Elegant Newsletter

Kenneth N. Kunzman MD Gerald F. Fenster MD Amy D. Lazar MD

Board Certified in Otolaryngology

Ear Nose & Throat / Facial Plastic & Reconstructive Surgery / Head & Neck Surgery / Allergy

56 Union Avenue, Somerville, New Jersey 08876

Drs. Kunzman, Fenster & Lazar continue to improve and expand our services. We have a most caring staff and bring our combined 50 years of experience to our patients. You can expect and receive the most professional medical attention to your ear, nose and throat problems.

Diane Rieck, LPN, has dutifully worked in our office as a surgical schedule coordinator, allergy nurse and floor nurse for the past seven years. She and her husband are moving out-of state to pursue relaxation and retirement. Diane’s energetic and charming presence in the office will be greatly missed by everyone and we wish her happiness in all of her future endeavors.

We are delighted to welcome three new employees to our team: Diane Drexinger, and Carol Romano to our front desk and Fran DeSesso as our new surgical coordinator. Welcome aboard!

Within the field of medicine, technology is constantly evolving to provide safer, faster and higher quality care for our patients. Over the past decade, surgery for diseases of the sinuses has made leaps and bounds. Fiberoptic nasal telescopes (endoscopes) provide detailed close-up views of the structures of the nose, enabling the surgeon to remove diseased sinus tissue and to open blocked breathing passages. However, in order to look around corners and to safely place surgical instruments into certain regions of the nasal cavity, sometimes more information is required. The latest instrumentation to address these issues is called The InstaTrak^@ Three-Dimensional (3D) Guidance system.

If your physician recommends the InstaTrak System for your sinus surgery, you will first go the radiology department at Somerset Medical Center for a special CT scan of your sinuses. A headset designed for you will be positioned prior to imaging. The special CT scans will be stored in a computer such that images of your sinus anatomy can be used in the operating room. Thus, your surgeon can be constantly guided by the InstaTrack at every step of the procedure and virtually eliminate complications.

Microdermabrasion, the Lunchtime peel, is a revolutionary new method of facial skin rejuvenation. By using finely powdered crystals under pressure, the outer layers of skin are gently and painless removed. Cosmetics can be applied immediately following treatment. Please contact Marge Derkach, LPN, our esthetician, Monday through Thursday, for further information

In response to our patient demand for cosmetics safe to use for patients with allergic sensitivities and for surgical aftercare, we have searched and discovered a non-reactive, gentle complete cosmetic line. We are proud to announce the availability of this special line of hypoallergenic, low-oil, fragrance-free cosmetics for our patients. Please contact Marge Derkach, LPN, our esthetician, Monday through Thursday, for further information

Smoking can lead to diseases of the heart and lungs, and cancer of the mouth, throat, and lungs. Patients and physicians often work together in helping people kick the habit. Nicotine gum and patch were the first available over-the-counter methods used for nicotine replacement therapy (NRT). More recently nicotine nasal spray, nicotine inhaler, and bupropion (Zyban^@) have been approved as prescription medications for NRT by the FDA. The following is a discussion of the various treatment options:

1. Patch & Gum can be used at the same time, for up to five years. This method should not be used during pregnancy or with heart disease.

2. Nicotine Inhaler this is a small plastic tube that releases a nicotine mist into the mouth, but not to the lungs. It can cause throat discomfort.

4. Bupropion (Zyban^@) - is an antidepressant that has a side effect of smoking cessation. It is very effective, even in patients who have failed other NRTs.

The American Psychiatric Association endorses the use of NRT therapies when used together with training and education about the importance of smoking cessation. If you are a smoker who has tried the gum and patch without success, talk to your physician about other NRT methods. Taking this step to quit smoking could be the most important change in your health in the millenium!

Snoring occurs when there is obstruction of airflow through the mouth or nose. During sleep, structures in the nose and in the back of the throat contact surrounding tissues and vibrate to cause the snoring sound. Forty-five percent of adults occasionally snore and 25% routinely snore. Snoring has important social and medical implications and occurs more frequently in males, and in overweight people, often worsening with age.

Sometimes snoring is interrupted by episodes of breath holding. This is called obstructive sleep apnea (OSA), and is considered to be serious when apneic episodes last more than ten seconds each and occur more than seven times an hour. OSA can cause daytime sleepiness, poor concentration, elevated blood pressure and enlargement of the heart muscle. If OSA is suspected, a sleep study should be performed.

Treatment for snoring depends on the cause. Causes can include blocked nasal passages, enlarged tonsils and adenoids (often seen in children) long thick soft palate and uvula, and weak muscles in the throat and tongue among others. A thorough ear, nose and throat exam is necessary to make a proper diagnosis.

· Uvulopatatopharyngoplasty (UPPP) is a procedure to tighten the tissues of the palate in OSA patients. This is done under general anesthesia.

· Laser-Assisted Uvula Palatoplasty (LAUP) treats snoring and mild OSA by vaporization of the uvula and a portion of the soft palate. LAUP can be performed in the office setting.

· Somnoplasty^SM uses radiofrequency energy delivered through a needle to shrink the palate for snoring, nasal turbinates for nasal obstruction, and/or base of the tongue for OSA. This technique is relatively new. It is a minimally invasive outpatient procedure.

· Continuous positive airway pressure or CPAP is a nasal mask worn at night to prevent collapse of the airway in patients who cannot have surgery or choose not to have surgery.

There are several strategies that are easy to try to stop or reduce snoring. These include: proper diet and exercise; weight loss; avoid alcohol and late night snacks or meals; stop use of sleeping pills or other medications that will make you tired at night; try sleeping on your side or tilt the head of your bed up; establish regular sleeping patterns.

Snoring is not just a funny noise. It can be associated with OSA and can lead to serious health problems. If you are suffering from snoring be sure to consult your physician.

Hearing loss effects the ability to hear speech at normal conversational levels. Hearing aids can amplify speech sounds, but they also amplify background noise that may interfere with understanding speech. If the background noise is soft enough or the speech is loud enough, a hearing impaired person with aids will do well. But, if the background noise is too loud, hearing aids will be of little benefit.

Directional microphones provide a new strategy to help hearing aid users listen to only the sounds they want to hear. By giving maximum sensitivity to sounds from the front and less from the sides and back, directional microphones have been shown to improve the ability to understand speech in noisy situations.

The Widex Senso digital and digitally programmable hearing aid can be ordered with a directional microphone. Non-digital hearing aids can be built with multiple microphones and the user can select the desired microphone depending on the listening situation. Either system is effective for noise management. If you have further questions please ask our audiologists for assistance.

Come visit us at SENTAdoc.com, for information about our practice, ENT patient education, and links to other ENT sites.