Gary Rampino's sinus problems have caused him a decade of pain, loss of smell, and aches in his teeth and ears.
"Last night, I had a terrible earache. I woke up and I feel that earache and I feel all this pressure," Gary says as he points to the pain in face.
The symptoms have forced Gary into an endless cycle of nasal sprays, decongestants, steroids and infection-fighting pills.
"You get the sinus infection, you take antibiotics, and it starts all over again," he says.
Now the problem is getting worse -- bad enough to convince him to have sinus surgery.
Otolaryngologist Dr. Randall Latorre reviewed Gary's CAT scan before the surgery, and pointed out that the lining is swollen, making it hard for fluid to drain.
To fix the problem, Dr. Latorre will make the openings to Gary's sinuses bigger. It's a procedure he will perform in his office -- a procedure that has only recently become offered on an outpatient basis.
Three years ago, all his patients went to an operating room. That changed 18 months ago when he decided to perform the procedure in his office. Patients get pills and local anesthetic, like the Novocain administered in a dentist's office instead of general anesthesia.
Skipping anesthesia allows him to treat patients of all ages, including some people in their 90s.
Before the procedure begins, Dr. LaTorre checks to see if Gary's nose is numb.
"If it's too muc, tell me -- we can reposition things to make you feel comfortable," he says as he moves pieces of cotton soaked in anesthetic.
Instead of sutures or scalpels, an inflatable balloon gently breaks the bones in the face, enlarging the passages that lead to the sinuses, which are kind of like caves.
"The bone is really eggshell thin, so when you fracture that bone with the balloon system, it puts it into a permanent solution while preserving the lining."
Doctor Latorre tracks from one sinus to another using a tiny camera and a bright light you can actually see shining through Gary's face.
"I'm literally inside his sinus. There's his frontal sinus right there. That without a doubt tells me I'm in his sinus that I've just dilated."
Without a doubt, because Gary's sinus lights up red. If you compare just how much light before and after the procedure you can see a definite difference. Dr. Latorre is able to advance the light farther after enlarging the opening to the sinus allowing us to see even more.
It's the same kind of difference that's changing how Kara Madden breathes.
"I was a little bit skeptical about it, I wasn't sure about how I was going to do. Within three days I was doing great, I could smell and breathe out of my nose," she says.
There are some risks, including bleeding and infection. Since the balloon is so strong, it can also perforate the sinuses. That can be a serious problem since the brain is so close to one of the sinuses. If you choose to have this procedure in a doctor's office, make sure the doctor is board certified and has experience both in and out of the operating room.
When it comes to cost, most insurance companies cover the procedure. Dr. LaTorre said since moving to the office, patients sometimes only need to satisfy the co-pay, which can be as low as $20. Most patients go back to work and return to normal activities in two to three days.
Dr. Randall LaTorre
Sinus Surgery Options