Home

Meet Dr. Faw

For Patients

For Physicians

Conditions We Treat

Services We Perform

Contacts

Evergreen Sinus News

New concepts in our understanding of sinus disease.

In the last year, two concepts have attracted a lot of attention from those studying the causes of chronic sinusitis. The first concept is the recognition that “biofilms” may play a significant role in some patients suffering from repeated infections. We are aware of biofilms in other clinical situations. Infection of implanted devices and dental plaque are two examples of biofilm activity. Biofilms are complex communities of microorganisms that develop a protective barrier and metabolism that makes them very difficult to eradicate by simply taking antibiotics. Biofilms are present in the lining of some chronic sinus suffers and there is some evidence that they are even more prevalent in the sinuses of patients who have had traditional FESS surgery. Catheter-based instruments may be able to facilitate minimally traumatic access to the affected sinus and help dislodge biofilms without creating an environment that favors their spread. Further research is needed in this area but the initial findings are intriguing.

Prince AA et al “Prevalence of biofilm-forming bacteria in chronic rhinosinusitis” Am J Rhinol. 2008 May-Jun;22(3):239-45.

Cohen M. et al “Biofilms in chronic rhinosinusitis: A review” Am J Rhinol Allergy. 2009 May-Jun;23(3):255-260.

Another observation is from physicists who are studying airflow dynamics of the nose and sinuses. The sinuses are known to naturally emit Nitric Oxide (NO) Nitric Oxide is a pluripotent gaseous messenger with potent vasodilating, and antimicrobial activity. The role of NO in the sinuses is likely to enhance local host defense mechanisms by directly inhibiting pathogen growth and stimulating mucociliary activity. The NO concentration in a healthy sinus exceeds those that are needed for antibacterial effects. Traditional sinus surgery may actually diminish the concentration of this helpful gas by making the opening from the nose to the sinus too large. Again, newer catheter-based approaches may preserve this function and result in better long-term results. Once again, further research is needed. Stay tuned.

Lundberg JO “Nitric oxide and the paranasal sinuses” Anat Rec (Hoboken). 2008 Nov;291(11):1479-84.”

............................................................................................................................................................................................

Dr Faw was one of the invited discussants at the international “Sinus Forum” held in Washington DC in July. The meeting was attended by several hundred sinus surgeons from around the world. He presented his experience with Balloon Sinuplasty and taught over 100 surgeons how to use some of the new advances in catheter-based technology. The experience was stimulating and enriching for all who attended. He came back with a host of new ideas and concepts that should benefit our patients. We are committed to continuing development of our understanding and skills.

 

Make Appointment
Home