Welcome to the center for Rhinology, Sinus Surgery and Minimally Invasive Endoscopic Skull Base Surgery at Beth Israel Medical Center. This Website will provide an introduction to our comprehensive approach for various disorders of the nose, sinuses, skull base, and eye orbit. Our individualized care focuses on developing a tailored approach using the latest advances in medical and surgical techniques.

Sinusitis and other nasal disorders

Sinus infections affect more than 37 million people in the United States annually and can result in severe symptoms and quality of life impairment. Common symptoms may include nasal blockage, sinus headaches, excessive mucous drainage, post-nasal drip, decreased sense of smell, and chronic cough. The goal of treatment is to restore normal sinus health and function. The initial consultation focuses on the individual's sinus history with the goals of identifying any predisposing factors and initiating effective treatment. Our team approach incorporates a patient-centered use of medications, topical therapy, allergy treatment and complementary-alternative medicine. The majority of patients are successfully treated without surgery. In addition to sinusitis, our center provides comprehensive care for other disorders affecting the nose including:

• Nasal polyps
• Deviated nasal septum
• Seasonal and environmental allergies
• Surgery for snoring and obstructive sleep apnea
• Nose bleeds (epistaxis)
• Cerebrospinal fluid leak
• Surgery of the eye orbit for Graves' disease and blocked tear ducts
• Nasal septal perforation
• Disorders of smell and taste
• Benign and malignant tumors affecting the nasal cavity including inverting papilloma

The most modern surgical advances are available to patients requiring surgery of the nose, sinuses and surrounding structures. The goal of sinus surgery is to restore the normal function of the sinuses with minimally invasive techniques that optimize safety, outcomes and recovery. The following procedures are available:

• Minimally invasive endoscopic sinus surgery is routinely performed on an outpatient, ambulatory basis with rapid recovery and return to work. Nasal packing is avoided and some patients are candidates for having surgery with sedation and local anesthesia, avoiding the need for general anesthesia.
• Image guided endoscopic surgery incorporates a three dimensional CT scan roadmap during surgery, similar to GPS technology. This allows for improved visualization of the anatomy and is used for patients undergoing revision or advanced sinus procedures with endoscopic techniques.
• Balloon sinusplasty enlarges the natural sinus openings using balloon catheters with minimal manipulation of tissue.

Endoscopic Surgery

The minimally invasive endoscopic add surgery program at Beth Israel Medical Center provides comprehensive multi-disciplinary care including diagnosis, medical treatment and surgery for hard to reach tumors and conditions such as:

• Pituitary adenoma
• Meningioma
• Chordoma
• Craniopharyngioma
• Cerebrospinal fluid leak
• Juvenile nasopharyngeal angiofibroma

Initial evaluation by the medical and surgical teams provides you with a complete assessment and discussion of the various treatment options. Our multidisciplinary approach incorporates experts in Neurosurgery, Otolaryngology, Neurology, Endocrinology, Ophthalmology, Radiology and Radiation Therapy. In patients undergoing surgery, the surgical team is supported by experienced Neuro-Anesthesiology and Neuro-Intensive Care specialists.

Our surgeons are among the leaders in minimally invasive endoscopic surgery for these tumors and conditions. Our approach incorporates endoscopic techniques and image guidance technology that allow for improved visualization of the surgical area. This results in increased access to the tumor and improved safety. Additionally, this allows us to perform minimally invasive surgery that avoids skin incisions, craniotomies (openings of the skull) and retraction of the brain. Most patients are able to be discharged from the hospital after a few days.