Winner By A Nose

Minimally invasive outpatient procedure opens blocked sinuses.

As a farm boy growing up in Massachusetts, Henry Molinari loved horses so much that he would skip school and steal away to a nearby racetrack, where he received an education in how to care for and train thoroughbreds.

Photo by Nerissa Johnson.

Henry Molinari

“I started out mucking stalls,” Henry reveals with a chuckle. “But I loved every minute of it and worked my way up to where I trained thoroughbreds for many years until I changed over and started training standardbred horses.”

“Standardbreds are the kind that race with the rider in a sulky behind them. I not only trained those kinds of horses; I also drove them. But I wound up having a few wrecks that ended the driving part for me, so after that I just trained them.”

Henry, 80, brought his training talents to Florida several years ago, and his passion for thoroughbreds and standardbreds remains so great that he sometimes has to fight off the urge to become part owner of one.

About five years ago, Henry found himself fighting an impulse to stay in bed and sleep all day.

“It was very strange because all of a sudden I started feeling very sluggish and tired,” Henry explains. “And that’s odd for me, because I’ve been a very active person all my life. Even now, I still go out bike riding every day, sometimes twice a day.”

“The good news is that it really didn’t affect my breathing all that much, but I was fighting this urge to just lay in bed all day. At the same time, I was starting to get a lot of sinus headaches, and they were lasting a long time. It really wiped me out.”

Henry struggled with sinus issues for several weeks. When he finally sought medical attention, his doctor started with an allergy test. That test came back negative, meaning Henry’s problem was not caused by allergies.

Henry’s doctor then suggested he visit a specialist. Based on the recommendation of a close friend, Henry visited Devang M. Shah, MD, of Atlantic Ear, Nose & Throat.

“When Henry first came to us, his biggest complaint was that he was suffering from a lot of nasal congestion and sinus pressure,” Dr. Shah reports. “Based on those complaints, I ordered a CT scan of his sinuses.”

The CT scan showed that Henry was suffering from a major blockage in his sinuses. To treat such blockages, physicians have two choices. One is traditional sinus surgery. The other is a minimally invasive procedure called a balloon sinus dilation.

“With the traditional approach, we take the patient to the operating room, put them to sleep under general anesthesia and treat them with a device that’s sort of like a Roto-Rooter that removes tissue and opens up the sinuses,” Dr. Shah explains. “It’s a very aggressive approach and, as you might expect, there’s a long recovery period that usually includes taking a few days off from normal activities because a significant amount of pain medication is often required afterward.

“There are times when it’s absolutely necessary to do that surgery. But some sinus problems are amenable to simply opening the sinuses. That’s what the balloon sinus dilation does, and that’s why I recommended it for Henry.”

The balloon sinus dilation carries far less risk than traditional surgery, because it is performed using a local anesthetic that allows the patient to remain awake throughout the procedure.

“We start by giving the patient a Valium and some pain medication to relax them a bit,’’ Dr. Shah educates. “Then we administer the local anesthetic. Once that has taken effect, we find the opening of the sinuses and gently insert the deflated balloon.

“There’s a bone that surrounds the opening of the sinus, and once the balloon is in the right spot, we slowly inflate it with water. As the balloon is inflated, it gently shifts that bone over and enlarges the opening. Once that’s done, we remove the balloon. Shifting that bone is what keeps the sinus open, because you’re actually changing the shape of the opening. It’s not as though you’re moving soft tissue that is going to flop back, so the procedure works very well.”

“Another one of the great things about this procedure is that there’s hardly any bleeding involved, and there’s no bruising or packing of the nose afterward. Patients usually go back to their normal activities the next day.”

That’s how it was for Henry. He says that after two days he felt “like a new man,” and he has felt that way ever since the procedure was completed. His energy level is back to normal, and he’s breathing easier than he has in years.

“The balloon treatment that Dr. Shah did has helped me tremendously,” Henry raves. “I really could not be happier with the outcome. Dr. Shah is like a magic man the way he took care of me.
He did a heck of a job.

“And I want to add that I could not have been treated any better than I was by everybody at Atlantic Ear, Nose & Throat. It’s a very classy outfit, the people are great and I highly recommend them to anyone.”

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    • Atlantic Ear, Nose and Throat, P.A.

      Atlantic Ear, Nose & Throat is a comprehensive, full-service otolaryngology practice with offices in both Seminole and Volusia counties. In the practice, Devang Shah, MD, and Daniel Rothbaum, MD, combine surgical excellence with a compassion... Read More

    • Devang Shah, MD

      Devang M. Shah, MD, is board certified in otolaryngology. After receiving his medical degree with honors from Robert Wood Johnson Medical School, New Brunswick, NJ, he completed his surgical internship and residency at Johns Hopkins Hosp... Read More

    • Daniel Rothbaum, MD

      Daniel Rothbaum, MD, is board certified in otolaryngology. After receiving his undergraduate degree from Harvard University and his medical degree from the Yale School of Medicine, he completed his general surgical internship and residency at J... Read More