Nose & Sinuses

The nose and the adjacent four sinus regions, known as the frontal, maxillary, ethmoid, and sphenoid sinuses, are lined with a soft tissue called a mucous membrane which is covered with cilia or microscopic moving "hairs". Cilia actively clear the nose and sinuses of dust, pollen, and irritants that get stuck on the mucous membranes after inhaling air. In addition to cleaning inhaled air, the nose warms and humidifies the air we breathe.

 

Swelling or inflammation of the nasal and sinus lining occurs with exposure to environmental irritants and viruses and can overwhelm the body's natural defenses, making possible a bacterial infection of the sinuses known as sinusitis. Nearly 50 million Americans are affected by sinus disorders annually.

 

Some patients may suffer from repeated sinus infections also known as recurrent sinusitis, usually defined as 4 or more sinus infections per year, or may suffer from continuous sinus infection symptoms also known as chronic sinusitis and usually defined as having sinus infection symptoms lasting more than 3 months. Along with sinus disorders, we also treat a variety of conditions affecting the nose.

 

Some of the nose & sinus conditions we commonly treat are:

 

  • Allergies & Hay Fever

  • Nasal Valve Collapse

  • Nasal Polyps

  • Recurrent Acute Sinus Infections

  • Nasal Congestion

  • Deviated Nasal Septum

  • Recurrent Nosebleed

  • Sinus Infection

  • Chronic Sinusitis

  • Chronic Rhinitis

  • Taste & Smell Disorders

  • Non-Invasive Sinus Procedures

  • Recurrent & Chronic Tear Duct Infections

Pediatric Chronic  Ear Infections and Tonsillitis

Ear infections affect up to 75% of children in the US by the time they reach the age of three. Children with ear infections may experience earache, fever, ear discharge, headache, and dizziness. While many viral ear infections go away on their own within a few days, some persist, and can lead to bacterial ear infection. In addition to pain and discomfort, untreated recurrent bacterial ear infection can cause immediate hearing loss and contribute to long-term hearing loss and ear disease.

 

Depending on the severity of your child's condition, treatment and prevention of his or her ear infections may include antibiotics, nasal steroid sprays, and discussion regarding the placement of ventilation (ear) tubes. In general, ventilation tubes are recommended for children who have 3 ear infections before age 6 months, at least 4 infections in 6 months, or at least 6 infections in 12 months. Also, ear tubes are often recommended in children who have chronic ear fluid in both ears for at least 3 months or ear fluid with speech delay/speech issues attributed to hearing loss.

 

Tonsillitis is an inflammation of the tonsils, the fleshy areas at the back of the throat, caused by a virus or bacteria. It is especially common in children and spreads through contact with throat or nasal fluids. Tonsillitis causes the tonsils to become swollen, red and painful. Tonsillitis can usually be treated at home through rest and by drinking plenty of fluids, as well as antibiotics for bacterial infections. If a child has had several cases of tonsillitis in a short period of time, surgical removal of the tonsils, called tonsillectomy, may be recommended to prevent future throat infections. Your provider will discuss if tonsillectomy is right for your child after there have been tonsillitis episodes occurring at least 7 times in 1 year, 5 times per year for 2 years, or 3 times per year for at least 3 years. Consideration will also be given to the severity of the illnesses, associated complications, and school absences due to past infection.

We strive to provide the most effective treatment while taking into consideration the comfort of our patients and concerns of their parents

INTRA-CAPSULAR TONSILLECTOMY (IC)


Intra-Capsular Tonsillectomy (IC): refers to the surgical removal of the tonsil tissue leaving the tonsil capsule intact. This method does not expose the muscles under the tonsil.
Fortunately, innovation has allowed patients and parents a choice for a less painful and less complication-prone method for tonsillectomy- this is called intracapsular tonsillectomy or IC tonsillectomy. Intracapsular tonsillectomy is a method of tonsillectomy in which the tonsil tissue is ablated or removed (using Coblation) while leaving the tonsil capsule intact. IC tonsillectomy minimizes trauma to the sensitive muscles of the throat that surround the tonsil. Likewise, preventing muscle exposure speeds healing and, most importantly, decreases the risk of delayed post-operative bleeding. Research has shown IC tonsillectomy to be less painful and be less
prone to cause post-operative tonsil bleeding.


TOTAL TONSILLECTOMY (TT)


Total Tonsillectomy (TT): refers to the surgical removal of the tonsil including the tonsil capsule. This method exposes the muscles under the tonsil. Despite the benefits of IC tonsillectomy, there are some situations when TT is still the preferred technique. Talk to your doctor to know which method is right for you or your child.


A systematic review of all randomized controlled trials comparing IC versus TT has shown that IC (compared to TT):
• Reduces post-operative pain
• Reduces the need for post-operative pain medicine
• Reduces the rate of post-operative bleeding
• Prevents recurrent tonsillitis at the same rate
• Demonstrates higher patient satisfaction scores

 

Ear Conditions

Our ears allows us to hear and help with balance. Most commonly caused by age, hearing loss is a common condition that affects up to 25% of people between the ages of 65 and 75, and up to 75% of people over the age of 75. Problems within the balance (vestibular) system of the ear are also more common with age and affect over 2 million people each year.

At Bridger Ear, Nose and Throat, we help diagnose and treat hearing and balance disorders as well other conditions affecting the ear.

Some of the ear conditions we commonly treat are:

 

  • Balance Disorders

  • Eardrum perforation

  • Ear Infections

  • Ear Wax Impactions

  • Hearing Disorders & Hearing Loss

  • Swimmer's Ear

  • Tinnitus (Ringing)

  • Baha Implant or osseointegrated hearing implants

Balloon Sinuplasty

Sinus Ostial Balloon Dilation

Sinusitis is a common condition that affects over 37 million people each year, causing pain, pressure and congestion in the forehead, nose, cheek and eye area. Over 17 percent of women and 10 percent of men in the US are affected by sinus problems. These problems can be temporary and develop as the result of a cold, or may be long lasting and exist for months with no relief from the troubling symptoms.

The sinuses are the hollow air spaces behind the bones of the upper face, which can become blocked and inflamed to cause a buildup of mucus.

 

This buildup can cause pain, pressure and fullness along with:

  • Difficulty breathing

  • Yellow or green mucus discharge

  • Teeth pain

  • Loss of sense of smell or taste

  • Headache

  • Fatigue

  • Sore throat

 

Sinus problems can often affect patients' quality of life and interfere with regular activities. If you are suffering from sinus problems, it is important to meet with a doctor and discuss your treatment options.

There are several medications available for treating sinusitis and related problems, including antibiotics, nasal steroid sprays, decongestants and saline nasal sprays. While many people can feel relief with the help of these medications, others may still experience their symptoms and have trouble enjoying regular activities.

Since many people do not respond to medication for sinusitis symptoms, a stronger treatment method is sometimes recommended. Sinus surgery is a traditional treatment option that clears blocked sinuses by placing an endoscopic instrument in the nose to examine the area and remove bone and tissue to enlarge it. Unfortunately, this treatment can lead to post-operative pain, bleeding and scarring.

Balloon sinuplasty is an FDA-approved advanced treatment option to relieve the symptoms of chronic sinusitis. This minimally invasive procedure uses a thin, flexible balloon catheter that is placed in the nose and gradually inflated to relieve blockages in the nasal passage by gently restructuring the bones in the nose. It restores normal sinus function while maintaining the lining of the sinus and keeps post-operative pain and bleeding at a minimum.

This procedure offers patients many benefits as an alternative to conventional sinus surgery. Some of these benefits include:

  • Minimally invasive - The soft, flexible tube gently opens sinus openings and avoids damaging surrounding tissue or bones

  • Safe - Balloon sinuplasty is regarded as a safe and effective procedure with no serious complications

  • Faster recovery times - Many patients return to their regular activities within 24 hours

  • Reduced bleeding - By not removing tissue or bone during this procedure, bleeding and other surgical side effects are often reduced

 

Balloon sinuplasty is performed in the office under local anesthesia or under general anesthesia on an outpatient basis. The average procedure takes about 15-45 minutes to perform, and patients can return home shortly after. After balloon sinuplasty, most patients can return to work and other normal activities within 24 hours.

Most patients enjoy significant relief from their sinus symptoms after undergoing balloon sinuplasty. Although the length of these results may vary, clinical information reports continued improvement up to two years after surgery.

While balloon sinuplasty is an effective treatment for relieving many sinus problems, it is important to note that not everyone can benefit from this procedure. Balloon sinuplasty does not treat ethmoid sinusitis or nasal polyps, and cannot be used on patients with extensive scarring within their sinus openings.

There are no serious risks or complications involved with the balloon sinuplasty procedure. It is FDA-approved for the treatment of sinus conditions and has been safely performed on thousands of patients across the world.

To learn more please watch the video below or contact our office, or visit www.balloonsinuplasty.com. We look forward to providing you relief from your sinus symptoms!

Pediatric ENT

Although children are often affected by the same ear, nose and throat conditions as adults, they are often more susceptible to these conditions and require special care to treat these complex conditions.

 

Our doctors are specially trained to diagnose and treat a wide range of ear, nose and throat conditions affecting children, including:

  • Chronic Ear Infections

  • Tonsillitis

  • Sleep Disordered Breathing and Snoring

  • Sinus Infections

  • Tongue and Lip Tie (ankyloglossia)

  • Nasal Obstruction

  • Hearing Loss

  • Speech Delay

Head & Neck

Head and neck describes a general area of interest that includes most of our main senses, hearing, sight, sense of smell, and taste, as well as the physical structure of our head, face and neck.

 

At Bridger ENT, we help diagnose and treat disorders of these senses, as well as treat disfigurement, deformity or trauma to the head, face and neck. Form and function are our primary concerns, therefore, our surgical treatments merge the best surgical correction with the best cosmetic result.

 

Some of the head & neck conditions we commonly treat are:

 

  • Facial Fractures

  • Nasal Fractures

  • Head, Face, and Neck Lacerations

  • Facial Pain and Headache

  • Temporomandibular Dysfunction or TMD

Baha Implant - One Sided Deafness

A bone anchored hearing aid (Baha) is an implantable device used to improve hearing in patients with certain types of hearing loss by stimulating the inner ear through the bone. Approved by the FDA since 1996, this type of hearing aid has been used successfully across the world for over 30 years, providing effective relief for patients of all ages.

Bahas can be used to improve hearing for patients with conductive or mixed hearing impairment. This type of device is ideal for patients who are not candidates for regular hearing aids due to an ear deformity, chronic ear drainage, narrow ear canals, or allergic reaction to the plastic in hearing aid molds. Made up of three different parts, including a titanium screw, a button-like extension (abutment) and the actual hearing aid or sound processor, a Baha is surgically implanted behind the ear through a minimally invasive procedure.

This procedure takes less than an hour to perform on an outpatient basis, using local or conscious sedation anesthesia for adults and general anesthesia for children. Patients can return home the same day as their procedure. During the initial procedure, the titanium screw and abutment are placed into the skull behind the ear, while the sound processor is connected to the abutment three months later allowing immediate use of the implant. The three month waiting period ensures that the titanium becomes integrated into the bone for long-lasting use of the implant.

Our doctors will determine whether or not a Baha is right for you after a thorough evaluation of your individual conditions and after reviewing your recent professional audiogram (hearing test).

Cancers of the Head & Neck

Head and neck cancers encompass several different diseases that can affect the mouth, nose, throat and other surrounding areas. Over 50,000 Americans are diagnosed with head and neck cancer each year, as these diseases account for 3 to 5 percent of all cancers. Many cases of head and neck cancer can be prevented through life changes.

 

Several different types of cancer can affect the areas of the head and neck. Most begin in the lining of moist, mucosal surfaces such as the mouth, nose and throat. The cells in the lining are known as squamous cells, and may therefore be affected by squamous cell carcinomas.

 

The different types of cancer associated with the head and neck include:

 

  • Oral cavity

  • Salivary glands

  • Nasal cavity

  • Pharynx (including nasopharynx, oropharynx and hypopharynx)

  • Larynx

  • Lymph nodes

 

Head and neck cancers are most often caused by tobacco and alcohol use, especially cancer of the oral cavity and larynx. Other factors that may lead to cancer in these and other sites include sun exposure, HPV, and radiation exposure. Tobacco use is linked to 85 percent of head and neck cancers.

Fortunately, many people with head and neck cancers experience symptoms right away that lead to an early diagnosis of the condition.

 

Symptoms of head and neck cancers vary depending on the type of cancer, but may include:

 

  • Lump in the neck

  • Hoarseness or other change in the voice

  • Growth in the mouth

  • Blood in saliva

  • Difficulty swallowing

  • Earache

  • New or changed growths on skin

 

If you are experiencing any of these symptoms, your doctor may perform an in-office endoscopy, recommend imaging tests such as ultrasound or CT scan, recommend an open or needle biopsy, along with a complete physical examination. Treatment for these cancers depends on the type and location of the tumor, as well as the patient's age and overall health. Treatment often includes surgery to remove the cancer, chemotherapy and/or radiation therapy.

 

It is important to discuss treatment options with your doctors, as certain methods may have long-term effects on the way you look, talk, eat or breathe. Making healthy life changes, including avoiding smoking and alcohol use, will help prevent the disease from recurring, as well as reduce the risk for other diseases.

Sleep Disorders & Snoring

Sleep disorders are common conditions that involve difficulties falling asleep, staying asleep, or waking up. Sleep disorders may develop as a result of changes in the brain regions and neurotransmitters, stress, anxiety, depression, poor sleep habits or many other possible causes. By not getting sufficient sleep at night, many people are affected during the day and may have difficulty completing their everyday activities.

 

Some of the most common sleep disorders include:

Insomnia - Not getting enough sleep at night as a result of trouble falling asleep or waking up frequently.

Snoring and Sleep Apnea - These conditions involve breathing irregularities while sleeping, which can result in loud noises, blocked airways and interrupting sleep. If left untreated, sleep apnea may lead to high blood pressure and an increased risk of stroke and heart attack.

Narcolepsy - Narcolepsy is a brain disorder that causes excessive daytime sleepiness and may be prone to suddenly falling asleep for several seconds up to more than 30 minutes.

Restless Legs Syndrome (RLS) - This condition causes tingling sensations in the feet and legs, prompting people to move them and seek relief. This movement can disrupt sleep and may lead to constant leg movement while awake.

You can take certain actions to help get a good night's sleep, such as setting a routine, exercising regularly, avoiding caffeine, nicotine and alcohol, avoiding lying in bed while awake and relaxing before bedtime.

Throat Conditions

Though we often take our ability to swallow and speak for granted, many people have difficulty with these simple tasks and may experience pain, discomfort and lack of control when trying to speak.

 

Our doctors provide comprehensive diagnostic and treatment services for a wide range of voice and swallowing disorders and are specially trained to help you restore function in your voice. We also treat many other throat related conditions.

Some of the throat conditions we commonly treat are:

  • Throat Reflux or Laryngopharyngeal Reflux Disease (LPRD)

  • Hoarseness

  • Laryngitis

  • Sore Throat

  • Swallowing Disorders

  • Recurrent Tonsillitis

  • Chronic Tonsillitis, including Tonsil Stones

Board Certified by the American Board of Otolaryngology 

Brennan Dodson, MD

Bridger ENT

1648 Ellis St, Suite 301

Bozeman, MT 59715

Tel: 406-556-9798

Fax: 406-556-9795

info@BridgerENT.com