Call Us Today! 703-573-3687
Laurence O’Halloran MD
Timothy Egan MD
Heinz Scheidemandel MD
Antonio Cachay MD
Sarah Blank MD

New Treatment for Sleep Apnea

16 Feb 2017 

Dr Egan is the only surgeon in Fairfax County who is trained to implant the Inspire device for the treatment of obstructive sleep apnea. Inspire therapy is a breakthrough implantable treatment option for people with Obstructive Sleep Apnea who are unable to use or get consistent benefit from Continuous Positive Airway Pressure (CPAP). While you’re sleeping, Inspire monitors every breath you take. Based on your unique breathing patterns, the system delivers mild stimulation to the hypoglossal nerve which controls the movement of your tongue and other key airway muscles. By stimulating these muscles, the airway remains open during sleep.
The Inspire obstructive sleep apnea device is controlled by a small handheld remote. The remote allows you to turn Inspire therapy on before bed and off when you wake up.

Read more about Inspire …

 

Snoring

15 Dec 2016 

 

Why do I snore?

According to the American Academy of Otolaryngology, 45% of adults snore at least occasionally, and 25% of adults are habitual snorers.

Snoring occurs when there is an obstruction to airflow through the passages at the back of the nose and mouth. The obstruction causes vibration of the collapsible part of the airway, when the tongue and upper throat meet the soft palate and uvula.  Snoring is more common in men and those who are overweight, and it usually gets worse with age.

There are many causes of snoring.  In children, snoring is commonly due to enlarged tonsils and adenoids.  Snoring can cause significant sleep disturbances, and healthy sleep habits are vital to ensure your child’s healthy growth and development.  If your child chronically snores, they should be evaluated by an otolaryngologist, who may recommend having their tonsils and adenoids removed.

In adults, snoring can be related to a variety of factors. The following factors can contribute to excessive snoring:

  • Poor muscle tone in the tongue and throat – When these muscles relax during sleep, the tongue can fall backwards and obstruct the airway. This can be exacerbated by alcohol and sleep aids.
  • Excessive throat tissue – overweight people with a thick neck can have excess soft tissue which narrows the airway. Children often have enlarged tonsils and adenoids which can lead to snoring. A long soft palate and uvula can also narrow the airway and act as a noisy flutter valve that causes snoring during relaxed breathing.
  • Obstructed nasal airway – Allergies and colds or sinus infections can cause a stuffy nose, which requires extra effort to pull air through the nose. When this happens, you can have collapse of the floppy tissue at the back of the throat, which leads to snoring. A deviated nasal septum or nasal polyps can also cause a nasal airway obstruction and thus snoring.

Snoring can also be a sign of a more serious condition called obstructive sleep apnea. This condition is characterized by multiple pauses in breathing of 10 seconds or longer.  This disrupts the natural sleep cycle and causes patients to feel poorly rested despite getting enough sleep.  Additionally, it can cause serious health concerns, as the pauses in breathing cause poor oxygenation of the blood, which in turn forces the heart to work harder.  Untreated obstructive sleep apnea can lead to an increased risk of heart attacks, strokes, diabetes, and many other serious health conditions.

If you or your bed partner are a heavy snorer, it is important to be evaluated promptly to ensure that you do not have obstructive sleep apnea or another serious cause of snoring. Our physicians are expertly training in evaluating and treating snoring conditions.

There are a number of both surgical and nonsurgical options to treat chronic snoring and obstructive sleep apnea. If you or your partner suffer from heavy snoring, please call our offices today to set up a consultation.  One of our physicians will thoroughly evaluate you and together, you will come up with a treatment plan tailored specifically to you.

Early Morning and Evening Appointment now available!

7 Dec 2016 

Early morning and evening appointments now open on select Wednesdays! (7 AM – 7 PM)

Call for availability.

Tinnitus

5 Dec 2016 

Tinnitus:

Do you experience ringing in your ears? Does it sound like an insect is constantly buzzing by your head?  If so, you may be suffering from what is known as tinnitus.  Tinnitus is the perception of sound without an external noise being present.  Over 50 million Americans suffer from tinnitus, and about 1 in 5 adults have bothersome tinnitus which negatively affects their quality of life.  Tinnitus is not a disease in and of itself; rather it is a symptom that is most commonly associated with the hearing system.

Tinnitus can be caused by different parts of the hearing system. For instance, an excess buildup of wax can lead to tinnitus, as can middle ear infections.  Medications can also sometimes cause tinnitus.  One of the most common medications known to cause tinnitus is aspirin.  Most tinnitus is due to problems with the inner ear and is related to hearing loss. As we age, the incidence of tinnitus increases.

Pulsatile tinnitus, or tinnitus that sounds like your heartbeat, is a special category of tinnitus. In this instance, the tinnitus may signal the presence of vascular abnormality in the middle or inner ear.  If you experience this type of tinnitus, you should see your ENT as soon as possible for a full evaluation.

Unilateral (or tinnitus only in one ear) tinnitus may also signal the presence of an abnormality, such as a benign tumor, on or near your hearing nerve. Again, your physician will work with you to determine if this is the cause.

Tinnitus can commonly be affected or exacerbated by stress, fatigue, poor diet and exercise, and excess caffeine intake.

Unfortunately, there is no definitive cure for tinnitus, although there are several management techniques that can help minimize it. Here are some tips to help you cope:

  • If your doctor determines that hearing loss is present, a hearing aid can be helpful
  • White noise or background noise (such as a fan or TV) can help minimize tinnitus; distraction techniques help keep you from focusing on the tinnitus
  • Avoid stress as much as possible
  • Research relaxation techniques, such as meditation and yoga, as these have been shown to be beneficial in reducing subjective tinnitus
  • Avoid caffeine – stimulants have been known to temporarily worsen tinnitus in some people

If you experience any of these symptoms, or you are bothered by your tinnitus, call our office today to schedule a visit. Our doctors are expertly trained in this subject and will work with you to determine the cause of and best treatment plan for your tinnitus.

23 May 2016 

OPEN HOUSE
Open House 2016- Modified

Sudden Hearing Loss

1 Dec 2015 

Sudden Hearing Loss

Hearing loss can be caused by a variety of different things; however, sudden onset hearing loss is an alarming condition. Imagine that one day you can hear perfectly and the next, your hearing is gone. This condition is known as sudden sensorineural hearing loss, and it is an ENT emergency. Prompt evaluation and treatment is key to recovery.
Sudden sensorineural hearing loss (or SSNHL) is usually one-sided. There are a number of causes for SSNHL, but the most common of these is a viral infection that attacks the inner ear and hearing nerve. Another, less common, cause of sudden hearing loss is a vestibular schwannoma, or a benign tumor of the hearing nerve. SSNHL is rare, with estimates of the annual incidence ranging from 5-20 cases per 100,000 people. This may be an underestimate, however, as many cases likely go unreported.
If you experience a sudden loss of hearing, urgent evaluation is recommended, as the longer treatment is delayed, the less likely there is for recovery of hearing. During your evaluation, you will undergo a thorough ear exam, as well as a hearing test. Your doctor will determine if other testing, such as an MRI, is needed to further evaluate your hearing loss.
After you have been diagnosed with SSNHL, your doctor will discuss a treatment plan with you. If you do not have other medical issues that prohibit it, this plan will almost certainly include a steroid burst followed by a taper. Intratympanic (or through the ear drum) steroid injections have also been shown to significantly improve hearing in patients with severe sudden sensorineural hearing loss. These options will all be discussed with you in detail at your appointment.
If you experience sudden onset of hearing loss, do not delay in seeking care. Recovery in hearing depends strongly on the promptness of evaluation. Call us today if you think you might be experiencing sudden sensorineural hearing loss.

Reflux

25 Oct 2015 

Most people associate “reflux” with heartburn symptoms. However, a significant portion of people afflicted with gastroesophageal reflux don’t have any of these symptoms. Instead, these people suffer from “silent reflux,” otherwise known as laryngopharyngeal reflux (LPR). The etiology is the same, but the symptoms can be entirely different. Both types of reflux occur when there is a backflow of stomach contents going up towards your mouth. The stomach acid irritates the lining of the throat and causes symptoms.

Surveys suggest that over 60 million adults suffer from GERD. This is likely an underestimate, however, as many people suffer from silent reflux and do not associate their symptoms with heartburn. Often, LPR can be overlooked or misdiagnosed. As otolaryngologists, we are experts in this topic. In fact, up to 10% of an ENT’s practice can be comprised of patients suffering from LPR.

The most common symptoms associated with LPR include globus sensation (or a “lump in the throat”), chronic cough, throat clearing, excessive throat mucus, sore throat, and hoarseness. Often, these symptoms will be worse in the morning or after a big meal.

Treatment involves a combination of dietary and behavioral modifications, and medical therapy. LPR can be difficult to treat, and may take weeks to months before you notice any changes. Other, more serious, conditions may mimic the symptoms of LPR, so it’s important to be evaluated by an expert if you experience any of these. Call us today to schedule an appointment to see if LPR may be causing some of your symptoms.

Allergy Shots

13 Oct 2015 

cherry blosumAllergy Shots:

Allergy shots are the most effective way to treat nasal allergy problems. They act by desensitizing the body to allergens such as dust and pollen that cause symptoms such as nasal congestion, eye itching and runny nose. Ask your Fairfax ENT physician about allergy testing and treatment.

What to expect after tonsillectomy

1 Jul 2015 

Q: Why do tonsils & adenoids need to be removed?

A: Tonsils & adenoids are most often removed when they become enlarged and block the airway, restricting breathing. This can lead to loud snoring, restless sleep and gasping.  They are also removed if certain illnesses such as strep throat and tonsil infections cannot be treated with antibiotics.

Q: Will I be asleep during the tonsillectomy?

A:  Yes, the procedure is performed under general anesthesia, which means you are asleep, and will not feel a thing.  With young children one parent is allowed in the operating room while the child goes to sleep.  For young children it is often possible to put them too sleep before the IV is placed so the child does not experience any pain.

 

Q: How long will my son or daughter take to recover from a tonsillectomy and adenoidectomy?

A: Young patients will typically require 10-14 days of recovery.  Most children will be out of school for 1-2 weeks. We recommend avoiding exercise and strenuous activity for 3 weeks after surgery.

Q: Will I need to stay overnight?

A: In most cases, a tonsillectomy is an outpatient procedure.  Patients younger than 2 years of age or those with severe apnea may require an overnight hospital stay.

 

Q: What can I expect when my son or daughter comes home from surgery?

A:   Sometimes, patients  vomit after surgery, but vomiting should cease about 24 hours after surgery. It is not unusual to have a low grade fever. You should call your doctor is the temperature exceeds 101.5°F

 

Q: Why is my child still snoring after surgery?

A: Many parents become concerned when their child continues to snore after surgery. Especially if the reason for surgery was to correct loud snoring and  obstructive breathing.  Don’t worry it is very normal for your child to continue to snore for several days after surgery because of swelling. When the swelling resolves you will frequently see that your child no longer snores. In fact they are sometimes so quite that parents wonder if they are still breathing.

 

Q: What is the white spot in my throat after tonsillectomy?

A: Scabs in the area where the tonsils and adenoids were removed will appear white and cause bad breath.  They will often break away in pieces about a week after surgery. While this looks like pus it is not a sign of infection and is not reason for concern.

 

Q: Is it normal to have ear pain after tonsillectomy?

A: Yes, children will often complain of  ear pain after tonsillectomy. Sometimes the ears actually hurt more than the throat even thought the ears were not operated on. This is because the same nerve provides sensation to the throat and the ear.

 

Q: Is it normal to loose weight after a tonsillectomy?

A: Weight loss is very typical in tonsillectomy. Patents should not worry about calories or nutrition for the first two weeks after surgery.  The most important thing is that your child drinks plenty of liquids and stays well hydrated. This not only prevents dehydration but it helps keep the throat from drying out which.  When the pain resolves your child will begin eating again and are back at the normal weight in no time.

 

Q: Is it normal to bleed after tonsillectomy?

A: Minor bleeding from the nose or in the mouth is very typical, but if you experience flowing blood from the mouth or nose, contact your physician and go to the emergency room right away.

Q: What is the best way to recover from surgery?

A: It is very important that patients drink plenty of fluids, such as water and apple juice, to recover quickly. It is also important that patients try not to rush to get back to school or work and get plenty of rest.

Q: Why is there only mild pain the first few days after tonsillectomy?

A: The swelling of the surgical area has not yet happened, therefore no pain is felt. The first few days after surgery there tends to be less pain.  About 3 days after surgery the pain will increase and will continue for 10 – 14 days.

New treatment Obstructive Sleep Apnea

12 May 2015 

Dr Egan will be one the of first doctors in Northern Virginia to implant the new Inspire device.  inspire

What is Obstructive Sleep Apnea(OSA)

OSA is a condition where patients repetitively stop breathing during the night. The muscles of the throat relax when we fall asleep and in some patients this can lead to collapse of the upper airway which prevents airflow.

What is Inspire?

The Inspire device is an implanted stimulator used to treat obstructive sleep apnea. The device continually monitors your breathing throughout the night and provides a gentle stimulation to the muscles of the upper airway. The muscle stimulation prevents the throat from collapsing.  The device is implanted so there a no visible or removable parts. It is controlled by a small remote control. Simply turn on the device at night and turn it off in the morning.

Is Inspire Right for you?

CPAP remains the first line treatment for OSA.  If you are unable to tolerate CPAP schedule an appointment to see if inspire is right for you.

 

Proven Results.

Before receiving FDA approval the inspire devices underwent rigorous testing to make sure that it is both safe and effective.  A recent study in the New England Journal of Medicine found that patients treated with the Inspire had:

  • 68% reduction in episodes of sleep apnea.
  • Significant improvement in quality of life and daytime functioning.
  • 85% of bed partners reported no or improved snoring.

For more information visits www.inspiresleep.com