themselves in the nose. These illnesses also tend to cause coughing and sneezing, which project these germs out of your body. For this reason, you can easily spread these bugs to anyone around you.

But the infectious material in a sinus infection is behind the face, not actually in the nose. So while it’s possible to spread a sinus infection, they don’t spread easily without very close contact.

By taking a few precautionary measures, you can go about your daily life without fear of spreading your sinus infection to others.

How Can You Keep from Spreading a Sinus Infection?

Try incorporating these common sense practices to keep from spreading your sinus infection.

  • Wash your hands! This seems basic, but it always bears repeating. Handwashing really is the best way to prevent the spread of germs! Be sure to wash with soap and water before handling food, after using the restroom, and especially after blowing your nose or touching your face.
  • Cover your cough! Feeling a tickle in your throat? Turn away from those around you and cough into the crook of your elbow. This prevents germs from getting all over your hands while still stopping droplets from spreading.
  • Stay home when possible. Even though it takes pretty close contact to spread a sinus infection, staying home and getting rest can help you get back to your normal routine as soon as possible.
  • Get better faster. Try using home remedies like over-the-counter medications or a neti pot to help speed up your recovery. In fact, one study in children showed that nasal irrigation was almost as helpful as antibiotics in clearing up sinus infections!

What Increases the Risk of Getting a Sinus Infection?

Environmental and seasonal allergies can increase your risk of developing a sinus infection. Allergies don’t cause sinus infections, but they do increase their likelihood. Allergies cause inflammation, swelling and drainage, and all of these things increase the likelihood of a sinus obstruction.

When Should You See a Doctor About Your Sinus Infection?

Most sinus infections stay viral and resolve on their own. But if home remedies aren’t helping, if your drainage turns yellow or green, or if your sinus infection sticks around for more than a week or 10 days, it might be time to give your ENT doctor a call.

Still have more questions about whether your sinus infection is contagious? Not sure if you’re dealing with a viral or bacterial infection? Contact ENT Associates of Lubbock today, and we can help you figure out your next steps!

Does A Balloon Sinuplasty Hurt? What You Need to Know

Sinus problems leave you feeling miserable.

Chronic sinus issues like infections, pain, pressure, and headaches seem inescapable with any type of allergy or irritation.

But why do some people seem to experience these symptoms regularly while others only rarely struggle with sinus problems?

Yes, people who are prone to sinus issues may have more sensitivity to allergens and viruses — but they also likely have smaller openings in the sinuses which makes even a small irritation feel much worse. And if this explains why your sinuses are always flaring up, a balloon sinuplasty may be just what you need.

Unless it hurts.

In which case, you’re not so sure.

Take a deep breath… if you’re not too congested. Balloon sinuplasty is not a painful procedure. To put your mind at ease, we’ve explained what most patients experience — and why the procedure works to start with!

Why Balloon Sinuplasty?

The sinuses are air-filled pockets within the skull. These pockets need a way to aerate. They do this through small crevices into the nose itself. Patients with chronic sinus problems like infections, pain, pressure, headaches typically have narrowed openings between the sinuses and the nose.

Because these crevices are narrow, they’re more easily occluded with any type of allergy or irritation. In order to find relief, they need wider entrances into the sinus cavity. The balloon enlarges these small openings.

How Balloon Sinuplasty Works

This procedure is extremely low-pain because we start by numbing the nose entirely. Once the nose is completely numb, we pass a balloon through the “ostia” (the openings into the sinuses).

We dilate the balloon for about 10 seconds, deflate it, and remove it. During this short period of inflation, the balloon widens the bony entrance from the nose into the sinus cavity.

Each person has six of these openings. We can open all — or whichever the patient needs.

When we dilate the balloon, we actually move these small bones permanently. But it’s not as dramatic as it sounds. The bones in your nose aren’t what we typically associate with solid bone. Instead, these are paper-thin bones (think fingernails) that move easily.

does balloon sinuplasty hurt

Does Balloon Sinuplasty Hurt?

This is a low to no pain procedure for patients. We take about 20-30 minutes to fully numb the patient before we begin. We start with all-topical numbing agents — using both decongestants and anesthetics to thoroughly numb the nose. We then inject a numbing agent into the nose. But by that point, patients don’t feel it.

When we insert the balloon and dilate it, some patients describe the feeling as a slight pressure. Some people feel a release of pressure because the sinuses finally open. Other patients don’t feel anything — they don’t even flinch.

If you feel pressure, the location depends on which sinus we’re dilating. When we dilate the frontal sinus, you may feel pressure near the eye. When we dilate the maxillary/cheek sinus, you’ll feel pressure in the upper teeth. When we dilate the sphenoid sinus, sometimes you feel pressure in the back of the head to varying degrees.

Whatever the feeling, it only lasts for about 10 seconds per sinus.

For some, this compares to a dental procedure — you’re awake, numb, and maybe a little uncomfortable occasionally, but with the right medication, you don’t feel pain.

For most people, their only complaint is they didn’t do it sooner.

Is Balloon Sinuplasty Right For You?

The symptoms we commonly treat with this procedure include:

  • Nasal obstruction
  • Frontal or forehead pain
  • Cheek pressure/pain
  • Headaches
  • Recurrent sinus infections

We always begin treating these symptoms with medical therapy. If medications are ineffective, we take a CT scan and confirm the patient is a good candidate before we opt for a balloon sinuplasty. If a patient qualifies for balloon sinuplasty, the procedure is almost always covered by insurance.

Related: What Does a Balloon Sinuplasty Cost With & Without Insurance?

Is Balloon Sinuplasty Proven Safe?

While the concept of using a balloon for medical treatment can seem novel to some, it’s nothing new in the medical world. The balloon for sinuplasty has been around for about a decade, but cardiologists have been using a similar balloon for artery dilation for much longer.

There are several types of balloons available, but we use the type we feel is safest for patients. It’s been tested tens of thousands of times with almost zero complications. In fact, the type of balloon we use is so good, other companies blatantly copyright infringe and pay a royalty for every product they sell. It’s the best.

Both the balloon and the guidewire we use to insert it are extremely gentle. In fact, the guidewire won’t even break an egg yolk. It’s an extremely safe procedure for the patient.

If you’re struggling with chronic sinus problems and think a balloon sinuplasty might be right for you, don’t let the fear of pain stop you. Overall, it’s a highly effective, minimal pain, and low-risk procedure.

Eustachian Tube Balloon Dilation: Everything You Need to Know

For such a small part of the body, the ear has a huge impact on how we feel and how we perceive the world. If we zoom in even further, we see that the ear has much smaller components that equally affect our quality of life.

The Eustachian tube, a tube that connects the ear to the nose, is one of the vital small pieces that helps the ear function as it should. In fact, nearly 100% of problems inside the ear come from Eustachian tube dysfunction. If it’s stopped up, both our hearing and general comfort decline drastically.

While we’ve known this tube existed for hundreds of years, only recently have we found an effective way to treat its issues. With Eustachian tube balloon dilation, we can now resolve ear tube dysfunction with a safe, non-surgical procedure.

Here’s everything you need to know:

What are Eustachian Tubes?

Eustachian tubes, which connect the ear to the nose, allow the ear to ventilate and regulate pressure.

The ear has an air-filled cavity called the middle ear space. The only way this cavity can be aerated is through the back of the nose, via the Eustachian tube. This cavity always produces a small amount of fluid naturally. The fluid drains from the ear into the nose through the Eustachian tube.

These tubes are also how our bodies regulate pressure changes. When the ambient pressure in the environment changes (think flying high or diving deep), you have to equalize the pressure. The body does that through the Eustachian tubes.

How Eustachian Tube Balloon Dilation Works

Eustachian tube balloon dilation is the only procedure that exists to repair Eustachian tube dysfunction.

Until now, we didn’t have a great way to address Eustachian tube problems. Even 400-500 years ago, we have documented research of doctors trying to figure out how to make this tube work better. But until recently, there were few effective solutions. Our only option was inserting an ear tube through the eardrum to replace the function of the Eustachian tube temporarily by allowing the ear to directly aerate through the ear canal.

Eustachian tube balloon dilation now offers a way to address the problem at the source — the back of the nose. In this short procedure, we insert a balloon to dilate and enlarge this tube.

We start by thoroughly numbing the back of the nose where the Eustachian tube empties. We then insert the balloon up the tube and inflate it inside the tube. Once we inflate the balloon to the right pressure, we leave it inflated for two minutes. We then deflate the balloon and remove it.

During these few minutes, the balloon opens the Eustachian tube and brings significant improvement to function. The Eustachian tube is made from a combination of bone and cartilage. We inflate the portion that’s cartilage. While the effects are not permanent, research continues to show consistent improvement in tube functioning for one year or more.

Is Eustachian Tube Balloon Dilation Right for You?

Before we recommend this procedure to our patients, we rely on objective data to determine if it’s necessary.

Patients should consider Eustachian tube dilation if they:

  • Previously needed one (or multiple) sets of ear tubes.
  • Retain fluid in the ear that doesn’t go away and/or leads to multiple ear infections

Patients with fluid in the ear likely experience symptoms of aural fullness, pressure sensation, muffled hearing, hearing in a barrel, and occasional ear pain.

We rely on exam findings that indicate the need for improved fluid drainage to determine eligibility for ear balloon dilation, not on reported symptoms alone. For example, if a patient complains of ear pressure but has no history of fluid in the ear or ear tubes, we don’t opt for this procedure.

Eustachian Tube Balloon Dilation Risks

Eustachian tube balloon dilation risks are minimal — as is pain. It’s typically very well-tolerated in patients.

If you need tube balloon dilation, but elect not to have the procedure, symptoms of fullness, pressure, and muffled hearing will continue until you receive treatment, likely with an ear tube.

Not only are Eustachian tube balloon dilation risks minimal for health, but the success rate is also extremely high. Research shows up to 93% of patients report improvements in their symptoms.

Finally, we have the means to address the problem doctors have been working to solve since they first discovered this tube exists. And, we can fix it with relatively high success.

If you think Eustachian tube balloon dilation might be right for you, give us a call and we’ll evaluate your eligibility for this procedure. This may be just what you need to solve your symptoms and provide the relief you’ve been looking for — all without surgery or risk.

Swimmer’s Ear: Causes, Symptoms & Treatment

Summer is here! While most people (especially kids) take this as an open invitation for regular pool time, some dread the inevitable swimmer’s ear that will soon follow all that time in the water.

As you prepare for your days on the lake, in the pool, or at the beach, here’s what you need to know about swimmer’s ear treatment… and prevention!

What is Swimmer’s Ear?

Swimmer’s ear, also called otitis externa, describes inflammation of the external ear. While ear infections (otitis media) take place in the middle ear, a swimmer’s ear infection affects the skin of the auditory canal and the skin on the ear itself… basically any skin outside of the eardrum.

As the name indicates, swimmer’s ear is common in swimmers. But the reason for the infection is less clear.

In the past, swimmer’s ear likely occurred because people used to swim in dirty water. Essentially, they were swimming in bacteria, which would enter the ear and cause an infection. Since the eardrum forms a barrier to the middle ear space, the bacteria didn’t move to a middle ear infection, but the external ear reacted.

Now, the problem may come from a nearly opposite reason in swimmers — the ear is too clean. Ear wax controls the pH balance of the ear canal and prevents bacteria from growing. But if the ear is completely clean and washed out from regularly swimming, the pH or biome of the ear canal may be altered, allowing for the growth of bacteria. Essentially, an ear that’s too clean might create an environment for opportunistic bacteria infections.

How To Know If You Have Swimmer’s Ear

Swimmer’s ear is extremely painful. This infection also turns the ear red and causes swelling. The ear canal may even swell to the point where it’s difficult to see into the ear. In most cases, a red painful ear, especially after time in the water, indicates swimmer’s ear.

Some people also experience drainage that oozes from the inflammation in the ear. Because of the drainage, hearing can be muffled, making it sound like you’re wearing an earplug.

swimmers ear treatment

Swimmer’s Ear Treatment

Swimmer’s ear is relatively easy to treat. Because it’s a skin condition and we have access to the skin that’s affected, we can treat it with drops. When you apply the right combination of antibiotic or steroid drops to the skin, the infection usually improves quickly.

In some severe cases, oral antibiotics and/or steroids are also necessary to completely eliminate the infection.

If the canal is so swollen the drops can’t enter the ear, we can insert a wick — a small, elongated piece of foam. You then apply the drops to the end that’s sticking out. The wick dissipates the drops through the canal to the areas that cannot otherwise be reached.

How to Prevent Swimmer’s Ear

Swimmer’s ear isn’t typically recurring. While some people experience it repeatedly, it’s not linked to inherent risk. Instead, repeated cases of swimmer’s ear happen because you are repeatedly exposed to the same conditions that allow bacteria to enter the ear.

If you repeatedly experience swimmer’s ear, consider these options for prevention:

1. Wear a swimmer’s earplug.

Choose a water-resistant plug — not just a foam plug for sound.

2. Wear an ear mold.

Instead of an earplug, you can wear a form-fitted silicone mold. This mold, custom-made by your doctor, can be inserted into the ear to prevent water from entering the ear. For most people, ear molds are more comfortable than earplugs.

3. Use swimmer’s ear drops.

This alcohol-based solution dries out the ear canal. Ear drops can be effective, especially after swimming in a lake.

However, don’t overdo it. Over-drying the ear isn’t healthy. Only use drops after swimming — not as a preventative measure.

If you have ear tubes, avoid ear drops or any alcohol in the ear. The alcohol will travel through the tube and cause extreme discomfort.

4. Don’t irrigate the ear or clean it too much.

Avoid cleaning the ear with cotton swabs. Also, do not turn your ears to irrigate them during a shower or apply alcohol as a preventative measure.

As a rule, the dryer the ear, the better.

Don’t let fear of swimmer’s ear keep you out of the water. With the right prevention and treatment plan, you should be set for a great time in the water that won’t leave you paying the price for days to come.

When to Worry (And Not Worry) About Nosebleeds

Nosebleeds seem to come at the worst times. No one wants to bleed — especially in public. And when a nosebleed strikes, it can be frustrating to manage. Maybe your nice dinner is abruptly interrupted with a nosebleed. You can’t get it to stop — and now there’s blood everywhere. If you’re lucky enough to make it to a bathroom, it still creates a mess.

Even a short or light nose bleed is frustrating. It ruins clothes, stains sheets, and always requires clean-up.

Nosebleeds are often harmless, but if they happen frequently, you may need to see a doctor. When is it time to worry about nosebleeds — and when is it just an inconvenience?

Here’s how to tell:

What Happens During A Nosebleed

Epistaxis, the medical term for nosebleeds, most often begins from the tissue in the anterior (front) of the nose. Usually, the bleeding comes from the center wall of the nose called the septum.

Multiple arteries intersect at a specific point on the septum called the Kiesselbach’s Plexus. This creates a high concentration of blood supply in one small area. If this area dries out, causing the skin to become chapped and cracked, it can bleed profusely.

Most of us have experienced something similar on our lips. If they’re too dry, our lips crack and bleed. But in this part of the nose, there’s a much higher blood supply, making it bleed much more heavily.

Typically, it happens like this: The skin dries out. The patient rubs, picks, or blows their nose and then, GUSH, nosebleed.

Related: Chronic Runny Nose: At What Point Should You Worry?

In very rare cases, nosebleeds are posterior. This type of nosebleed comes from the large artery in the back of the nose. These will not stop with at-home management techniques (described below). Posterior nosebleeds only stop when a medical professional inserts packing. In some cases, we opt for surgery to cauterize the vessel or we use embolization — where we block the blood vessels from the inside to stop bleeding.

What Causes Nosebleeds

While the reason for a nosebleed is simple (fragile skin was irritated and bled), certain factors definitely increase the likelihood of a nosebleed. In fact, when a nosebleed occurs, you can typically blame one of these five factors:


A dry climate wreaks havoc on the skin. Out in west Texas, we’re no strangers to nosebleeds caused by the climate. Dry air in general, however, can irritate the nose. Even turning the heat on in the winter can make the problem worse.

Digital Manipulation

Picking the nose obviously triggers nosebleeds, but even blowing or wiping the nose due to allergies or a cold can irate the area and initiate a nosebleed.

Nasal Steroid Sprays (and other allergy medications)

Flonase and other steroid sprays list nosebleeds as a potential side effect because these medications dry out the nose. To a milder extent, oral antihistamines (like Claritin, Zyrtec, or Allegra) can also contribute to nosebleeds.

Related: When to Worry About Your Lingering Sinus Infection

Blood Thinners

Patients taking blood thinners can’t readily form a clot in their blood. This means the nosebleed won’t stop quickly.


An injury to the nose, particularly in this area of blood vessels, can easily trigger a nosebleed.

when to worry about nosebleeds

How To Stop a Nosebleed

If your nose begins to bleed, don’t panic. It’s a common occurrence that’s typically solved through a reliable sequence of steps. Here’s what you need to do:

1. Do NOT lean your head back.

Despite what you’ve heard, don’t tilt the head backward. You’ll swallow the blood as it drains back, which can make you throw up.

2. Lean your head forward.

Crane the neck forward as if you’re about to sniff.

3. Pinch the nose.

Using your fingers, pinch the soft part of the nose, squeezing the nostrils together. Most often, that’s where the bleeding is coming from. Use enough pressure to barely turn your fingernails white.

4. Hold the nose (constantly) for five minutes.

Don’t release the pressure. Watch the clock. It can feel like a long time but resist the urge to stop and check before your five minutes is up.

5. If it’s still bleeding, use decongestant spray.

Use Afrin or over-the-counter decongestant spray if the nose is still bleeding after five minutes of consistent pressure. Spray the decongestant directly in the nose, or soak a cotton ball with the medicine and insert the cotton ball into the nose.

Do not use Afrin preventatively. Only use it during an actual nosebleed.

6. Pinch the nose again.

Hold pressure for another five minutes.

You can repeat this 1-2 times if necessary.

In most cases, the nose stops bleeding by this point. However, if it’s still bleeding after several rounds of this process, it’s time to visit the emergency room.

What Won’t Stop a Nosebleed

When you’re dealing with nosebleeds, people try all sorts of quick treatments. But several are completely ineffective.

As you treat your nosebleed, avoid these common mistakes:

  • Pressure on the nasal bones
  • Ice pack on the neck (but an ice pack on the face could help!)
  • Leaning your head back

How to Prevent Nosebleeds in the Future

Ideally, people would choose to prevent nosebleeds from occurring altogether. While there’s no sure fix, these simple habits can help you prevent nosebleeds from occurring.

  1. Run a humidifier every night. It doesn’t matter if it’s cold or hot — you just need more moisture in the air. Hydration is key.
  2. Use saline spray 2-3 times per day. You can even use a saline gel spray if it’s more convenient.
  3. Trim your fingernails. Sharp nails irritate the skin if they touch this sensitive area.
  4. Resist picking, scratching, or rubbing your nose.
  5. Do not pick scabs. If you have a scab in the nose, apply saline until it naturally comes off. (We’ve actually seen patients pick holes through their septum!)
  6. Keep blood pressure under control.
  7. Avoid too much aspirin/ibuprofen. These mild blood thinners make it much more difficult for the blood to clot.

When To Worry About Nosebleeds

It’s difficult to distinguish between the inconvenience of a nosebleed — and an actual medical issue. And there’s no perfect answer to knowing it’s time to visit a medical professional to treat your nosebleed.

However, if nosebleeds progress to a point where they regularly disrupt your life, see your doctor. They’ll talk you through the options for treatment and prevention to get your nosebleeds under control.

Adult Tonsillectomy: What To Expect & How to Prepare

Didn’t a tonsillectomy sound kind of fun when you were a kid? How great would it be to eat ice cream for a week and not go to school! But now that you’re grown, you’re not sure what to expect or how significant an adult tonsillectomy really is.

What are the tonsils anyway, and how might removing them make a difference? If you’re considering a tonsillectomy, here’s what you need to know:

What’s the Purpose of Tonsils?

The tonsils are lymph nodes exposed to the environment. Our skin protects us from the external environment, but your nose and mouth are conduits through which bacteria and viruses get inside the body. To keep germs out, the body has a ring of lymphoid tissue called the Waldeyer’s Ring.

The adenoids, palatine tonsils, and lingual tonsils form this ring of immune system tissue to protect the body from viruses and bacteria. Essentially, it attempts to fight off infections before they make it fully inside.

There are two main reasons we remove tonsils:

1. Chronic tonsillitis: General guidelines suggest seven infections in one year, five infections per year for two years in a row, or three infections per year for three years qualifies a patient as “chronic.” Keep in mind, these are guidelines, not the rule for every patient or insurance company. Symptoms such as halitosis (bad breath), tonsil stones, chronic sore throat, and puss or abscesses on the tonsils point to a chronic issue and the possible need to remove the tonsils.

2. Obstructive Sleep Apnea: The other primary reason we remove tonsils is to treat obstructive sleep apnea. Indicated by excessive snoring and blockage of the throat during sleep, sleep apnea isn’t a condition we ignore. If a patient is experiencing obstructive sleep apnea, we may opt for an adult tonsillectomy or one of these alternative treatments.

Occasionally, we remove tonsils due to a concern of cancer, but that’s in a minority of cases.

Adult Tonsillectomy FAQs

If you and your doctor decide to proceed with a tonsillectomy, you’ll likely have several questions surrounding the procedure. We’ve answered our patients’ most frequent questions below so you know what to expect.

Before Your Tonsillectomy

Do insurance companies cover a tonsillectomy?

Yes. In fact, it’s so common most companies don’t even need to pre-authorize it. If we recommend an adult tonsillectomy, insurance companies usually comply. Sure, there are a few companies that push back, but these procedures are generally easily approved.

What’s the recommended pre-surgery diet?

The diet before surgery isn’t restrictive. But as with any surgery, don’t eat or drink after midnight on the day before.

How long do people take off work?

Recovery from an adult tonsillectomy is more involved than with children. Plan on taking two weeks off work to allow for a full recovery. This allows the tonsils to heal and helps avoid potential complications.

During The Operation

What do patients experience during the operation?

When patients arrive at the surgery center, they’ll get an IV before going back to the operating room. Once in the OR, we use a mask and an IV to administer anesthesia. When the patient is asleep, we operate through the mouth. We put a retractor in the mouth to hold it open, taking the tonsils out by removing them from the surrounding muscle.

We also double-check the adenoids to make sure they’re no longer there. Adenoids usually shrink and disappear entirely by the age of 12, so it’s rare that adults need these removed as well. However, if any tissue remains, we remove it.

When we’re done, we remove the retractor and wake the patient.

How long does a surgery typically take?

The surgery itself takes only about 20 minutes. Once we account for the time it takes a patient to go to sleep and wake up, plan on 40 minutes for the entire procedure.

Should a friend/family member accompany me?

Due to COVID precautions, we don’t allow visitors at this time for adults. While we typically prefer for our patients to have someone with them, we’re taking these extra measures to keep everyone as safe as possible. However, you still need to arrange for someone to drive you to and from the surgery center.

After Your Tonsillectomy

What is the post-op diet?

Patients often lose anywhere from 5 to 10 pounds after surgery because it’s painful to swallow. When you eat, opt for a soft diet: yogurt, mac and cheese, pudding, and scrambled eggs. Cold foods that melt and coat the throat are also great options — popsicles, shakes, smoothies, and slushies.

Hydration is the most important part of your recovery. It decreases the risk of bleeding and can decrease overall pain. Any fluid is good fluid — just avoid red liquids so you don’t confuse it with blood if vomiting occurs.

We also advise patients to avoid drinking through a straw, especially thick liquids like milkshakes. Theoretically, the suction could pull a scab from the throat and we want to avoid bleeding as much as possible.

Continue this soft diet with plenty of liquids for at least two weeks.

How active can patients be during recovery?

Keep activity to a minimum during your recovery. To decrease the risk of bleeding, avoid all strenuous activity, heavy lifting, or anything that raises your heart rate or blood pressure for at least two weeks. During the first week, you probably won’t feel like it, anyway.

What are signs of post-op complications?

Bleeding is the main complication that comes from this procedure and the reason we strongly recommend hydration and a soft diet. A week after surgery, the scabs begin to fall off the throat. If a scab comes off prematurely, there may be some bleeding. If it doesn’t stop on its own, we may have to go back to surgery to stop the bleeding.

Other side effects include potential constipation (from pain medication), dehydration, and fever caused by dehydration. As long as you drink plenty, you minimize your chance of these complications.

What pain relief is prescribed or recommended?

We recommend liquid pain medication around the clock. Patients should take the prescribed combination of hydrocodone and Tylenol every 4 hours for the first 2-3 days, even waking up so they don’t miss a dose. Staying ahead of the pain is much easier than trying to chase it after it starts. If patients need additional pain management, they can also take Ibuprofen between doses of prescription pain medication. With this combination, we can typically successfully manage pain.

Have any other questions? Give us a call and we’ll take steps to see if an adult tonsillectomy is the right treatment for you.

The Top 3 Reasons You May Need to Remove Your Tonsils

Most people don’t mind having a little extra protection — especially when it comes to their health. We wear a jacket when the temperature drops and the wind picks up. We apply sunscreen for our time outside. We take supplements or vitamins to boost our immune systems. We get vaccines to prepare our bodies for potential threats.

Typically tonsils act as another form of protection. This lymphoid tissue in the back of the nose and throat works to fight off infections that enter the nose and mouth before they get to the rest of the body. They stop viruses and bacteria before they make it fully inside.

But sometimes, tonsils start causing more problems than they prevent. In these cases, there may be a reason to remove tonsils depending on the exact problem and the tonsils it’s affecting.

Types of Tonsils

There are actually three different types of tonsils.

The Palatine tonsils at the side of the throat are the tonsils that we typically remove during a tonsillectomy. When people casually refer to a tonsillectomy, these tonsils in the throat are what they’re referencing.

The adenoids, or tonsilla pharyngealis, are the tonsils at the back of the nose. These are most commonly removed in children and tend to shrink with age, but adults occasionally need these removed as well.

Lingual tonsils (tonsilla lingualis) located on the back of the tongue, are almost never removed. Only rare occasions such as recurring infections after a tonsillectomy or specific types of sleep apnea result in the removal of these tonsils.

Depending on the issue the patient is experiencing, we assess if removing one of these types of tonsils will solve their problem.

What Are the Reasons to Remove Tonsils?

While the tonsils are supposed to improve our health, for some, the tonsils are the source of their problems, particularly when they become enlarged. If you’re experiencing one of these symptoms, a tonsillectomy may be your solution.

1. If swollen tonsils cause blockage to your airway

Swollen tonsils may be the explanation for why you’re not sleeping well at night. Perhaps you’ve wondered why you (or your spouse or child) snore loud enough to rattle the walls, or you often wake up in a gasp. These are signs of sleep apnea, a condition when breathing abruptly starts and stops during sleep. While swollen tonsils aren’t always the cause of sleep apnea, it is the most common cause in children and a potential cause of sleep apnea in adults.

Sleep apnea is a serious health concern that needs to be addressed. For some, a tonsillectomy proves to be the solution.

2. If you experience recurrent tonsillitis

No, a sore throat by itself is no reason to remove tonsils, but when tonsillitis occurs repeatedly over the course of a few years, your doctor may recommend a tonsillectomy. Most ENTs agree that seven infections in one year, five infections for two consecutive years, or three infections per year for three years indicates a patient is experiencing chronic tonsillitis.

Patients with tonsillitis may notice symptoms such as extreme bad breath, tonsil stones, chronic sore throats, and drainage from the tonsils. If you’re experiencing these symptoms regularly, a tonsillectomy may be the solution your ENT recommends. (Related: The Parent’s Guide to a Quick & Smooth Tonsillectomy in Children)

3. Tumors or growths on the tonsils

Anytime we notice an abnormal growth in the body, removal is a consideration. When an asymmetrical growth or a concern of malignancy appears on the tonsils, an adult tonsillectomy is a viable treatment option. Keep in mind, this is a rare occurrence and not a frequent reason to remove tonsils.

Is Medication an Alternative to Surgery?

If your doctor recommends a tonsillectomy, there’s not typically a medication alternative. As ENTs, we always try medical treatment before we opt for surgery. If the infection continues to return, the patients would need to continually take antibiotics. While antibiotics will fight the infection, the repeated use of these medications wears out your body and gut.

When we get to the point of talking about the option of a tonsillectomy, we’re beyond the point of a one-off infection that we can quickly remedy with medication. At this point, if you choose to keep your tonsils, you’re opting for long-term antibiotic use, which can be difficult to handle.

Are There Any Potential Complications?

Bleeding is the most common complication that follows a tonsillectomy. As the throat heals, it forms scabs in the area where the tonsils were removed. If patients become dehydrated or eat foods that irritate the throat, these scabs can come off prematurely and bleed. In some cases, this leads to an additional procedure.

Other complications following a tonsillectomy are extremely rare.

What Is the Recovery Process After the Procedure?

Most people recover in about two weeks following their procedure. For others, it may take more time to fully heal. Plan on about two weeks away from work with a restricted diet and limited activity. However, once you heal, you’re not just back to normal — you’re much better than you were.

How to Know if an Adult Ear Tube Placement Can Help You

When we think about someone getting tubes in their ears, we typically picture a toddler who can’t shake their constant ear infections. But needing tubes in the ears happens for adults, too. While it’s less frequent than child procedures, adults sometimes need ear tube placement surgery, although for a slightly different reason.

Most kids need the surgery because of their anatomical development. The ear is connected to the back of the nose through the “Eustachian tube.” When a person is young, that tube is short and horizontal, which makes it more likely for the nose to drain into the ear. Cue the ear infections. Anytime there’s inflammation in the nose, the fluid drains back into the ear.

In adults, the station tube has developed to be longer and more vertical. This increased separation between the nose and ear makes it much less likely that the nose drainage will funnel towards the ear. This space also allows the ear to aerate more efficiently — which is why adults don’t get as many ear infections.

Still, for some adults, the eustachian tube doesn’t allow the ear to vent like it should, making ear tube placement a possible solution. If you’re considering pressure equalization tubes, ventilation tubes, ear grommets, or tympanostomy tubes (all names for ear tubes), here’s the basic info you’ll want to know first:

What Are Tubes and Why Might I Need Them?

In some adults, eustachian tube dysfunction doesn’t allow the ear to operate correctly. For some patients, allergies or infection causes blockage in the nose due to inflammation. In other patients, the tube developed to be too narrow. Whatever the reason, the ear isn’t working as it should.

Ear tube placement allows the ear another way to equalize pressure. The tube, which looks like a small grommet, is made of soft rubber in order to be minimally traumatic to the eardrum. Once inserted, it vents the ear, acting as a pressure valve to compensate for the lack of function from the eustachian tube. It works to drain fluid, relieve negative pressure, and sometimes alleviate a feeling of fullness in the ear as well.

What Is an Ear Tube Placement Procedure?

In adults, ear tube placement is more of a small procedure than a surgery. Using a microscope, we start this simple in-office procedure by placing a drop of a numbing agent on the eardrum itself. The inside of the ear goes completely numb within 10 seconds. Then, we make a small incision in the eardrum and place the tube within the incision. The tube keeps the eardrum from closing, allowing it to vent over time.

There’s no need for the procedure to take place under general anesthesia in an outpatient surgery center for adults. The only reason we opt for a different setting for kids is to keep them from making sudden movements while we attempt to place the tube, which may cause damage to the ear. Overall, it’s very simple and well-tolerated procedure in the office.

Are Ear Tubes Permanent?

Ear tubes are not permanent, but there are different types of tubes we can use depending on the duration we want them to remain in the ear. We usually start with tubes designed to stay in the ear 3-6 months before the eardrum pushes them out naturally. Typically, these tubes last longer in kids.

For some patients, one tube placement is enough to solve the issue. For others, we may opt for repeat ear tube placement. If a patient needs another placement, we’ll consider longer-lasting options, including special tubes designed to last for several years.

What If The Tube Comes Out Too Soon?

Once we place the tube in the ear, we don’t have any direct control over its exact placement or how long your body allows it to remain in the ear. In some cases, it may come out too soon. For other patients, it may stay in too long. When the tube doesn’t naturally come out after several years, we may consider pulling it out. Although rare, these situations can result in a small or large hole in the eardrum that may need to be repaired.

The most common complication, however, is that the tube clogs. A little dried blood or mucus may not allow the tube to drain properly, but it’s easily fixable in the clinic.

What to Expect on the Day of the Procedure?

This is a quick, five-minute procedure. There’s no preparation necessary for the patient. Depending on the patients’ needs, we can place these in one or both ears.

There’s no recovery period involved either. Patients can get back to normal immediately following the procedure.

When Should You Consult an ENT?

If you’re getting recurrent ear infections, fluid in the ears, or extreme ear pain and pressure, come see us to find out if ear tubes might be a solution to your problem.

Related: What Does An ENT Do At Your First Appointment?

What Does An ENT Do At Your First Appointment?

We all know an ENT deals with the ears, nose, and throat — but what do they actually do about the problems we’re experiencing? When you’re referred to a specialist, it can be a struggle to set the right expectations. What does an ENT do at your first appointment anyway? Are they going to diagnose your issue, prescribe medication, recommend surgery, or refer you to someone else?

For many, it eases their minds to know just how much an ENT can take care of. We not only see the patient, diagnose their problem, and treat it medically, we also perform surgery. The subtitle under “ENT” is “head and neck surgery” so if a patient needs surgery, we don’t have to refer them to another doctor. We can take care of it ourselves.

If you’re getting ready for your first appointment, be assured, as long as a problem is within our scope of practice, we can typically take care of patients from start to finish.

What Does an ENT Do at the First Appointment?

Your first appointment with an ENT will be tailored to your problem, but there are a few universal expectations you can have when you visit ENT Associates of Lubbock.

When you first arrive, our front desk assistants will obtain your demographic and insurance information. A medical assistant will then enter pertinent medical history (prescriptions, surgeries, previous imaging, etc.) into your chart. They will bring you back to an exam room and obtain patient vitals such as blood pressure, pulse and temperature.

Next, expect to see a physician. We don’t have a PA or nurse practitioner, so you know you’ll see your doctor. We start the first visit by talking through your history of present illness, so we understand the story of what’s been happening in your body.

what does ENT do first appointment

We then conduct a physical exam, looking very closely at the ears, nose, and throat using specialized tools. For issues with the ears, we examine them under a microscope, even cleaning them under the microscope if necessary. This is a safer and more effective way than they can be cleaned elsewhere. If there’s a problem with the nose or throat, we use cameras and scopes to diagnose the problem quickly and move closer to fixing the issue. If you have sinus problems, we have an in-house CT scanner to quickly obtain imaging of the sinuses. We also have an Audiologist on staff so we can immediately conduct extensive ear testing, including assessing eardrum mobility and pressure if necessary.

These resources help us thoroughly examine whatever area needs further investigation based on the issue of concern.

In some cases, we can immediately address the issue — even during the first appointment. If the patient is having nosebleeds, we can do a nasal cautery. If the patient has excess fluid in the ears, we may recommend immediately placing tubes in the ears. With the combination of our in-house diagnostic equipment and ability to do in-office procedures, we often can quickly get patients the treatment they need immediately.

How Do I Prepare for an ENT Appointment?

Prepping for your first ENT appointment is easy — just make sure you have your paperwork and questions ready.

Bring these items with you:

  • New Patient Paperwork: If you fill out this new patient paperwork ahead of time, it’ll make the process a little quicker on the day of your appointment. We send it ahead and it’s available online.
  • List of any medications and supplements you take
  • Insurance Card
  • Questions: If you think you might forget details during your appointment, write down your questions, thoughts, and symptoms to help guide your discussion.

What Happens During the Visit?

The direction of your appointment depends on your complaints. For example, if the complaint is regarding the ear, we’ll do ear tests including an audiogram and a tympanogram (eardrum mobility/pressure). If you are complaining of sinus pain, we might use a nasal scope to visual the area. We tailor each appointment to the specific issue the patient is experiencing.

What Are the Next Steps After the First Visit?

In the first visit, our goal is to get a diagnosis and initiate treatment. We try to treat issues medically first. If a patient has an infection, we prescribe an antibiotic. If they have allergies, we try to control those with topical sprays or oral medication.

Then, we follow up at a later appointment. For unresolved sinus issues, we may take a CT scan to get a better idea of what’s happening under the surface. We offer this option in the office to make it as convenient as possible. If we see medication isn’t sufficient, we’ll explore surgical options depending on the issue.


Can I eat before an ENT appointment?

Yes, eat anything you want. There’s no bloodwork involved in your ENT visit.

Well, actually, maybe avoid garlic and onions… 🙂

Does an ENT evaluate vertigo?

Yes, if a patient thinks they have vertigo, we’ll check the symptoms and see if we can figure out what’s going on. Our first goal is to understand if it’s in the ear or not. Often vertigo is dizziness that doesn’t come from the ear, so it’s not always an issue we can address. If it’s not the ear, we can refer you to another specialist.

Can you see an ENT without a referral?

This depends on your insurance. Check your policy — and if you’re in doubt, just give us a call and we’ll give you your best options.

When is a nasal endoscopy necessary?

If we suspect a nasal pathology is causing symptoms and we can’t see it with just our eyes, we can do an anterior rhinoscopy. If that’s not complete enough or we’re still suspicious of something, we can do a nasal endoscopy that will allow us to see further back into the nose and identify the issue.

How painful is a nasal endoscopy?

Our procedure isn’t painful. We use numbing spray so patients only feel a little pressure but no pain.

If you’re experiencing an issue occurring from a problem in the ear, nose, or throat, you may find comfort in knowing that an ENT is often a one-stop-shop for addressing these issues – whether you need medication, an allergy diagnosis, or surgery to solve the problem. In your first appointment, we’ll take the first step to find out what solution may work best for you.

The Parent’s Guide to a Quick & Smooth Tonsillectomy in Children

You think your child needs a tonsillectomy. For some reason, the tonsils are causing a problem and now you’re faced with surgery for your little one. While no parent wants to deal with surgery for their child, a tonsillectomy is a relatively simple procedure that can drastically improve a child’s symptoms after they recover. Plus, it helps prevent long-term negative effects.

If you’re considering a tonsillectomy for your child, here’s what you need to know:

What Do Tonsils Actually Do?

Tonsils are basically lymph nodes exposed to the outside world. In the back of the mouth and nose, there is something called the Waldeyer’s Ring — a circle of lymphoid tissue designed to filter and protect the body from the environment. We have the adenoids in the back of the nose, palatine tonsils on the sides of the throat, and lingual tonsils on the back of the tongue. These form a circle of immune system tissue designed to filter out what’s coming in from the outside.

Why Do the Tonsils Cause Problems?

Problems with the tonsils occur for two reasons:

1. Enlarged Tonsils

The tonsils get so swollen they start blocking the airway. Some people are born with big tonsils. Sometimes people get an infection, and when the tonsils become swollen to fight it, they stay enlarged.

Regardless of the cause, enlarged tonsils can lead to obstructive sleep apnea in children. This is a serious pathology — the cognitive function, behavior, and even teeth of your child can be affected when they’re not breathing properly and sleeping well at night.

Similarly, the adenoids can become enlarged and completely block the nose. This can exacerbate or worsen chronic allergies and chronic sinus infections.

Enlarged adenoids that cause obstruction can even affect facial development. While breathing through the nose, the tongue naturally applies gentle pressure to the pallet on the roof of the mouth. This pressure helps the face grow wider. But when adenoids are enlarged, the patient is forced to breathe through their mouth. In children, this lack of pressure on the pallet means the face grows longer instead of wider.

Some adults still show classic signs of childhood adenoid enlargement in the way their face is shaped. The medical term is adenoid facies that essentially means they have a long face. Because their mouth was open for so much of their childhood, their face didn’t appropriately widen.

2. Chronic Infections

Infections (recurrent or ongoing) also serve as a reason to remove tonsils. An infection is defined as chronic when there are seven infections in one year, five infections per year for two consecutive years, or three infections per year for three years.

While while some insurance guidelines in their criteria for the number of infections required for surgery, these numbers serve as the general rule for how we determine tonsil infections to be chronic. Most commonly, tonsil infections are caused by strep bacteria, but can also be caused by other types of bacteria or viral infections.

What Symptoms Suggest Tonsils Need to Be Removed?

As a parent, you may not always know when your child’s tonsils are enlarged or infected, but you might notice other symptoms that indicate that tonsils could be problematic.

Sleep issues are a primary symptom of enlarged tonsils, but it’s often misinterpreted. When a child has obstructive sleep apnea, they sleep poorly. But when kids are poorly rested, their symptoms are different from adults. While adults feel tired, groggy, and sluggish, kids show symptoms of poor sleep with hyperactivity, acting out, behavioral issues, and even bed-wetting. While these behaviors may seem to be the opposite of what many expect from poor sleep, this often indicates that the child is tired and doesn’t know what to do with that feeling. Some kids are even misdiagnosed as ADHD when behavior may be a result of sleep trouble due to enlarged tonsils.

Adenoid issues may be a little easier to identify. For children with enlarged adenoids, their parents may notice they seem to have constant nasal infections and drainage. If this happens to the point where it’s chronic, we may choose to remove the adenoids.

Recurrent tonsil infections show up as sore throats, halitosis (bad breath), tonsil stones, snoring, or an abscess beside the tonsil. Chronic infections that present these symptoms would be another reason to remove the tonsils.

There are also two rare reasons for a tonsillectomy in children, but they’re still worth mentioning.

  1. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal)

This rare disorder shows up as cognitive, psychiatric issues that coincide with strep infections. While extremely uncommon, if PANDAS is the issue, patients show remarkable psychiatric improvement after surgery.

  1. PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis)

In this condition, patients have exactly what’s described in the name – fevers that come and go, cold sores (aphthous stomatitis), sore throats (pharyngitis), and protruding lymph nodes in the neck (cervical adenitis). We resolve this by performing a tonsillectomy in children.

FAQs: Before, During, and After a Tonsillectomy in Children

If you and your doctor decide a tonsillectomy is best for your child, you likely have some questions about what to expect at the various stages of the procedure.


Do insurance companies cover tonsillectomy in children?

Yes, nearly every company covers tonsillectomies. Our office staff will contact your insurance company prior to surgery to ensure that we are meeting their criteria.

Should patients arrange care for the recovery period?

Yes, the surgery itself takes 20-30 minutes. The patient will recover for about an hour at the surgery center and go home the same day. Someone should plan to remain at the surgery center with the child for the duration of the procedure and the immediate recovery.

Depending on the age of the child, patients take 10-14 days to recover at home. They’ll feel like they have a bad sore throat or strep infection and will find it painful to swallow. Plan to have an adult nearby during this time period to help keep the child hydrated and restrict activity.

What foods should the child eat or avoid before surgery?

In the days prior to surgery, there are no necessary precautions to take with food or diet. Most pediatric tonsillectomies are performed early in the morning, so our office will instruct patients to abstain from food or drink after midnight in the hours leading up to the surgery.


What will the child experience during the operation?

We give children under the age of 12 an oral dosage of Versed (a well-tolerated pediatric medication) to help them relax when they arrive at the surgery center. Once in the OR, we use a mask to gently put them to sleep. After they’re asleep, we put in an IV and then proceed with the surgery.

Can a parent stay with a child during the operation?

Prior to COVID restrictions, we allowed two parents to come to the surgery center. However, now we’ve restricted this to one parent. The parent can remain with the child up until they enter the OR. As soon as they wake up in the recovery room, we allow the parent to return to the child.

How long does surgery typically take?

A tonsillectomy in children is a 20-30 minute procedure, then 1-2 hour stay in the post-op recovery area. After the procedure, we make sure they’re drinking and recovering well before we send them home.


What’s the post-op diet?

Kids should remain on a soft food or liquid diet for 7-10 days following the tonsillectomy. They can eat yogurt, ice cream, jello, mac and cheese, mashed potatoes, pudding, shakes, smoothies, popsicles, and anything else soft and soothing. We find that cold food that melts seems to coat the throat and ease their discomfort.

A child may not want soft foods for a couple of days following surgery and that’s okay, as long as their are drinking plenty of fluids. This includes sports drinks, juice, water, milk… whatever they’ll drink!

Any fluid is good fluid in this case, but try to avoid straws, especially with thick liquids like milkshakes. The pressure could pull a scab off the throat. Also, avoid red fluid. If the child vomits, we want to be able to distinguish between blood and other liquids.

It will hurt to swallow, so sometimes getting children to drink enough after a tonsillectomy is challenging, but be vigilant. Dehydration can cause increased pain and extend the healing time needed after surgery.

Should a child be resting in bed, and for how long?

We recommend no strenuous activity for the 10-14 day recovery period. While a child doesn’t have to be laying in bed this entire time, we want to avoid anything that increases their heart rate or blood pressure. For example, no sports or jumping on the trampoline during this time.

For the first week, they likely won’t want to do much. The second week can be more difficult to restrict activity.

How do parents decide if a child can return to school?

For most kids, they’ll miss a week or so of school, and can return the second week if they’re off medication and are not still in pain. However, during that second week, they need to rest during recess and PE.

What risks should a parent look for after the operation?

One notable risk of this surgery is bleeding. This happens for about 1/100 patients. About a week after the surgery, a scab may come off and cause bleeding in the back of the throat. In some cases, we need to do surgery to stop that bleeding. To minimize the risk, we focus on hydration (without straws).

This is also important to avoid — that’s why we encourage drinking so many fluids. Dehydration can lead to fevers, increased pain, and increased risk of bleeding.

If young kids refuse to drink, there are services that can come to your house and set up an IV to replenish fluids intravenously. If it becomes even more of an issue, urgent care centers can also administer fluids through IV.

This can occur with the pain meds. While it doesn’t happen often, we occasionally see constipation as a side effect. When this occurs, we usually recommend Miralax or other over-the-counter solutions.

A low-grade fever is fairly common after surgery. If a child’s temperature is higher than 102 degrees, we want patients to call us and let us know.

What pain relief is prescribed or recommended?

There are several approaches to prescribing pain medication for children. We typically prescribe narcotic pain medication for our patients because it is an extremely painful surgery. We prescribe a combination of Tylenol with hydrocodone in liquid form. Patients should take this medication every 4 hours (day and night) for the first 7-10 days.

Additionally, some patients may need to take ibuprofen in between doses of the prescribed medication. As the child improves, they can ease off the medication.

Be aware that most patients increasingly improve over the first week after a tonsillectomy, but around Day 7 the majority of patients will regress for a day or two. The patient will have less pain in the throat, but can expect to have referred nerve pain in the neck, jaw and ears. This is completely normal and can be treated with continued pain medication.

If you have any other questions about a tonsillectomy for your child, don’t hesitate to call us and set up a consultation. A tonsillectomy may not be an easy solution, but it’s often the necessary next step to helping a child find long-term relief from their tonsil problems.

What CPAP Alternatives Should You Consider? The Best Solutions for Sleep Apnea

What is CPAP? CPAP is an acronym that stands for Continuous Positive Airway Pressure and is usually a great solution for obstructive sleep apnea. It’s a logical treatment that uses a machine to produce air and send it to your nose through a hose and face mask to keep your airway open while you sleep. Yes, it’s been around a while, but it’s still the gold standard of sleep apnea treatment. In fact, we use CPAP standards as the bar by which we measure all non-CPAP alternatives to evaluate their effectiveness.

That being said, CPAP is difficult to tolerate. If you’re on CPAP, you may be able to relate to some of its problems.

Problems with CPAP

While CPAP can be highly effective, it only works if the patient can use it correctly.

For some, the face mask doesn’t fit well. CPAP offers alternatives of nasal masks, masks for the nose and mouth, or masks to cover the entire face. Even so, these options still do not accommodate for the facial structure of every patient. And when the mask doesn’t fit, it leaks.

When a CPAP mask leaks, it blows air into the eyes and can dry them out. This can become so extreme, patients need to consult with an ophthalmologist for dry eye solutions.

These leaks also make noise, which can irritate patients and keep them awake. Naturally, patients try to tighten the straps to prevent the leaks. But if they make straps too tight, they end up with headaches and strap indentations on their face.

Some patients who use only the nasal mask find it blows in their nose and right out of their mouth, which can be really frustrating and impair sleep.

But even patients who are able to find a mask that fits struggle with the complications of a CPAP machine. The CPAP is quite a contraption. It can be cumbersome to travel with, you can’t really talk once it’s on, and you have to keep it clean.

These problems, frustrations, and general inconveniences leave many patients looking for non-CPAP alternatives.

What Are the Best CPAP Alternatives?

Patients considering apnea CPAP alternatives have four primary options. Here’s a snapshot of each:

Oral Appliance Therapy

Dentists and oral surgeons use this appliance for mild sleep apnea. It works by positioning the teeth in such a way that the jaw is pulled forward while you sleep. When the jaw is pulled forward, the tongue is pulled forward too and the airway opens.


This non-CPAP alternative is a non-invasive, effective option for many patients, but it is only effective for mild sleep apnea.


For more severe cases, it doesn’t work. For some patients, this therapy causes soreness in the jaw and can create alignment issues with the teeth. Additionally, oral appliance therapy can be expensive and insurance may not cover it.

Sleep Apnea Pillow

This is simply a wedge pillow that forces people to sleep on their side.


This is a non-invasive, cheap CPAP alternative for patients who have sleep apnea because of their sleep positioning. Patients should know if this is a viable option for their situation based on the results of their sleep study. For some people, when they lay on their back, their sleep apnea gets worse. When they lay on their side, it goes away. So, a pillow that helps them stay on their side can cure their sleep apnea.


This isn’t an option for those whose apnea is not caused by sleep positioning.

Nasal Decongestants and Nasal Airway Surgery

Either through medication (oral or topical) or procedure, the goal of these treatments is to open the airway, so the patient breathes better. When we do this by surgery or medication, people feel like they have an improved quality of sleep. But if you were to repeat their sleep study, it’s often unchanged. Patients with apnea will find that they still have the same number of apneas each night. Their subjective sensation is the quality of sleep is better.


While this doesn’t eliminate apnea, it can improve CPAP compliance. If the nose is more open, the pressure on the CPAP machine doesn’t have to be as high. Plus, the patient just feels like they’re sleeping better. Another perk: they snore less.


If you do surgery, there’s recovery involved. Plus, even though the patient seems to be sleeping better, they have the same apnea they did before.

sleep apnea cpap alternatives


This is CPAP with bi-levels of air pressure. BiPAP offers one level for inspiration and another level for expiration. You inhale at one pressure, the pressure changes, and you exhale at a different pressure. It makes breathing with a CPAP more comfortable.


This CPAP option is a little easier to tolerate, especially for patients who need higher air pressure. When the pressure is high, it’s tough to exhale against a strong force of air. BiPAP minimizes that complication.


It’s still a CPAP machine, and it’s still not cheap. You need to buy the machine, hose, and mask, and you need to replace parts every year.


Inspire (also knowns as hypoglossal nerve stimulation) is one of the apnea CPAP alternatives that works without any external contraption. A small implanted pacemaker opens the airway by moving the tongue forward while you’re sleeping at night.


You get off the CPAP machine. You just have to use a remote to turn it on at night. After surgery, there’s nothing complicated. You’re not attached to a hose all night and you can sleep in any position. Travel is simpler too — you only need to bring the remote, which is the size of a computer mouse. It’s the latest, greatest, and overall best CPAP alternative on the market.


Inspire does require surgery. It’s more invasive than other options and is only available for those with moderate-to-severe sleep apnea who have unsuccessfully tried CPAP. Additionally, patients must fall into a specific weight range to qualify for Inspire.

After surgery, however, it’s easy and effective.

If you’ve experienced problems with CPAP and are interested in finding out if Inspire or another non-CPAP alternative may work better for you, give us a call for a consultation.

What Does a Balloon Sinuplasty Cost With & Without Insurance?

At ENT Associates of Lubbock, we never rush a surgical procedure.

If you’re at the point of needing a balloon sinuplasty, it implies your ENT has maximized medication treatment options. At this point, the alternative treatment options are worse than a sinuplasty itself. The only other option to sinuplasty (after medical treatment) is taking numerous antibiotics and dealing with the GI complications that come with it.

The key here is trusting your ENT. Always make sure you’ve tried medical management as the first-line therapy.

But when that’s not working, it may be time for surgery — which leaves you wondering just how much this will set you back. While we wish there was a clear-cut answer, there’s not. In reality, the sinus surgery cost with insurance (or without) varies based on the following factors.

Do You Have Insurance?

If so, balloon sinuplasty cost with insurance first depends on the deductible. To better estimate your costs, find out:

  • What’s your deductible?
  • How close are you to meeting your deductible?

How high or low your deductible is and how much you’ve already paid will determine how much you’ll owe. Depending on the plan, you may also have a percentage to pay after meeting the deductible.

Balloon sinuplasty costs without insurance vary as well. The total cost depends on how many sinuses we need to dilate and if we need to couple the procedure with another (such as a turbinate reduction) at the same time.

For patients without insurance coverage, we offer payment plans on a case-by-case basis.

Is Balloon Sinuplasty Covered by Insurance?

Most insurance companies cover the procedure, but there are different requirements for approval depending on the companies. Each company has different metrics for determining if the patient needs the treatment.

In order to get it approved, we always perform a CT scan and exhaust all medical treatment options with medications before recommending a procedural option. With this approach, most insurance companies take the recommendation of the doctor and cover the procedure, but some smaller companies still claim that balloon sinuplasty is “experimental or investigational” to avoid covering it.

If your insurance company denies coverage, our office has steps in place to see if we can overturn the denial decision with a physician peer review or appeal.

What Alternative Treatments Exist for Chronic Sinusitis?

We always try medicine first. Topical sprays, saline irrigations, oral antihistamines, oral antibiotics, and oral steroids are our first line of medical defense against sinusitis. Before we consider a procedure, we want to make sure the problem can’t be managed with medicine.

Before we opt for a sinus procedure, we also need to see an established pattern of infections or a chronic long-lasting infection that won’t go away. By the time we recommend a balloon sinuplasty, a patient will have tried all the possible medications for the issue and show signs that this is an ongoing problem.

What Can You Do to Relieve Symptoms Instead of a Balloon Sinuplasty?

There aren’t many alternatives after medications have failed to solve the problem. When a patient needs sinuses addressed, we either recommend a balloon sinuplasty or an endoscopic sinus procedure. The problem likely comes from an anatomical narrowing or blockage in the sinus cavity. The only way to address the issue is to physically open up the passageways. There’s not much else you can do to relieve these symptoms without surgical intervention.

What’s the Best Next Step?

The best way to know if a balloon sinuplasty is right for your sinusitis (and how much it will cost for your situation) is to give us a call and come in for an evaluation. Perhaps you’ve tried some medications but didn’t use them properly. We may be able to coach you on the use of these meds and solve the problem. Or maybe it really is time for a balloon sinuplasty and we can start looking at the details of what your cost with your insurance.

When we meet with you, we can evaluate what you’ve tried, what you need to do, and what you might change. Only when it’s necessary will we then move on to consider if a balloon sinuplasty is the solution to your sinus problems. Our office staff will work with you and your insurance company to find out the most accurate pricing and establish a payment plan that your comfortable with if needed.

Trouble Breathing Through Your Nose? It could be Nasal Airway Obstruction

Trouble breathing through your nose? When our patients come in with this complaint, they’re likely dealing with a blockage in the nose, also known as nasal airway obstruction. This blockage prevents air from flowing smoothly through the nose.

Nasal blockage is not only frustrating, it can also be problematic. Humans are essentially meant to be nasal breathers. The nose is designed to humidify and warm air, so it’s more comfortable to breathe through your nose. When you can’t, it’s uncomfortable. Plus, it can lead to a dry mouth or sore throat.

Interestingly enough, studies even show improved memory when breathing through the nose. Apparently, the proximity of oxygen to the brain is helpful to cognitive function.

If you have trouble breathing through your nose, it’s time to find a solution. Nasal obstruction symptoms come from four main areas of the nose. If you’re experiencing nasal airway obstruction, here’s what may be causing it and what you can do about it.

1. Mucosa

The mucosa is the lining on the side of the nose that covers the entire interior surface of the nose. Think of it like the skin on the inside. When the lining becomes inflamed, it obstructs the nose and produces more mucus. This issue commonly presents as allergic rhinitis with symptoms of a stuffy, itchy, runny nose — that’s an inflamed lining.

Many patients with a mucosa issue regularly use nasal decongestant sprays like Afrin. We actually do not recommend this type of nasal medication. When people overuse a decongestant spray, their nose becomes more congested than it was before, and they develop a condition called rhinitis medicamentosa. Basically, it’s an addiction to Afrin.


When we begin treatment for a problem with the mucosa, we first recommend patients stop using nasal decongestant sprays. Then, we begin medication.

When treating nasal obstruction symptoms, we always try medical treatment before exploring surgery or procedures. Mucosa problems are medically treated, so for patients struggling to breathe through the nose, we begin here.

We start with topical sprays, using a combination of nasal steroids (Nasonex, Flonase, Rhinocort, or QNASL) and topical antihistamine sprays (Azelastine or Patanase). We can also consider recommending an oral antihistamine such as Claritin, Zyrtec, or Allegra. We try combinations of these products for about a month.

For some people, medication solves their breathing problems. But for others who still struggle to breathe through their nose, we explore the other structures that may be causing the problem.

2. Turbinates

We have three kinds of turbinates: superior, middle, and inferior. The inferior turbinates increase the surface area of the nose which allows air to be more hydrated, humidified, and warmed before it enters the lungs. But when these inferior turbinates become enlarged, they can cause nasal airway obstruction.

These structures can dynamically change in size by the hour. Many people complain that one side of their nose is stuffed up, then the other, especially when they try to sleep. This happens because the inferior turbinates have a potential space in them that fills with fluid. Gravity pulls fluid into the open space. This leads to dynamic congestion that gets worse with a sinus infection, allergy flare-up, or when laying down.


If inferior turbinates are the root of the issue, we can perform a turbinate reduction. We conduct this simple procedure in the clinic in less than 30 minutes. The goal of a turbinate reduction is to reduce the inflammatory tissue. We go under the surface, suction the tissue out, and move the turbinate over to create more space. It’s kind of like liposuction for the turbinate. We take out the volume so there’s more space in the nose.

A turbinate reduction is quick and well-tolerated. Plus, recovery time is minimal. Most patients have a slight nose bleed for up to 24 hours and congestion for about a week. This non-invasive and long-lasting procedure provides a highly effective solution for those with turbinate issues.

3. Nasal Valve

The nostril (outside of the nose) is medically known as the nasal valve. For some patients, this collapses when they take a deep breath in. When exercising or trying to inhale deeply, they’ll feel like they just can’t get enough air into their nose.

Patients can self-identify a likely nasal valve collapse by looking in a mirror when they inhale and seeing if the outside of the nose collapses in. Also, if patients find breathing becomes easier when using nasal breathing strips, it implies there may be a nasal value issue causing the problem.


To treat nasal valve collapse, we now use a treatment called Vivaer to remodel the nasal tissue. We insert a small probe under the surface of the nostril, open the nostril, and heat the tissue strategically. As it cools, we can change the position of the tissue by a few millimeters, which can mean a significant improvement in breathing. Also, it stiffens the tissue, so it’s less likely to collapse.

If the patient is experiencing problems with both the nasal valve and the turbinates, we can do the Vivaer procedure at the same time as a turbinate reduction.

In the past, we relied on alar batten grafts to resolve nasal valve collapse. In this procedure, we take cartilage from the septum and implant it in the nasal sidewall to hold open the nasal valve, which is a much larger procedure with a longer recovery time. In some cases, this is still necessary, but Vivaer has largely replaced it as a much less invasive alternative.

4. Nasal Septum

The wall in the middle of the nose, or nasal septum, is another potential cause for nasal obstruction symptoms. This area is partly cartilage and partly bone. When it’s deviated (pushed to the side), it can create airflow problems.

A deviated septum can be congenital or come from a trauma such as a break or repeated injury to the nose. For many people, this problem worsens with age. Cartilage continually grows, and as it does, it exacerbates the problem.


A deviated septum most often requires a surgical septoplasty. This outpatient procedure takes about one hour and then about a week to recover. We perform most surgeries in an outpatient surgery center under general anesthesia. For minimal septum deviations, we can do operations in the clinic with local anesthesia.

If you’re experiencing nasal obstruction symptoms such as difficulty sleeping, trouble breathing while exercising, or excessive snoring, give us a call. After we clear a nasal airway obstruction, people sleep more soundly, snoring improves, and in general, they just feel better. And who doesn’t want that?

How Does a Balloon Sinuplasty Work? Your Top Questions Answered

You’ve had one sinus infection too many. In fact, you’ve probably had 10 sinus infections too many. You’re considering balloon sinuplasty as a treatment option, but you still have a few questions. 

For one, does balloon sinuplasty actually work? 


But that’s not all. We’ve taken the most frequently asked questions we hear from patients and answered them here: 

Does balloon sinuplasty work effectively? 

For the right patient, it works very well. Our job is to make sure you’re the best candidate for it. Over 95% of our patients are extremely satisfied with the results. For sinus headaches, pain and pressure in the sinus, and recurrent or chronic sinus infections, this procedure is particularly effective. 

Will I have pain after a balloon sinuplasty?

You’ll have significantly less pain after balloon sinuplasty than with endoscopic sinus surgery — plus, the recovery time is shorter.

Patients may experience slight pain in the sinuses for one to several days after this procedure. We prescribe pain medications, but most people don’t need them beyond a couple of days. Within four days, most patients feel about 80% back to normal. Full recovery takes up to six weeks. 

Will I have congestion after balloon sinuplasty?

Expect temporary “rebound” congestion for about a week after a balloon sinuplasty as the mucosa (nasal lining) heals. The balloon sinuplasty is only minimally traumatic to the tissue and therefore heals quickly. As the inflammation subsides, so does the congestion.

What is the balloon sinuplasty success rate?

In our experience of doing hundreds of these procedures, the balloon sinuplasty success rate is extremely high — easily above 95%. Overall, it’s an extraordinarily successful procedure.

What are the advantages of balloon sinuplasty vs. sinus surgery?

Overall, balloon sinuplasty is much less invasive than sinus surgery and doesn’t require general anesthesia, making it possible to do the procedure in office. It also tends to be less expensive than traditional sinus surgery because you do not have to pay for the cost of the surgery center or anesthesia provider.

Balloon sinuplasty causes very little injury to the tissues in the nose, which enables patients to heal faster than from a sinus surgery. Because we use the sinus pathways that already exist rather than surgically create openings, less scar tissue forms, which is another contributing factor to quick recovery. Essentially, balloon sinuplasty allows us to open the sinuses without undergoing full surgery.

How do I see if I’m a balloon sinuplasty candidate?

For any patient combating chronic sinus issues, we always start with medical management. We first try topical sprays, steroids, and antihistamines. Then, we prescribe oral antihistamines, oral antibiotics, and if need be, oral steroids. If these treatments are ineffective, we consider balloon sinuplasty. 

If you’ve already had all of these medical management treatments by the time you come to an ENT, we can move forward in evaluating if you’re eligible as a balloon sinuplasty candidate. If you haven’t used medical management options, we’ll try whatever you lack in your medical regimen.

If you’re still symptomatic after medical management and not improving, we perform a CT scan. We offer CT scans in the office and review the immediate results together, making it as convenient for patients as possible. 

If the CT scan indicates a balloon sinuplasty would be helpful, that’s what we recommend. If we see that the balloon won’t take care of the problems, we may recommend sinus surgery or another intervention.

Does balloon sinuplasty have FDA approval?

Yes, and there are several FDA-approved balloons available. The one we use is the Acclarent balloon because of its low side effect profile and high safety rating. The guidewire is so gentle, it won’t even break the yoke of an egg, yet it maneuvers effortlessly through the tightest sinus pathways.

Do my sinuses have to be packed with gauze?

No packing is involved whatsoever. 

Will I have facial bruising?

There’s no bruising of the face and typically no swelling. This procedure doesn’t change a patient’s external appearance, however, you may have some facial tenderness for a day or two following the procedure. 

Do I need to visit a hospital?

No, you don’t have to visit a hospital since we do not administer general anesthesia. 

While we do require a COVID-19 test day before for any procedure, no other lab work is necessary for most patients. Patients on blood thinners may need lab work and will need to stop blood-thinning medications prior to the procedure. 

How long does the procedure take?

The procedure takes about 1-1.5 hours in total. This includes the 30 minutes typically required to fully numb the nose and a 20-30 minute procedure. Patients should plan to have someone drive them to and from the appointment. 

Will my future sinus treatments be limited after the procedure?

No, this doesn’t limit your options in the future. 

Should the sinuplasty not work or if you develop allergies or a worsening disease over time, you can use any topical spray, allergy management, and you can even opt for endoscopic sinus surgery. If anything, balloon sinuplasty gives you more options because hopefully the sprays and irrigations will get further into the sinus cavities after the procedure. 

Is balloon sinuplasty permanent?

Yes, this is a one-time procedure. In the 16+ years since its development, we’ve seen long-lasting, effective results. 

Any further questions? If so, give us a call. We’re happy to answer your questions and help you decide if balloon sinuplasty is right for you. 

Nasal Valve Collapse: Symptoms, Treatment & Recovery

Could you have nasal valve collapse and not realize it? 

A nasal valve is essentially the nostril, or the outside part of the nose. Sniff in and look for a ‘collapse’ of those external walls of the nose — that’s the nasal valve. It’s a triangular area that we think of as the outside nostril, made up of the ala and inferior turbinate. 

Symptoms of nasal valve collapse can vary. Some people notice their nasal valve is collapsed on a static basis, meaning it stays narrow all of the time and limits airflow regularly. Others notice that their nostrils seem to close when they breathe in deeply during exercise. Patients with any type of nasal valve collapse may experience congestion that seems to stay on the entrance of the nose. However, if they pull their cheek open with their fingers or use breathing strips that pull the outside of the nose, it relieves their specific congestion.  

Sound familiar? You may be suffering from nasal valve collapse. 

What Causes Nasal Valve Collapse? 

Usually, nasal valve collapse is simply anatomical. It occurs because of how the nose naturally developed. The reason people’s noses look different is because their cartilage forms in different shapes, sizes, positions, and directions. These differences affect more than cosmetic appearance — it also affects function. If there’s not enough supporting structure in the lateral sidewall, it can collapse. 

Whatever the cause, not everyone immediately identifies they have a nasal valve collapse. Some people have had it so long, they don’t recognize the symptoms anymore. They’ve become used to the limited airflow over time. In some cases, the collapse has worsened after years of wearing low-sitting glasses, making the change gradual. 

In other patients, the minor anatomical issue has become more pronounced through years of growth. As you age, cartilage grows — the cartilage in your nose is no exception. If it becomes more narrowed over time, especially if there’s a slight septal deviation, the collapse worsens. 

Allergies can confuse identifying the issue, too. People often visit the ENT assuming, “I must have allergies because I can’t breathe through my nose,” when in fact, a collapsed nasal valve may be to blame. 

Treatment for a Nasal Valve Collapse

In the past, our best solution to a nasal valve collapse has been to conduct one of two types of grafts: spreader grafts or alar batten grafts. 

In either of these surgeries, we conduct a Septorhinoplasty where we open the nose, take cartilage from the septum, and strategically place it under the surface of the skin to hold the nose open and create more space in the airway. It’s a fairly involved procedure that has to be performed in a hospital or surgery center setting under general anesthesia and requires incisions into the nasal cavity with a lengthy recovery. It is often not covered by insurance and can sometimes be prohibitively expensive.

While this is still may be the best procedure for some, we now have new technology that provides a non-surgical, painless, in-office solution with little to no recovery time! 

Vivaer offers a non-surgical approach to strengthen tissue in the nasal valve. Originally developed by plastic surgeons, this tissue remodeling instrument allows us to target the place of collapse with radio frequency heat to strengthen and reshape the tissue. 

We start by applying lateral outward pressure to open the valve. Then, we engage the device to alternate heating up the tissue for 15 seconds and cooling it off for 15 seconds in a new position. Through this process, we open the valve and stiffen the valve so it stays open and prevents future collapse. We’re only slightly adjusting the tissue, but this 1-2 millimeter difference in placement is all that’s necessary to significantly improve breathing. 

While it’s only been available for a few years, we’ve seen consistent great results with Vivaer and are excited to offer our patients a non-surgical option where previously, there was none. 

What to Expect From a Vivaer Treatment

Before the day of your treatment, we’ll prescribe pain medication and an anxiolytic (anxiety-reducing medication) for you to take prior to your appointment. Patients need to arrange for a driver to bring them to the appointment and take them home. Once in the office, we start by numbing the nose, which takes about 20 minutes. The procedure itself takes just 15 minutes to complete. Overall, it’s a well-tolerated, generally painless procedure. 

If we’re only conducting a Vivaer treatment, there’s no bleeding following the procedure. If you have Vivaer done in conjunction with another nasal procedure, there may be some slight bleeding. The patient will likely experience crusting at the nostril and congestion for two to three weeks as the tissue heals. We provide ointment for the patient to apply regularly to crusted areas. Patients heal completely within three weeks. 

Here’s what a recent ENT Lubbock patient had to say about Vivear:

Difficulty breathing, especially at night, has been a problem for me since I was a young man. In 1999 I underwent a rhinoplasty, which was supposed to help, and on several occasions I have tried a cpap machine. Also, I’ve taken several different medications to reduce allergies and reflux. Nothing had a noticeable effect. I asked my doctors about seeing an ear-nose-throat doctor, but all of them said it would be of no use. I decided to try, anyway, and I made an appointment with Dr. David Cuthbertson.

Dr. Cuthbertson saw me in his office and thoroughly explained the Vivaer treatment. I said I had been complaining about breathing difficulty for decades, so we should try it. I am so happy that I did. Since the procedure I have been breathing much better, and I can simply go to bed and sleep. Sometimes during the day I have to stop and think about the fact that my nose is clear. I know that not everyone will have the same experience, but I would encourage anyone to try it. The discomfort of the procedure is minimal. Dr. Cuthbertson has to be the right guy. He’s an expert, and he’s polite and kind. I’m lucky to have met him and to have had the benefit of his expertise.

-Edward S.

To make this option even better, Vivaer is long-lasting. It’s a one-and-done procedure that brings results that should last a lifetime. 

If you suspect you’re suffering from nasal valve collapse, give us a call and we’ll see if Vivaer is a solution that will work for you.

Can’t Sleep with a CPAP? Here’s the Solution

While snoring with a CPAP may stop, sleeping with a mask on is tough. It irritates you, you take it off, and bottom line, you’re still not getting good rest. The CPAP just isn’t bearable. 

Obstructive sleep apnea is a common problem — it affects more than 20 million Americans and often goes undiagnosed and untreated. The primary acute side effect is fatigue, which may sound minimal, but studies show this fatigue results in a measurable increase in accidents and a significant decrease in the overall health. More long-term effects including congestive heart failure, pulmonary hypertension, strokes, heart attacks, and obesity are also all linked clearly to obstructive sleep apnea.  

Obstructive sleep apnea is more than an “I snore so my partner can’t sleep” issue— it’s a serious health concern that needs to be addressed. And now you have more treatment options than just the CPAP machine. 

How CPAP Works

Those who have visited their doctor about obstructive sleep apnea have likely been instructed to use a CPAP machine. Historically, it’s the only approach to addressing sleep apnea, and it’s still the most common treatment. The CPAP (Continuous Positive Airway Pressure) works by blowing a steady column of air into your airway, which stents it open. 

It’s a great idea in theory, but constant air blowing in your face can make it difficult to breathe… much less sleep.

How to Know if CPAP Is NOT Right For You 

While most people stop snoring with CPAP, many can’t keep the mask on and sleep soundly. This 1980s technology still serves some patients well, but for those who need a more comfortable option or seem to still snore with CPAP, we’ve been searching for an alternative. 

As ENTs, we’re regularly looking for ways to improve the anatomy of the upper airway to solve the problem. We’ve tried surgical approaches such as: 

  • If you have large tonsils, remove them.
  • If you have a large floppy palate, trim or shorten it.
  • If you have a bad septal deviation or nasal obstruction, surgically open it. 

These alternative procedures are more invasive than CPAP, and can have great results, but don’t work for everyone. Even so, CPAP isn’t always the right long-term solution either. Some still snore with CPAP and others see little improvement in their sleep because they’re so uncomfortable. 

Signs a CPAP is not right for you

A CPAP machine may not be the right solution for several possible reasons: 

  • Your facial structure doesn’t fit the mask well
  • Your facial hair prevents the mask from fitting well 
  • Nasal congestion and obstruction prevent you from using the nasal pillow
  • The mask loosens regularly, causing the air to blow in your eyes, resulting in dry eyes
  • If you require high pressure on the machine, you may need to tighten straps so much it results in headaches and indentations on the skin
  • You cannot comfortably sleep on your side or stomach while wearing the mask

If you’ve struggled with CPAP for one of these reasons, we finally have a consistently successful surgical treatment for sleep apnea. With Inspire, you may be able to get off CPAP for good. 

How Inspire Works  

Inspire’s sleep apnea innovation works by preventing the tongue from blocking the airway. Basically, it’s a pacemaker for your tongue, telling it to move out of the way when you’re trying to breathe.

Inspire is a small device that’s implanted in the right side of the chest, just under the clavicle. This device has two leads: 

  1. One lead is a pressure sensor placed between the ribs. This sensor detects when you’re trying to breath by sensing the pressure on the thorax and the intercostal muscles. 
  2. The other lead stimulates the nerve that controls the tongue. The problem with obstructive sleep apnea is the tongue blocks the air from coming in. The small cuff wrapped around the nerve gives a small electrical impulse that pushes the tongue out of the airway, opens the palate, and creates a remarkably more open airway. Essentially, anytime you try to breath, it moves your tongue out of the way. 

Is Inspire the Right Solution For You?

Patients who struggle with CPAP may be eligible for Inspire if they also have: 

  • Moderate to severe sleep apnea: AHI 15 and above
  • BMI within a certain range depending on insurance (typically 32-35)

If you meet the requirements above, we do a drug-induced sleep endoscopy (DISE) to ensure the patient is a good candidate for the procedure before we consider surgery. In DISE, we put the patient to sleep for about five minutes and use a camera to watch the obstruction in the back of their throat to better evaluate if Inspire will effectively solve the problem. 

Patients who qualify will appreciate another great benefit as well — almost all insurance companies cover the procedure, including Medicare. The insurance process used to take months, but as companies have come to recognize how effective it is, it typically only takes a few weeks to receive approval. 

The Inspire procedure itself takes just 3 hours. It’s FDA approved, and Dr. Cuthbertson of ENT Associates of Lubbock is the only one who offers the procedure between El Paso and Dallas. If you’re ready to move away from your CPAP machine and think Inspire may be the right option for you, contact us to see if you qualify. 

What You Need to Know About Balloon Sinuplasty: Risks, Recovery & Side Effects

Sinus issues are the last problem you want to worry about these days.

You have infections that won’t go away (or keep coming back!) and it’s interrupting your life. You’ve tried allergy medications, antibiotics, and pain relievers, but nothing seems to fully clear up your sinuses — and if it does, it’s short-lived. 

Could balloon sinuplasty be the answer you’ve hoped for? How involved is balloon sinuplasty and what is the recovery period? 

While there is some recovery involved, most patients find balloon sinuplasty to be far less intimidating than they expected. Here’s what you need to know about the procedure and the details of what’s at risk (spoiler alert: not much!)

What is Balloon Sinuplasty? 

Balloon sinuplasty is a procedure to open sinus passages. It can be performed in-office, under local anesthesia, and with a recovery period of only 1-2 days!

Everyone has air-filled spaces in the skull called sinuses. We have maxillary sinuses in the cheeks, frontal sinuses in the forehead, ethmoid sinuses between our eyes, and sphenoid sinuses behind the eyes. 

Problems happen when these passages become obstructed. When the outflow point is narrow (and therefore easily blocked), you experience pain, pressure, infections, drainage, malaise, low energy, and/or fever. Balloon sinuplasty allows us to open the sinus passageways to prevent these chronic issues and symptoms. 

Cardiologists use a similar balloon for angioplasties in the heart. Using a balloon, they dilate carotid arteries to improve blood flow to the heart and avoid the need for open heart surgery. Similarly, we use balloon sinuplasty to improve the patient’s sinus drainage pathway and avoid the need for more extensive surgery.

Am I A Candidate for a Balloon Sinuplasty?

Balloon sinuplasty treats patients with chronic sinus issues. People who experience recurrent sinus infections three or more times per year that seem to persist despite medical management, or people with chronic sinus infections that seem to never fully resolve are potentially strong candidates for this procedure. 

Balloon Sinuplasty vs. Sinus Surgery

Balloon sinuplasty is much less invasive than a traditional functional endoscopic sinus surgery (FESS). During FESS, patients undergo general anesthesia where they’re completely asleep in the operating room. Using a variety of instruments, we then cut open and remove significant amounts of tissue and bone within the sinus cavities. Recovery is often extensive and the cost is much higher than office-based procedures because it involves anesthesia and facility charges, in addition to the surgeon.

Balloon sinuplasty uses a non-surgical approach to open these passageways. This procedure takes advantage of the patient’s anatomy by enlarging openings rather than creating artificial openings. 

Patients do not need general anesthesia, but instead are given local anesthesia to completely numb the nose. Plus, it’s designed to be done in the office, eliminating the need to use a surgical center. 

Balloon Sinuplasty Risks

A balloon sinuplasty comes with extremely low risk. While there are different types of balloons on the market for this procedure, we use the balloon we feel is the safest. With the Acclarent balloon, the guide wire that inserts this balloon is so soft and delicate, it wouldn’t even break an egg yolk. Another potential risk is that the procedure may not be fully effective depending on the significance of your sinus disease and a more extensive sinus surgery could still be necessary. 

The “Day of” Timeline

Before the day of the procedure, we prescribe a pain medication and an anxiolytic (anxiety reducing medication) for the patient to take before their appointment. Patients need someone to drive them to the office and home after the procedure. 

We start by fully numbing the nose using topical medications, which takes about 30 minutes. After the nose is completely numb, we inject more numbing medication before beginning the sinuplasty. The procedure itself takes 20-30 minutes. During the procedure, the patient may feel slight pressure while the sinuses are dilated but should feel no real discomfort. 

After we finish, we suction the nose so it’s completely clean. The patient can leave immediately afterwards. Patients should expect to be in the office for 1- 1.5 hours for the entire process. 

What to Expect: Balloon Sinuplasty Recovery

While recovery is very manageable, there’s still a period of healing that must occur following this procedure. Expect about a three-day recovery, with mild lingering symptoms afterwards. 

In three to four days, most patients feel about 80% normal. Patients are usually back to 100% within a few weeks. Often, if we do the procedure at the end of the week, you’re back to work by Monday. 

Immediately following the procedure, patients experience slight bleeding for up to 12 hours. We’ll provide guides and care instructions for managing it. Most patients also experience nasal congestion for about a week as the swelling the cavities subsides. During this time, patients may also feel mild pain, headaches, and pressure in the sinus cavities. Remember, we actually moved bones around and it takes bones six weeks to heal completely. After three to four weeks, patients are almost back to normal, and by six weeks, they’re fully recovered.

Patient care instructions are also rather simple during balloon sinuplasty recovery: just avoid strenuous lifting and exercise for about a week. While it wouldn’t damage the surgery, it may start a nosebleed if you increase pressure too much. Otherwise, you can follow your normal diet and showering routines. 

Balloon Sinuplasty Side Effects

After balloon sinuplasty one should expect some bleeding for several hours immediately following the procedure and minor swelling. Until the swelling subsides, it makes the nose feel tender and a congested.

Overall, balloon sinuplasty risks are low and come with no long-term side effects. If you’re considering this procedure to remedy your sinus issues, give us a call or talk to your ENT about if this is the right procedure for you.


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