Treatment from Ear, Nose, and Throat (ENT) Surgeon in Boise
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When less invasive, non-surgical approaches are unsuccessful in treating ear, nose, and throat disorders, having an experienced, well-educated surgeon to take the next steps in treating your problems is essential. Dr. Peter Killian at Treasure Valley Nasal and Sinus Center is the leading sinus surgeon in the state of Idaho for these procedures. As a fellowship-trained rhinologist, Dr. Killian expanded his skills after residency by completing an additional year of training in endoscopic sinus and skull base surgery giving him a unique combination of surgical training and experience in performing these surgeries.
 
If you are ready to take the next step after primary care for your ear, nose, and throat conditions, call Treasure Valley Nasal and Sinus Center at (208) 593-4484 today, so we can help.


When Do You Need Nasal and Sinus Surgery from an ENT Dr.?
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Because Dr. Killian specializes in complex ear, nose, and throat conditions, many patients come to our ENT clinic having exhausted their options with other healthcare providers. Whether you are just beginning to uncover your ENT diagnosis or you have tried other forms of treatment to no avail, Treasure Valley Nasal and Sinus Center is here to help you take the next step.

Surgery is not often the first step for most common ENT diseases; however, once other options have failed, surgery is a reasonable (and possibly essential) option to resolve lingering and disruptive symptoms. Modern surgical techniques such as functional endoscopic sinus surgery (FESS) have also drastically reduced invasiveness, complications, and recovery time resulting in better outcomes for our patients.


Methods of Otolaryngology and Sinus Surgery
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Functional Endoscopic Sinus Surgery (FESS)
Also abbreviated to just “endoscopic sinus surgery,” refers to a surgical technique rather than just a single treatment for a single condition. Conditions that can be treated with FESS include:FESS is a minimally invasive surgical procedure that uses a small camera mounted on a narrow tube (a nasal endoscope) inserted through the nostril into the nasal and sinus cavities. This allows sinus surgeons to visualize these small cavities and passageways without incisions on the face. Similarly small and narrow surgical tools can then be inserted through the nostril to remove obstructions, widen airways, and sinus ostia, improving breathing and nasal and sinus drainage. This procedure may be conducted under local or general anesthesia, depending on the condition being treated, the extent of of the surgery, and the patient’s preference.
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Image Guided Sinus Surgery, or computerized surgical navigation. Again, this is a surgical technique and not a procedure intended to treat one condition. Because of rapid improvements in the clarity and accessibility of medical imaging like MRI and CT scans (magnetic resonance imaging and computed tomography scans, respectively), sinus surgeons have developed techniques to get clear images of an operating site both before and during surgery. Along with endoscopic sinus surgery (see above), the guidance provided by this imaging reduces the invasiveness of a procedure, increases a surgeon’s accuracy, increases safety, and results in smoother, faster recovery for patients.

Image guided sinus surgery is essentially like having a GPS for your facial skeleton. The imaging allows ENT doctors to make a “map” and mark specific “landmarks” that are important in guiding them to the appropriate location on the day of surgery. Having thorough imaging performed before surgery helps ENT surgeons plan the procedure with much greater understanding and detail. Image guided surgery has the following steps:
  • Imaging prior to surgery.
  • During and soon after the imaging, and in consultation with a radiologist, the ENT physician uses a computer to carefully examine the images and digitally tag the landmarks that are important for surgery. This might include tumor margins (boundaries) or the location of a cerebrospinal fluid leak, for example.
  • After documenting landmarks, the surgeon saves all of the data, the imaging and the “map”, to a computer or disk.
  • The surgeon uploads the information from pre-surgery imaging to the imaging navigation system being used during the procedure.
  • With a combination of the landmarks already identified and live imaging showing the location, direction, and movement of surgical tools, the surgeon completes the procedure.

The combination of past and present imaging gives surgeons greater accuracy, minimizing risk and again improving outcomes for patients.
Image guided sinus surgery can be especially helpful in:
  • Cerebrospinal fluid (CSF) leak repair, many of those leaks have first been diagnosed with a CT scan to begin with.
  • Performing revision sinus surgery when normal anatomic landmarks have been damaged, removed, scarred, distorted due to severe sinusitis or injury which makes their cases more complex.
  • Planning the removal of nasal or sinus tumors.
  • Guiding surgeries affecting the anterior skull base, as it is one of the more difficult areas in which to operate endoscopically.

PROPEL - Sinus Stent

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PROPEL is the first and only device clinically shown to keep the sinuses open after surgery, precisely deliver anti-inflammatory medication directly to the sinuses, and then dissolve.
 
Learn more about PROPEL

For more information about the types of ENT surgeries we perform click here
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If you have questions about these surgical methods or how they might work in your case, please call Treasure Valley Nasal and Sinus Center at (208) 593-4484 or contact us to learn more.
  Dr. Killian partners with St. Luke’s and St. Alphonsus hospitals.
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