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Babak Larian, M.D.
9401 Wilshire Blvd #650
Beverly Hills, CA 90212
Phone: (310) 776-6913
Fax: (310) 461-0310

 


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Allergies & Sinuses

Allergy & Sinus Surgery — Beverly Hills, Los Angeles, and Throughout Southern California

Allergy and sinus problems are burdensome and uncomfortable; they are a persistent occurrence for many people, and can be extremely painful and at times life-threatening. As a board-certified head and neck surgeon and a highly regarded provider of allergy treatment and sinus surgery for those in Beverly Hills, Greater Los Angeles, and all Southern California, Dr. Babak Larian has the experience necessary to help individuals reduce or eliminate pain and discomfort associated with allergies or other sinus conditions, and control their disease. He achieves success by having a close relationship with his patients in treating this often difficult problem.

Identification of Sinusitis
Diagnosing Sinusitis through In-office CT Scanning
Sinusitis Treatment
Targeted Endoscopic Sinus Surgery™ (TESS)
Image-Guided Sinus Surgery
Balloon Sinuplasty™
Identification of Nasal Allergies
Diagnosing Allergic Rhinitis through Blood / Skin Testing
Allergy Treatment
Allergy Shots

Identification of Sinusitis

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Our sinuses consist of small chambers in the face and skull bones next to the nasal cavity that have narrow openings into the nasal cavity that allows drainage of mucous out of the sinuses. Since healthy sinuses assist in clearing excess mucus, a sinus blockage from a viral upper respiratory infection or nasal allergies can lead to fluid accumulation, increasing the probability of a bacterial infection. If this infection lasts for less than four weeks, it is called acute sinusitis. An inflammation that persists for three months or longer is called chronic sinusitis. Sinusitis is characterized by discolored nasal discharge, congestion, decrease in the ability to smell and taste, and decrease in the ability to breathe through the nose. Chronic sinusitis can be very painful and cause infections that track into the eye and even the brain if not treated. Dr. Larian provides a variety of treatment options for both acute and chronic sinusitis, from medical therapy to revolutionary treatment including Balloon Sinuplasty™, image-guided sinus surgery, and Targeted Endoscopic Sinus Surgery. With his international reputation and leadership role in the field, Dr. Larian is also visited by patients from across the country and the world.

Diagnosis will require a complete history and a thorough exam. Nasal examination may include nasal endoscopy, which shows the internal nasal and sinus anatomy with a magnifying "telescope".

Fig. 1 - Sinus Anatomy Fig. 2 - Sinus Anatomy (Sinus CT Scan)

 

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Diagnosing Sinusitis through in-office CT Scanning

Sinusitis can be difficult to diagnose, since many of its symptoms are the same as those experienced with the common cold. In addition to a thorough exam and nasal endoscopy a CT scan may be necessary to help with diagnosis. The in-office CT scanner makes this very easy; it can be completed in 15 minutes, thus helping guide us as to the appropriate treatment plan instantly.

Sinusitis Treatment

Acute sinusitis can be treated in a variety of ways. All are aimed at opening the sinuses and allowing the infected material to drain out. Over-the-counter medications such as decongestants are helpful, but at time not enough at which point they may need to be combined with antibiotics. Chronic Sinusitis is more complex; treatment is geared towards controlling the underlying cause, which is usually chronic inflammation due to allergies. As such, addressing the allergies with avoidance therapy, various nasal sprays, oral medications and allergy shots are the primary modes of therapy. Surgery is the last choice, and is only done when all other treatments are exhausted.

Fig. 3 - Left Maxillary and Ethmoid Sinusitis

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Targeted Endoscopic Sinus Surgery™ (TESS)

As our understanding of the sinuses has improved, we have come to understand that sinuses have an intricate design and an amazing ability to regulate and drain themselves. Any surgical treatment should take this important fact into account and aim to improve this function. The Targeted Endoscopic Sinus Surgery™ (TESS) technique has been developed by Dr. Larian as a minimally invasive method of treating the problematic areas of the sinuses where there is blockage, with minimal effects on the surrounding tissue, while capitalizing on the inherent ability of the sinuses to drain themselves. During the procedure, a thin, flexible instrument known as an endoscope is inserted into the nose.

Fig. 4 - Endoscopic View of Nasal Cavity Fig. 5 - Endoscopic View

 

A wide variety of problems can be treated by this method, including chronic sinusitis, fungal sinusitis, nasal polyps, etc.

Fig. 6A - Non-infected Sinuses Fig. 6B - Infected Left Maxillary
and Ethmoid Sinuses
Fig. 6C- Targeted Endoscopic
Sinus Surgery

 

 
ESS pamphlet  

 

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Image-Guided Sinus Surgery

TESS combined with image-guided sinus surgery is another revolutionary treatment option for those with chronic sinusitis or who have polyps or frontal sinus disease. This advanced procedure works like a GPS system, using a sophisticated three-dimensional mapping system that uses real-time data and CT scans for accurate navigation of the sinus anatomy without damaging nearby tissues. This enhanced level of precision is important in avoiding complications since the sinuses lie close to the eyes, brain, and other vital organs and arteries.

Fig. 7 - Image Guided Surgery Fig. 8 - Image Guided Surgery

Balloon Sinuplasty™

Targeted endoscopic sinus surgery is also combined with state-of-the-art Balloon Sinuplasty™ to help improve the quality of life for sinusitis sufferers. During this minimally-invasive procedure, a flexible balloon catheter is inserted through the nose and into the targeted sinus. The balloon is then inflated in the blocked sinus passageway to open them up. This helps to widen the walls of the passageways, resulting in restored drainage and other functions of the sinuses.

To learn more about balloon sinuplasty as an effective sinusitis treatment option, please contact Dr. Babak Larian .

Each sinus is treated individually based on its particular problem. Narrow Boney opening maybe treated with balloon sinuplasty (Figure. Balloon Sinuplasty). Obstruction by polyps is removed and relieved by the micro-debrider.

Fig. 9A - Balloon Introduced
into Occluded Sinus
Fig. 9B -Baloon Opening of
Sinus Window
Fig. 9C- Open Sinus Draining
its Fluid
     
Fig. 9D- Actual Procedure

 

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At all times, the technique is used that has not only the lowest risk, but causes the least amount of trauma and preserves the maximum natural functioning of the sinuses. In doing so, healing and recovery is much faster and simpler. Due to the minimal amount of trauma bleeding is much less and in a great number of cases no packing is used.

What to Expect After Targeted Endoscopic Sinus Surgery™

After sinus surgery, minor bleeding and some discomfort are common. These symptoms can persist for the first week. Weekly office visits may be necessary for the first three weeks after surgery to endoscopically visualize the sinuses, remove any secretions/crusting to assure appropriate healing. Dr. Larian may also recommend that antibiotics be used, as well as a steroid nasal spray to reduce inflammation. Moisture is an important element of surgical recovery and we typically recommend that our patients undertake a number of steps to ensure their environment contains a sufficient amount of moisture, by using humidifiers and performing salt-water rinses several times a day.

Risks Associated with Targeted Endoscopic Sinus Surgery™

All surgery carries some form of risk. This risk is minimized, although not completely eliminated, when receiving treatment from an experienced surgeon. Endoscopic techniques, such as the one performed by Dr. Larian, have an excellent track record when it comes to safety. That said, minor complications could include scar tissue attaching to nearby tissue and bruising or swelling around the eyes. Major complications, although rare, can include injury to the eye area, heavy bleeding, and brain injury. In the hands of an experienced surgeon, and with the help of image-guidance systems, the inherent risks associated with sinus surgery can be minimized. To learn more about the state-of-the-art TESS procedure, please contact Dr. Larian today.

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Identification of Nasal Allergies

Nasal allergies, also known as allergic rhinitis or hay fever, are a common immune system disorder that affects more than 50 million people in the nation and is seen more commonly in those suffering from chronic sinus infections. Allergies occur when a substance enters the body that the immune system mistakenly believes is an invader and thus mounts an attack. Those who suffer from allergic rhinitis experience an extreme inflammatory response when exposed to these invaders, known as allergens, including inflamed sinuses, headaches, a runny and itchy nose, watery/itchy eyes, sneezing, and rashes.

Allergens can vary from person-to-person; however, there are a number of frequent culprits. One of the most common allergens is pollen. Pollen, which comes from plants, can become airborne and enter the nose, mouth, or other areas, causing an allergic reaction. Dust, mold, animal dander, smoke, and certain kinds of foods can also lead to allergy symptoms. In some cases, this reaction can be serious and may require immediate medical attention.

Diagnosing Allergic Rhinitis through Blood / Skin Testing

Identifying allergies that an individual is sensitive to is important in reducing inflammation to the sinuses. Testing to identify the specific allergen that prompts an allergic response can include a blood and / or skin test. These tests help you and your doctor determine if an allergic reaction can explain the symptoms you are experiencing. If an allergy is detected, a treatment plan is designed for you by Dr. Larian to reduce the day-to-day impact of allergies and other sinus issues. Please contact our practice in Los Angeles to schedule an allergy test with Dr. Larian.

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Allergy Treatment

After the environmental factors that are contributing to your allergies are determined, the first method of treatment is avoidance. This may mean minimizing your exposure to dust mites (microscopic organisms that frequently cause allergy symptoms), and mold in your home, especially the bedroom. Using an air-filter or purifier along with dust mite proof mattress and pillow covers help to ease allergy symptoms.

If you are unable to sufficiently reduce your exposure to allergens, then Dr. Larian may recommend other treatment methods, depending on your individual case. Medications, including antihistamines, steroid or saline nasal sprays, anti-inflammatories, expectorants, or decongestants, can be used to treat allergies. Dr. Larian can determine which type of medication is most suited for your individual needs.

Allergy Shots

If other treatment options fail, our allergy treatment and sinus surgery physician in Beverly Hills can provide you with allergy shots. Allergy shots work by injecting small amounts of an allergen into the body, allowing the body to build a tolerance to their presence and reduce or even eliminate its allergic reactions to them over time. Allergy shots are a safe and effective treatment option that helps individuals with allergies find relief from their most bothersome allergy symptoms. To learn more about allergy shots or to schedule an appointment with our allergy treatment and sinus surgery professional, contact our Southern California practice today, serving the Greater Los Angeles area.

Contact Dr. Babak Larian

If you are seeking relief from the affects of allergies, or have sinus issues and are seeking the latest in sinus surgery, our surgeon serving Beverly Hills, Los Angeles, and all of Southern California can help. To schedule an appointment, simply contact our ear, nose, and throat specialist today. Our practice also offers a variety of other treatments, including rhinoplasty, thyroid surgery, head and neck surgery, reconstructive surgery, speech therapy, salivary gland surgery, and more.

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