Dr. Jeffrey Tseng, MD

Nasal endoscopy is the use of a thin, flexible tube (called a 'scope') that is inserted into the nostril to examine the structures of the nose. The scope contains a fiber optic light and a camera that allow a physician to see much more of the nasal passages, airways, and sinuses than is possible with a standard nasal exam.

A nasal endoscopy is typically performed by an otolaryngologist (or ENT) in their office. It may be performed for a variety of reasons, but some common ones include:

• Sinus infections
• Nasal polyps
• Frequent nosebleeds
• Persistent stuffiness
• Obstruction in the nose
• Suspected tumor in the nasal passages

In most cases, a medication containing a decongestant and anesthetic is sprayed into the nose before the scope is inserted. The doctor uses the scope to examine any problem areas. If necessary, most scopes allow for tiny tools to be inserted and used to removed tissue or take samples. Nasal endoscopy is a very safe and relatively easy procedure.

Rhinoplasty may also be done to correct a deviated septum or other breathing impairment. In that case, the nasal structure is adjusted so that airflow is increased to a comfortable level.

Typically, rhinoplasty is only performed on adults because kids' and teens' faces are still growing and changing. After a rhinoplasty, healing will take 1-2 weeks, but subtle shifts in the face and occasional swelling can last up to a year.

Tonsillectomies are usually performed on children; however, many adults also undergo the procedure. A tonsillectomy generally only lasts for about half an hour following the administration of anesthesia. The otolaryngologist (ENT) or surgeon performing a tonsillectomy may employ a variety of medical techniques, such as:

• Cold Knife Dissection: A cold knife dissection is the most popular tonsil removal method. A surgeon removes the tonsils using a steel scalpel and repairs the region with sutures (stitches) or electrocautery (high heat) to stop bleeding. This technique is favored for those with obstructed breathing.
• Electrocautery: Other tonsillectomy methods include a full tonsil removal by electrocautery, where the surgeon uses a high heat device to burn off the tonsils and cauterize the bleeding tissue. Electrocautery is more painful than cold knife dissection.
• Harmonic Scalpel: A third technique is where the surgeon uses a harmonic scalpel (vibrating bladed device) to first cut off the tonsils, and then coagulate bleeding using the harmonic scalpel's heat and vibration. Harmonic scalpel is the most precise form of tonsillectomy.
• Radiofrequency Ablation: To perform the radiofrequency ablation technique, the surgeon places small probes into the tonsil that transmit radiofrequency energy to the tonsil tissue. The delivered energy damages and scars the tonsils, gradually minimizing the tonsils' size. Unlike the other three methods, radiofrequency ablation is performed in-office with or without general anesthesia and has minimal recovery time. Patients can expect to return to daily activities nearly immediately and may receive radiofrequency ablation every few months. While radiofrequency ablation does reduce tonsil inflammation, it is not often prescribed to those with severe tonsillitis or breathing disorders.

Patients are typically able to return home shortly after having their tonsils removed. Tonsillectomy recovery time may range from around ten days to two weeks. During this time, it is common for patients to have a sore throat, neck pain, and a hoarse voice. Patients are advised to consume soft foods such as ice cream and applesauce to avoid further throat irritation. After recovering from tonsillectomy, many patients experience improved breathing, reduced irritation, and an overall improved quality of life.