Millions of people suffer from sinus problems, which can be tough to treat. When sinusitis, an inflammation of the nasal sinuses, is chronic, it can be debilitating and life-threatening.
Dr. Alexander Chiu and his team at The University of Arizona Medical Center are specializing in these challenging complex cases, helping the division to earn recognition as one of the nation's top programs.
Out of about 5,000 U.S. hospitals, UAMC was ranked No. 30 in ENT by U.S. News & World Report’s Best Hospitals list of 2013-14.
And Chiu, professor of surgery and chief of the Division of Otolaryngology – Head and Neck Surgery in the UA Department of Surgery, was named one of the 2013 Best Doctors in America.
For patient James Dean, 66, the national ranking isn't high enough.
"They should be No. 1," said Dean, who suffered debilitating sinusitis for 15 years before Chiu performed minimally invasive sinus surgery that changed his life.
"I have never had more confidence in a doctor than I did in Dr. Chiu at our first meeting," Dean said. "My headaches are gone. I have my sense of smell back. I sleep better. I work better. Without Dr. Chiu I would still be sniffling and snuffling and on steroids."
Dean developed allergies after he and his family moved to Tucson from Illinois in 1980. He developed polyps, which prevented him from breathing properly.
"My nose was so plugged that my ears would pop when I swallowed," said Dean, a land surveyor. "My nose ran constantly. It got so bad at work I would turn out the lights, close the door and lie down under my desk.”
Steroids shrank the polyps, but they grew back. He tried surgery, but the relief was short-lived. Dean developed sinus infections and headaches that put him out of commission. His community ENT said further surgery was possible, but it would require opening his skull. "I would have had a big old bumpy scar across my forehead."
However, when a pre-surgery scan revealed erosion of the bone between the brain and the sinuses, Dean's doctor sent him to Chiu. The greatest concern was that Dean could suffer from a dangerous complication, such as meningitis.
"Although we think of sinusitis as a fairly benign problem, its location can make it potentially a very serious problem," Chiu said. "Your sinuses are right next to your eyeballs and your brain. You can have a serious eye or brain condition that started with a sinus infection."
Instead of opening his skull, Chiu went through Dean's nose and drilled open his frontal sinus, removing polyps and allowing it to drain. "He is now safe from having an infection in his brain," Chiu said.
Recovery from the three-hour outpatient surgery was fairly simple. Endoscopic surgery, Chiu's specialty, results in no facial scars, less pain and easier recovery.
"The operation was on a Wednesday and by Saturday I was at estate sales," said Dean, who along with Laurie, his wife of 46 years, is an avid collector of artwork by Tucson artists.
He said he feels great and is infection free.
Author of the textbooks, "Atlas of Endoscopic Sinus" and "Skull Base Surgery and Sinonasal Tumor," Chiu is also editor-in-chief of the leading journal on sinus disease, American Journal of Rhinology and Allergy. He came from the University of Pennsylvania three years ago to start the UA's otolaryngology division.
"I was tasked with building something from scratch," Chiu said. "I came in with a very determined plan to make this one of the best programs in the country.
"What I wanted to do was to focus on the tough ENT cases and these tend to focus around head and neck cancer, revision surgeries (surgeries that have been done two and three times) and complex ear surgeries," he added.
Chiu has recruited national experts to the program, which now has seven surgeons. Among them: Dr. Abraham Jacob, director of the UA Ear Institute; and also Dr. Audrey Baker Erman and Dr. Thomas J. Gernon, head and neck cancer experts specializing in reconstructive surgery.
"From life-saving surgeries for head and neck cancer, to advanced treatments for chronic sinus problems, to helping deaf patients regain the ability to hear, our faculty in the Division of Otolaryngology are committed to improving the quality of life in our community and beyond," said Dr. Rainer W.G. Gruessner, professor and the UA Department of Surgery chairman.
And the department is equipped to handle the most difficult cases, including that of Aundrea Aragon who made international headlines in 2012 when Chiu and Dr. Michael Lemole, chief of the Division of Neurosurgery, teamed up to repair cracks in the back wall of Aragon's sphenoid sinus that allowed brain fluid to leak out of her nose. Both also partner to remove brain tumors through the nose.
The department is drawing patients from throughout Arizona, New Mexico and Southern California.
"We have faculty here that can practice anywhere in the country and we are so lucky to have them in Tucson," Chiu said. "We are representative of the new UAMC, which is bringing premier academic medicine to Tucson."