Michael Sillers

Alabama Nasal and Sinus Center, Birmingham, AL

The decision to operate on the frontal sinus is based on persistent symptoms that have been refractory to appropriate medical therapy with associated radiographic evidence of disease by computed tomography. There is currently no evidence to support operating on radiographically negative frontal sinuses, regardless of the availability of technology...

Balloon sinus dilation (BSD) instruments afford the opportunity for office-based sinus procedures in properly selected patients with chronic rhinosinusitis (CRS). This study evaluated patient-reported outcomes 1 year after office-based BSD. Adult patients with medically refractory CRS were prospectively enrolled into a multicenter, single-arm study...

Objectives/hypothesis: Balloon catheter dilation (BCD) of the paranasal sinuses is increasingly described as a standalone procedure in the office for minimally invasive treatment of patients with chronic rhinosinusitis (CRS). This study evaluates CRS-related healthcare utilization before and after in-office treatment as performed by otolaryngologi...

Background: Balloon sinus dilation (BSD) is an increasingly used tool in endoscopic sinus surgery (ESS). The tissue-sparing nature of the instrumentation allows for properly selected patients to undergo office-based procedures under local anesthesia. Methods: This was an Institutional Review Board (IRB)-approved, prospective, 14-center trial. Pa...

Purpose of review: Balloon catheter dilation (BCD) technology was introduced in 2005 as a device employed to dilate maxillary, sphenoid, and frontal sinus outflow tracts in patients with chronic sinus disease. With the evolution of the technology, BCD has been utilized in the office setting. The purpose of this review is to discuss the safety, tol...

Balloon sinus dilation (BSD) tools are increasingly used in endoscopic sinus surgery (ESS) and post maximal may cause less tissue trauma/bleeding, potentially enabling office-based ESS. We evaluate the feasibility of ESS performed in-office using BSD instrumentation. All patients had a diagnosis with chronic rhinosinusitis. Because of symptom resol...

This article addresses the challenge of persistent nasal airway obstruction following septoplasty, specifically as it relates to revision septoplasty. Emphasis is on the importance of and the steps to be taken in making a complete and correct diagnosis of the problem before any surgery is performed. The authors present two categories of revision su...

The primary objective was to assess the long-term effectiveness of balloon catheter sinusotomy. Patients who had sinus ostia dilated with balloon catheters were prospectively evaluated 1 year after surgery with nasal endoscopy, a CT scan, and the Sino-Nasal Outcome Test (SNOT-20). Sixty-six patients (202 sinuses) were examined. One hundred seventy-...

Assess two-year postoperative clinical outcomes for patients receiving balloon catheter sinusotomy. Patients who had sinus ostia dilated with balloon catheters were prospectively evaluated two years after surgery by Sinonasal Outcome Test (SNOT-20) and computed tomographic (CT) scan. Sixty-five patients (195 ballooned sinuses) were followed for two...

This study was performed to assess the feasibility of using intraoperative computed tomography (CT) to provide real-time updates to image guidance systems (IGSs) during surgery. The xCAT ENT portable intraoperative CT scanner (Xoran Technologies, Ann Arbor, MI) was used to acquire scans before, midway, and at the end of six cadaver dissections duri...

The aim of this study was to further evaluate the safety and effectiveness of balloon catheter devices to dilate obstructed sinus ostia/perform sinusotomy. Through a prospective, multicenter evaluation, safety was assessed by rate of adverse events, patency was determined by endoscopic examination, and sinus symptoms were determined by the Sino-Nas...

Within in the broad spectrum of disease that can affect the paranasal sinuses is a class of benign bony abnormalities known collectively as fibro-osseous lesions. Fibrous dysplasia, ossifying fibroma, and osteoma are three distinct entities that lie along a continuum from the least to the most bony content. They have similar appearance and makeup;...

To characterize the limitations of self-expandable stents in the management of benign tracheal stenosis, we performed a retrospective review at a tertiary care medical center. Patients who underwent tracheal stenting were assessed for the cause and severity of tracheal stenosis, comorbidities, stent-related complications, and follow-up airway proce...

Chronic rhinosinusitis is one of the most common diagnoses in the United States and accounts for millions of dollars in health care expenditure every year. Most patients are successfully treated with medical therapy, but many require primary functional endoscopic sinus surgery (FESS) to complete their treatment. Approximately 10-15% of patients who...

Hypothesis: Osteoplastic frontal sinusotomy with obliteration is still a viable option for the treatment of frontal sinus abnormality.REFERENCES1 +Goodale RLMontgomery WW Experiences with osteoplastic anterior wall approach to frontal sinus. Arch Otolaryngol 1958;68185- 271Link to Article[[XSLOpenURL/10.1001/archotol.1958.00730020281001]]2 +Hardy J...

This presentation is from the Rhinology and Sinus Committee of our academy. This presentation will bring the latest advances that have been made in endoscopic sinus surgery. The presenters are well-known members of the academy who have strived to improve the surgical technique and they will present their viewpoint on the latest advances in technolo...

The surgical care of chronic frontal sinus disease presents a significant challenge to otolaryngologists. Most cases refractory to medical intervention can be successfully managed with an endoscopic intranasal frontal sinusotomy. In rare instances, the disease process cannot be adequately managed through an intranasal approach alone, and a frontal...

Wegener's granulomatosis (WG), a multisystemic necrotizing vasculitis associated with the presence of antineutrophil cytoplasmic antibodies (ANCA), may present in a relatively abrupt manner with clinical manifestations in classical target organs making its diagnosis relatively straightforward(1). Often, however, patients with WG may have an insidio...

We sought to develop an algorithm for surgical approaches to the sphenoid sinus. Retrospective review was conducted of all patients who underwent a sphenoid sinusotomy by the senior author between July 1994 and August 2001. The study population consisted of 141 patients, in whom 5 different surgical approaches were used: transseptal (47 [33.3%]), t...

Functional endoscopic sinus surgery' (FESS) is a common otolaryngologic procedure, with over 250,000 operations performed annually. Computerized surgical navigation systems are available to assist the rhinologic surgeon in the complex dissection required for FESS. Our objective was to determine whether this system provided quantifiable benefits in...

Although intranasal frontal sinusotomy can now be performed for most cases of chronic frontal sinusitis, the osteoplastic frontal sinus procedure with obliteration, unfortunately, still is considered by many to be the standard for chronic frontal sinusitis against that which other frontal sinus procedures are judged. Unobliterating the previously o...

Functional endoscopic sinus surgery (FESS) has become the standard approach for medically refractory rhinosinusitis since its introduction in the United States in 1985. Transnasal endoscopic techniques have been applied to other pathologies involving the nasal cavity, paranasal sinuses, anterior skull base, and orbits in recent years. Computer-aide...

Clinical and virologic consequences of temporary interruption of HIV therapy are incompletely understood. To describe a febrile illness that was consistent with the acute HIV syndrome and occurred after interruption of antiretroviral therapy. Case report. University clinic. HIV-infected man. Plasma viral load, lymphocyte subsets, diagnostic evaluat...

Functional endoscopic sinus surgery (FESS), a relatively new treatment for chronic rhinosinusitis, has evolved over the past two decades. Since FESS was introduced in the late 1970s, considerable published evidence has indicated that this treatment is safe and effective for medically refractory rhinosinusitis. However, because we lack a systematic,...

Image-guided surgery represents a new technology with applicability to patients undergoing functional endoscopic sinus surgery for medically refractory rhinosinusitis. It also shows promise in helping to safely expand minimally invasive transnasal endoscopic techniques for nonrhinosinusitis diagnoses of the paranasal sinuses, orbits, and anterior s...

Previous studies proposed a dynamic, steady-state relationship between HIV-mediated cell killing and T-cell proliferation, whereby highly active antiretroviral therapy (HAART) blocks viral replication and tips the balance toward CD4(+) cell repopulation. In this report, we have analyzed blood and lymph node tissues obtained concurrently from HIV-in...

Quantitative analysis of the relationship between virus expression and disease outcome has been critical for understanding HIV-1 pathogenesis. Yet the amount of viral RNA contained within an HIV-expressing cell and the relationship between the number of virus-producing cells and plasma virus load has not been established or reflected in models of v...

This is a report of the use of endoscopic sinus surgery in the management of three patients diagnosed with rhino-orbital or rhino-orbito-cerebral mucormycosis. A retrospective review was performed of the clinical examinations and imaging studies of three patients who underwent endoscopic sinus surgery as part of their therapy for mucormycosis. In a...

Fibro-osseous tumors, including osteomas, ossifying fibromas, and fibrous dysplasia, are not uncommon benign lesions arising in the paranasal sinuses. Conventional wisdom advocates resection when these lesions are symptomatic, or when they exhibit rapid growth. Traditionally, resection has been performed via a variety of open approaches. With the a...

Our goal was to assess the role of MR cisternography in the examination of patients with suspected CSF rhinorrhea. MR cisternography was performed as a heavily T2-weighted fast spin-echo study with fat suppression and video reversal of the images in 37 patients over a 3-year interval. Twenty-four of the patients subsequently had exploratory surgery...

Angiography with selective embolization has become an accepted method of treating posterior epistaxis that is not controlled with conservative measures. The authors reviewed 112 cases of patients who had received selective angiographic embolization for refractory epistaxis from January 1990 to December 1995. There were 114 embolizations over this 5...

An external nasal dilator (Breathe Right, CNS, Inc., Bloomington, MN) has become popular with athletes. The dilator is an adhesive band with a central elastic strip. When applied across the nasal valve, the device theoretically increases nasal valve area. We used acoustic rhinometry (Hood Laboratories, Pembroke, MA) to measure the cross-sectional a...

In recent years cerebrospinal fluid (CSF) rhinorrhea has been managed successfully with transnasal endoscopic techniques. The most important and often most difficult step is the precise localization of the fistula. Computerized tomographic and radionuclide cisternography are two commonly used techniques for preoperative identification of the CSF fi...

Endoscopic intranasal frontal sinusotomy represents a relatively new technique for approaching disease in the frontal sinus. As with all "new" techniques, it has not withstood the scrutiny of time. It does represent, however, a significant alternative to external obliterative procedures for the frontal sinus. The frontal sinus can be visualized wit...

Plain films of the paranasal sinus were the imaging technique most frequently used before the advent of computed tomography. With improved resolution, computed tomography imaging has become the standard for evaluating patients with disease of the paranasal sinuses. With the widespread availability of computed tomography scanning, patients are likel...

Meningioma of the frontal sinus is a rare entity. Only nine cases of primary frontal sinus meningioma are reported in the literature. Two cases of frontal sinus meningioma, one primary and one secondary, are herein described. Each patient presented with headache and a frontal mass. Neither patient had fever or signs of meningeal irritation. Compute...

Functional endoscopic sinus surgery has gained wide acceptance as the procedure of choice for patients with medically refractory chronic sinusitis. During the past decade in the United States, success rates following functional endoscopic sinus surgery have been favorable. However, one of the most frustrating problems that has emerged is treating p...

Functional endoscopic sinus surgery (FESS) has emerged as the technique of choice in the treatment of benign diseases of the nose and paranasal sinuses. With emphasis on the functional aspect of this modality, patients have been treated with much less radical procedures when compared with traditional intranasal nonendoscopic and external techniques...

We have reported a case of spontaneous rupture of the stomach in an adult. Immediate onset of severe upper abdominal pain after overindulgence in food and drink along with radiographic evidence of pneumoperitoneum and the clinical findings of massive abdominal distention, epigastric tenderness, shock, and occasionally subcutaneous emphysema should...