Advanced relief for ear pain

Del Rey Sinus & Allergy Institute applies balloon dilation technology to solve eustachian tube conditions

Have you noticed how your ears feel pain, pressure and “pop” when you are in an airplane that’s climbing or descending? Have you felt ear pressure when diving in the pool or ocean? That’s because there is a difference in pressure between the outer ear and the middle ear (and inner ear). A passageway called the eustachian tube connects the middle ear to the back of your nose and throat and equalizes the pressure in your ear.

If you feel pressure in your head under these conditions, it can usually be helped if you swallow or yawn. This opens the eustachian tube and allows air to flow into or out of your middle ear, equalizing the pressure.

Most of the time, the pressure will equalize on its own or with the maneuvers mentioned above. Sometimes though, if you have allergies, a cold or sinus infection, the eustachian tube can become blocked and doesn’t work correctly. In that case, you may have muffled hearing or hear clicking in your ears. When the fluid in the middle ear can’t drain naturally to the back of your throat, it can become infected by bacteria or a virus. The trapped fluid in the middle ear is why most ear infections happen there.

In addition to allergy, cold or sinus infection, the eustachian tubes may not work due to:

  • Smoking
  • Upper respiratory infections
  • Nasal polyps
  • Aggressive ear cleaning

If the middle ear becomes infected, you could have ear pain, difficulty sleeping, muffled hearing, fever, headache or loss of balance. Ear infections are very common among children, because the eustachian tubes in children are shorter and less effective at drainage than adult tubes.

If you have chronic eustachian tube blockage or malfunction, you may be helped by dilation of the eustachian tube. The Food and Drug Administration just recently (September, 2016) approved the use of balloon dilation of the eustachian tubes, and Del Rey ENT Associates is a leading practitioner of this advanced technique. It involves no cutting, no bleeding or packing and can be done in our office in just a few minutes.


Dr. Farhad Sigari Named as Super Doctor 2017

We here at Del Rey Sinus & Allergy Institute are thrilled and proud that founder Farhad Sigari, M.D., FACS has been selected as a Super Doctor for 2017!

What does it mean to be selected as a Super Doctor? It’s not a simple process. As the organization states themselves, the selection process for Super Doctors is rigorous. It goes through several steps to identify doctors who have a high degree of peer recognition and professional achievement. Super Doctors is a selective listing of outstanding doctors, representing consumer-oriented medical specialties. In the case of Dr. Sigari, it’s as an ENT doctor, or officially, otolaryngologist.

They go through a multi-step evaluation. Here’s how they describe it:

  1. Survey of doctors

    First, we create a pool of candidates. Each year Super Doctors invites physicians to nominate colleagues they know to be exceptional in their specified field. Physicians are asked to consider the following question: “If you needed medical care in one of the following specialties, which doctor would you choose?” Numerous safeguards are in place to prevent ballot manipulation and doctors may not self-nominate.
  2. Candidate Search
    Our research staff also contributes to the pool of candidates by searching medical databases, online sources, and publications for doctors who have attained certain credentials, honors or professional achievements – what we term ‘Star Search Credentials.’ This process also includes physicians in less visible or highly specialized medical treatment areas.
  3. Research
    We evaluate candidates on 10 indicators of peer recognition and professional achievement.

    • Years of experience
    • Hospital appointments
    • Fellowships
    • Professional activities
    • Leadership positions
    • Academic achievements/positions
    • Board certifications
    • Publications, lectures & presentations
    • Honors and awards
    • Other outstanding achievement
  4. Blue Ribbon Panel Review
    Nominees are then grouped into specialties. Doctors, in each area, who have the highest scores from the nomination and evaluation steps are invited to serve on a “blue ribbon panel.” Each panelist is asked to review and evaluate a list of nominees from his/her area of focus.
  5. The Final Selection
    The last step is to total the points received from nominations, research, and blue ribbon panel review. Only the highest-scoring doctors are included on the Super Doctors list. The Super Doctors list is approximately 5% of the physicians within the respective state or region.

Of course, this is just one recognition of many that Dr. Sigari and the Del Rey Sinus & Allergy Institute have received. What’s most important to us is the experience of our patients. Check out the Yelp! reviews, where Dr. Sigari has more than 95 five-star reviews and counting!


Fast, Accurate Diagnosis

Obtaining a Fast, Accurate Diagnosis of Your Sinus Condition is Important

Del Rey Sinus & Allergy Institute is proud to be able to give you a fast, accurate diagnosis of your sinus condition and to be one of the very few ENT doctor’s offices in Los Angeles to feature an in-house CT scanner. As you may know CT (computed tomography) is among the safest and most advanced technologies for imaging your body.

Our medical suite features a Xoran MiniCAT IQ, which is a very compact CT system designed for specifically for high-resolution imaging of the sinuses, temporal bones and skull base. This advanced system gives us immediate feedback on your condition, enabling fast and accurate diagnosis so we can make the best recommendation for treatment.

What does this mean for you as a patient? Above all else, having this level of equipment in our office is a huge convenience for you. You can come in for a single visit and have an examination and recommendation for treatment, all at the same time. This means you have less time off work or out of your life and you don’t have to drive to any other facilities to find out what is causing your sinus issues and what you can do about it.

Additionally, the MiniCAT we use has an open design that puts you at ease. It’s just like sitting for an eye exam. The scan can be completed in less than 30 seconds! It’s also extremely safe. The scanner emits extremely low radiation, and we are fully shielded and compliant with State of California requirements for imaging equipment.

Most importantly, our in-office scanner provides high-resolution images of extremely high quality. Dr. Sigari can make use of the accurate images immediately to create a precise diagnosis of your condition and recommend the most appropriate treatment. Other doctors who don’t have in-house CT scanning capability may either have you drive elsewhere in town to obtain images, or put you on various medications to try to solve your sinus issues empirically.

Don’t play trial-and-error with your sinus condition. Get an accurate diagnosis in a single visit at Del Rey Sinus & Allergy Institute.

Our in-office CT scanner is part of our overall mission to provide you with the most advanced and most efficient solution for your sinus and allergy issues. With the ability to create detailed sinus images in-house plus our in-house surgical suite, we can provide you relief from your sinus issues in as little as a single visit.


Do you have a bacterial or a viral infection?

Do you have a bacterial or a viral infection?

One of the issues that confuses our patients the most is whether their condition is triggered by a viral infection or bacteria.

One of the most important things to note is that if you have a cold or flu, antibiotics won’t work.

This helpful chart from the Centers of Disease Control and Prevention (CDC) outlines the conditions that are viral and those that are bacterial:

Many of our patients want to take antibiotics as the “ultimate solution” for their conditions and when used properly, antibiotics can be helpful. But when you use antibiotics when they are not called for, or overuse antibiotics, it can contribute to antibiotic resistance. This occurs when the antibiotic kills most harmful bacteria, but leaves some behind. These survivors become more resistant to treatment by antibiotics and can make you more susceptible to an infection later.

The full story, and explanation of the proper use of antibiotics, is at the CDC site. You should only take antibiotics when instructed by your doctor for your immediate condition. Never keep antibiotics to use at a later date. To really know your sinus or throat conditions and the best treatment, please contact our office.


Spirox Latera Solution

Spirox Latera Solution for Nasal Airway Obstruction

Breathing through your nose accounts for about 70% of the air that reaches your lungs. Millions of Americans suffer from nasal airway obstruction (NAO), which impacts everyday life and basic activities such as normal breathing and sleeping. These nasal airway obstructions can result from many factors including septal deviation and enlarged turbinates.

One of the less-diagnosed causes of nasal obstruction is weakening of the upper and/or lower nasal lateral wall cartilage, leading to nasal valve collapse. Even a minor blockage of this important area can cause significant difficulty breathing and affect your quality of life. Nasal valve collapse has been historically difficult to treat because earlier techniques were invasive and could result in cosmetic change of the patient.
An expert physician like Farhad Sigari, M.D. has the tools and the training to accurately determine the type of nasal airway obstruction that you have. In the case of nasal valve collapse, Dr. Sigari is one of the first physicians in the United States to offer a new, advanced treatment: the Spirox Latera nasal implant.

The Spirox Latera implant is made from an absorbable material that dissolves naturally. The implant can be placed in just a few minutes and offers immediate relief from breathing obstruction due to nasal valve collapse.

Check out these key advantages of the Spirox Latera implant:

  • U.S. FDA approved
  • Immediate relief
  • Proven safe and effective in trials and clinical use
  • Minimal complications
  • No cosmetic changes
  • Minimal pain on implantation (local anaesthesia can be used), no pain after implant.
  • Fast procedure – implant can be placed in a few minutes
  • No down time after procedure; resume your normal activity right away

There has been a lot of positive press about this advanced technique. Now it’s available close to home, at the Del Rey Sinus & Allergy Institute. Here is some of the recent coverage of this innovative technology:

LATERA Absorbable Implant Supports Cartilages To Treat Nasal Obstructions, Spirox Reveals – BioSpace.com

Spirox wins FDA nod for Latera nasal implant – MassDevice

Spirox’s Latera nasal implant racks up positive results – FierceBiotech

Dr. Sigari is proud to be one of the first physicians in the United States to offer relief with the innovative Latera implant. Get in touch with us today to learn whether this advanced device is right for you.


Post-nasal Drip

Did you know? The glands of your nose and throat produce up to two quarts of mucus a day. Yikes. Mucus can be yucky (not a technical medical term) but it actually performs important work such as humidifying and purifying air before it reaches your lungs and breathing passageways. It also plays an important role in clearing away foreign invaders like bacteria and viruses before they can get into your body and cause an infection.
Normally, you’re not aware of this process because the mucus mixes with saliva and drips harmlessly down the back of your throat, and is swallowed slowly throughout the day.
When your body produces more mucus than usual, you may experience a runny nose with excess mucus coming out of the front of your nose. When the mucus instead runs down the back of your nose and into your throat to the point where you can feel it, it’s called post-nasal drip.

What causes post-nasal drip?
The excess mucus production that triggers post-nasal drip may be caused by a number of conditions including

  • Cold
  • Flu
  • Allergies
  • Sinus infection or sinusitis (inflammation of the sinuses)
  • Hormonal changes, such as pregnancy
  • Certain medications (including birth control pills and high blood pressure medications)
  • A deviated septum (misalignment of the wall that separates the two nostrils) or another anatomical problem that interferes with the normal production and easy flow of mucus
  • Changing weather fronts, cold temperatures, or excessive dryness in the air
  • Certain foods, including ones that are spicy
  • Environmental irritants, including chemicals, perfumes, cleaning products, and smoke

What are the symptoms of post-nasal drip?
Post-nasal drip can create several annoying symptoms, including:

  • A tickling feeling that makes you want to constantly clear your throat
  • Hoarseness
  • Sore throat
  • Coughing, which often gets worse at night. Post-nasal drip is the most common cause of chronic cough.
  • Ear infection if mucus plugs up your Eustachian tube, which connects the throat and the middle ear
  • Sinus infection if your sinus passages become plugged by mucus

What are the treatments for post-nasal drip?

Our first step in treating post-nasal drip is to accurately diagnose the cause of the problem. Self-diagnosis can be difficult for patients, because symptoms can have multiple causes. For example, if your mucus secretions are thick and yellow or greenish, that could be an indication that you have a bacterial infection. However, colds can also cause yellow or green mucus, and they’re caused by viruses, which won’t be helped by antibiotics.
Whatever your condition, if you are finding that your post-nasal drip is becoming a problem that interferes with your comfort, we can help. Dr. Farhad Sigari is a trained expert in the full range of ear, nose and throat conditions and we have seen dozens if not hundreds of cases just like yours. Del Rey Sinus & Allergy Institute can recommend an informed course of treatment.

Antihistamines – which reduce or block chemicals called histamines and thus reduce allergy symptoms – can help with post-nasal drip that’s caused by sinusitis and viral infections. Decongestants – which relieve swelling in your nasal passages – may also be helpful. For post-nasal drip caused by allergies, antihistamines and decongestants may be used along with steroid medications that can reduce stuffiness and swelling and nasal sprays that help keep your nasal passages clear.

Another treatment for post-nasal drip is to thin your mucus. Mucus can have different consistencies, and if it’s thick, it can be stickier and harder to drain, causing you more discomfort. Keeping the mucus thin can help prevent blockages in the ears and sinuses, which can lead to infection.

You can do this by drinking more water and using a humidifier or vaporizer or by taking a hot shower.

To learn more about your condition, explore our site or make an appointment now.


Sleep Apnea

One of the common complaints that brings people to the Del Rey Sinus & Allergy Institute is sleep apnea. Apnea is a serious sleep disorder which involves a sudden stoppage of breathing during sleep. In some patients, this stoppage can occur dozens of times each night.

Like allergies, sleep apnea is a very common and commonly misdiagnosed (and misunderstood) medical condition. Our office treats all forms of sinus disorders, so we can accurately diagnose your condition and recommend a suitable treatment. Anyone with sleep apnea should seek an evaluation for nasal obstruction.

What is sleep apnea?

Simply put, sleep apnea is the stoppage of breathing while you sleep. Besides being bothersome, serious sleep apnea can prevent you from having sound sleep; starve your body of vital oxygen; and even cause irregular heartbeat.

There are two types of apnea. Obstructive sleep apnea is caused by a physical blockage of the upper airway. When your airway is blocked, your diaphragm and chest muscles have to work extra-hard to restart breathing, and when this happens there can be a loud gasp or physical spasm.

Central sleep apnea is a condition of the brain where signals to the muscles used to breathe are blocked or impaired, so the body’s breathing system is not being properly controlled.

Who has sleep apnea?

Sleep apnea can affect almost anyone. It occurs in about 25% of all men and about 10% of all women, and also affects babies, children and particularly those who are over 50 years old. Obesity, having a large neck or structural abnormalities in the head or breathing pathways can all contribute to obstructive sleep apnea. This information is based on our own experience. For a general overview, check out the excellent article on WebMD.

Signs and symptoms of sleep apnea
Sleep apnea can go undetected by the patient for years, and is often reported by the patient’s sleep partner or roommate. The most common signs and symptoms include:

  • Snoring
  • Chronic fatigue
  • Restlessness during sleep, frequent nighttime awakenings
  • Sudden waking from sleep, with gasping or choking
  • Dry mouth or sore throat upon awakening
  • Trouble thinking or concentrating
  • Depression, anxiety
  • Night sweats
  • Sexual dysfunction
  • Headaches

Symptoms in children may not be as obvious and include:

  • Poor school performance
  • Low energy
  • Daytime mouth breathing and swallowing difficulty
  • Excessive sweating at night
  • Learning and behavioral disorders (hyperactivity, attention deficits)
  • Bedwetting

Effects of sleep apnea

Sleep apnea can pose a serious threat to your overall health. It can result in numerous problems including hypertension, stroke, arrhythmias, enlargement of the heart, heart failure, and heart attack. By disturbing your sleep, apnea can also result in fatigue-related consequences such as reduced mental function, inability to operate a car or machinery and academic underachievement in children and adolescents.

Diagnosis of sleep apnea

With our in-house CT scanning capabilities, we can evaluate the structure of your sinuses in a matter of seconds! This will help determine whether you have nasal obstructions which could contribute to your condition. We also have the ability to evaluate your throat and lower airway with resolution laryngoscopy to further determine screen for any other anatomical obstruction.

We may also recommend an overnight sleep study to test body functions during a typical night’s sleep. This can tell us whether you have a sleep apnea, and what type you have.

Treatments for sleep apnea

For mild obstructive sleep apnea, conservative therapy may be all that is needed. Losing weight may help in the case of overweight patients with obstructive sleep apnea. We also advise patients with obstructive sleep apnea to avoid the use of alcohol and certain sleeping pills, which can relax the airway and make it more prone to collapse.

In some cases, sleep apnea only occurs when you sleep on your back, so using pillows and other devices that help you sleep on your side can be helpful.

Surgical procedures may also help with obstructive sleep apnea where indicated. We generally will perform surgery for those patients who have excessive or malformed tissue obstructing airflow through the nose or throat, such as a deviated nasal septum, enlarged tonsils or other conditions which may constrict airways. These procedures are typically performed after sleep apnea has failed to respond to conservative measures.

If you suspect you or your friend or loved one has sleep apnea, make an appointment by filling out the form at the bottom of the page. We can help you #BreatheBetter today, no matter what condition you are experiencing.


Should You Use Nasal Decongestants?

Although we recommend that you employ some self-medication and home remedies for sinus trouble, some remedies are safer and more effective than others.

Nasal decongestants including Afrin, Neo-Synephrine and others can be used to treat nasal congestion, sinus infection and allergies. In general, these sprays are safe and can offer relief when used as directed. Many of these sprays include a limitation warning – such as not to use more than twice in 24 hours, or more than 3 days in a row. Why do they include such warnings?

The answer lies in how these drugs work. The active ingredients in most nasal sprays – such as oxymetazoline hydrochloride, phenylephrine hydrochloride or xylometazoline – work by closing blood vessels in your nose. The constriction of blood flow helps to minimize the effects of congestion and lasts about 12 hours.

If you use nasal decongestants for an extended period of time, however, the continued suppression of blood flow can damage nasal tissues and lead to worse congestion.

This ongoing interference with the body’s natural function can have many negative consequences, including edema (swelling) and lasting damage. Your body may increase the production of mucous in order to increase the blood flow that’s restricted by the medicine, which actually worsens the condition you’re trying to help!

Steroid and other types of nasal decongestants (including Flonase, Nasocourt, or Rhinocort) are the ones which we prefer and recommend, because they do not have these negative potential effects. Del Rey Sinus & Allergy Institute is here for you to help you make the right decisions for the health of your sinuses. Whether it’s allergy, cold or flu season, we can help you to Breathe Better, Today!


Recovery From Our In-office Balloon Sinus Dilation Procedures

We often say that balloon sinus procedures (also called sinuplasty) has a “fast recovery,” but we would like to provide you with more specific information about the recovery from sinus surgery.

Balloon sinus dilation is performed in many cases in less than one hour. Patients often elect to take a mild sedative pill before the procedure but can also elect to have the procedure without any medication before hand. As soon as 10 or 15 minutes after surgery and resume your normal level of activity. We do recommend that you rest and recover in a quiet environment that same day. You will generally be able to go back to work or your everyday life the very next day.

The chart below depicts typical recovery time and events that most (but not all) patients can expect (source: Entellus):

There is a chance that you will have some minor pain related to the surgery. In general, patients who have a balloon sinus surgery will not need prescription pain medication, and if so, for only a day or less. This is much less that what is usually required for endoscopic sinus surgery.

When you schedule your surgery at Del Rey Sinus & Allergy Institute, we will provide you with comprehensive pre- and post-surgery instructions. On the day of your procedure, you may have some anxiety, so we may give you an oral sedative or anesthesia, but many patients do not need either.
After the procedure, you may experience light bleeding. There is almost never any nasal packing required. The common risks of our in-office nasal procedure include minor pain, nosebleeds, fainting, and fast heartbeat in the case of local anesthesia. This minimally invasive surgery involves the modification of delicate bones that separate the nose and sinuses from the brain and the eye, which is a very sensitive area. The significant experience of Dr. Farhad Sigari and the Del Rey Sinus & Allergy Institute team helps avoid any complications of surgery.

Thanks to our local our revolutionary local anesthetic protocol we can often perform even the more advanced sinus procedure all in the comfort of our office without the need of general anesthesia.

One of the most helpful factors in fast recovery is our use of the Propel sinus stent.

The stent holds nasal passages open while delivering medication to reduce inflammation and promote healing. The stent dissolves by itself after about 45 days.

And for the most advanced and revision cases we can implement Image Guided Computer Aided procedures. Del Rey Sinus and Allergy Institute is one of the first and few centers in the country that has Fiagon Image guided system available for in office use!

Once the procedure has been completed, our patients experience long-term relief from their sinus symptoms. You should not need to have another procedure for many years, if ever.


Home Remedies for Sinus Health

Your sinus health is important to us. Even though Del Rey Sinus & Allergy Institute specializes in the medical treatment of sinus symptoms, we would really like for you to breathe freely all the time, without needing our help!

Here are some simple steps you can take yourself to ensure healthy sinuses, nasal passages and free breathing:

  1. Rest. It’s a very simple remedy but sleep is a great healer. When you sleep, your body produces more human growth hormone (HGH), which can help you fight infections and recover faster.
  2. Hydrate. The more you drink, the more your mucous can dilute and drain. Drinks with caffeine or alcohol have a dehydrating effect, which can make your symptoms worse.
  3. Keep sinus cavities moist. If you inhale while taking a hot shower, or cover your head with a towel as you breathe over a bowl of hot water, you can ease sinus pain and help your sinuses drain better.
  4. Rinse your nasal passages. Commercially available squeeze bottles or a neti pot can help keep your sinuses flushed and clear. It may take some practice to get proficient at irrigating the sinus cavity. Make sure to use water that is free of contaminants: distilled, boiled and/or filtered.
  5. Warm compresses. Placing warm and damp (but not wet) towels around the affected areas of your nose, eyes, and cheeks can help relieve pain.
  6. Elevate your head when you sleep. Keeping your sinuses drained is key to comfort, and this will help with drainage.
  7. Stay well. Easier said than done, but you want to avoid getting a cold. Avoid people who have colds and wash your hands with soap and warm water often.
  8. Avoid cigarette smoke and pollution. Any type of tobacco smoke (including that from e-cigs and vape pens) can irritate your nasal and sinus passages.
  9. Use a humidifier. Especially in the fall and winter months, when the air is particularly dry, a humidifier can help you keep your nasal and sinus passages moist while you sleep or go about your daily life.
  10. Consider over the counter medication such as antihistamines (claritin, zyrtec, allerga) and/or nasal steroids (Flonase, Nasocourt, or Rhinocort).

For overall ear, nose, throat and sinus health, we are here to help! Check back here and at http://www.delreymd.com for more info.