ENTA In The News

ENT AND ALLERGY ASSOCIATES, LLP (ENTA) NEWS COVERAGE


Students asked to write Anti-smoking song - November, 2009
Dr. Michael Bergstein of ENT and Allergy Associates spoke to Ossining High School students about the dangers of smoking. Source: health.lohudblogs.com

ENTA and The Great American Smokeout - November, 2009

Dr. Jared Wasserman, of ENT and Allergy Associates’ (ENTA) spoke to River Dell High School students about the dangers of smoking. This was part of ENTA’s overall efforts, in partnership with the American Cancer Society (ACS), to bring the Great American Smokeout (GASO) to life for teen audiences.

ENT and Allergy physician, Dr. Adrianna Hekiert, who practices in the Somerville, NJ office, speaks to Bridgewater High school students on the Dangers of smoking.

NY Post article

Oh, My Aching Sinuses!
Karen Wirtshafter M.D.
September 3, 2009
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Question: I have allergies that set off severe sinus infections that persist for weeks and keep coming back. I have nasal congestion, trouble breathing and headaches that make my life miserable. Is there anything that can be done?

Answer: Your problem, unfortunately, is very common—one you share with some 32 million Americans who suffer from chronic sinusitis. It is, in fact, one of the most common chronic diseases in the United States.
The good news is that there is an answer. Today, we have an array of medication and procedures that can bring relief and improve the quality of your life. Your doctor can help you find the treatment that works for you.
The sinuses are membrane-lined cavities filled with air that communicate with the nose and outside environment through narrow channels. Sinus infections occur when these small channels become obstructed by inflammation and swelling, which can cause many symptoms.
What causes the obstruction? It may be triggered by allergies, as in your case, or by viral and other infections. It also can stem from a climate change or anatomical problem, such as a deviated septum or nasal polyps.
There are two forms of sinusitis. The acute form has a more rapid onset often characterized by pain, headaches, tenderness and swelling over the sinuses, fever, nasal obstruction, and nasal discharge.
Sinusitis becomes chronic, like yours, when it persists for more than eight weeks or keeps coming back. It causes a myriad of symptoms, ranging from headaches and nasal congestion to post-nasal drip, chronic cough, clogged ears, and even bad breath. It impairs the patient’s physical and social functioning, vitality and general health.

Question: How is sinusitis treated?

Answer: The initial treatment for both acute and chronic sinusitis is aimed at clearing the infection. Your doctor may prescribe antibiotics and other therapies to decrease the inflammation, including topical or systematic steroids, antihistamines, decongestants, or mucus thinning agents. With chronic infections, the course of antibiotic therapy is longer from three to six weeks, using a broad spectrum drug. For persistent symptom, you may be referred to a specialist in treatment of the ears, nose, and throat, or ENT.
Your ENT physician will look for an underlying cause for your problems, such as polyps, sinus swelling, a deviated septum or enlargement of the turbinates. Fiberoptic nasal endoscopy performed in the physician’s office allow your doctor to visually inspect the deeper recesses of the nasal cavities and sinus drainage areas.
Your doctor may order a CT scan. This is the gold standard in sinus imaging as it gives a three dimensional view of what’s really going on in the sinuses. With this information, your doctor can prescribe a treatment plan that meets your needs.
The recommended treatment may involve a more aggressive medical regimen or, if needed, interventional surgical treatment. Sinus surgery has undergone a revolution in the last 20 years, with minimally invasive procedures being standard protocol. Among the common procedures are reduction of obstructing nasal tissue and functional endoscopic, catheter-based procedure which uses a small, flexible balloon catheter to open up blocked sinus passageways—much like the balloon therapy used to open up coronary arteries. All of these procedures are performed entirely through the nostrils. There are no external scars, little swelling and only mild discomfort.
If your symptoms persist, ask your physician about the options available. With the treatments we now have, we can help people like you become more comfortable and achieve a better quality of life.

Karen Wirtshafter, M.D., is board-certified in otolaryngology, or ENT doctor, and is a member of the Medical Staff of Saint Clare’s Hospital.

Rare Esophageal Cancer Hides in Common Symptoms
The Cancer Could Be Deadly but a Simple Test Can Catch It Quickly
By THEA TRACHTENBERG, KELLY HAGAN and LEE FERRAN
March 25, 2009
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Jeff Carpenter was having a little trouble swallowing and assumed it was acid reflux, a condition that ran in his family. But when the 41-year-old father of two went to the doctor, he got the shock of his life.

For an unlucky few, trouble swallowing could mean esophageal cancer, a rare but deadly disease. Dr. Tim and "Good Morning America" explore the terrifying phenomenon. Carpenter was diagnosed with esophageal cancer, a rare but deadly form of cancer that attacks the throat.

Carpenter said he was floored by the news; the thought of cancer had "never even crossed [my] mind."

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Click the video above [featuring Jonathan Aviv, MD, FACS] to watch the simple test to check for esophageal cancer that was performed live on "Good Morning America."

"It's surreal," he said. "You never think it's going to happen to you."

But Carpenter is just one victim in a recent surge of esophageal cancer that some experts believe is related to the nation's growing problem with acid reflux.

Esophageal cancer can develop when stomach acid backs up into the lower esophagus, in some cases damaging cells in the inner layer of the esophagus. This abnormal cellular change is known as Barrett's esophagus, which rarely becomes cancerous.

The disease often goes undiagnosed for long periods because its symptoms do not seem unusual.

"Sometimes it can manifest as having a cough that doesn't go away," said Dr. Allyson J. Ocean, an oncologist at New York-Presbyterian Hospital. "Sometimes it can manifest as [a] sore throat. Sometimes it can manifest as indigestion. And then a more ominous sign is difficulty swallowing."

Carpenter's difficulty swallowing, also known as dysphagia, is the most common symptom, but also one of the latest ones realized.

If the cancerous tumor has grown considerably, it will cause the opening of the esophagus to narrow to nearly half its usual width. By the time it begins causing a problem with swallowing, the cancer is often too large to cure easily.

Jonathan Aviv, MD, FACSDr. Jonathan Aviv, director of the Division of Laryngology at the College of Physicians and Surgeons, Columbia University, defines chronic coughing as a cough that lasts more than six weeks. Then, he said, it's time to see the doctor.

Carpenter was lucky, however, and caught his cancer early. After some chemotherapy and surgery, he was back to work.

To detect the cancer, doctors have developed a fairly simple test that literally takes a look down the throat.

A Test to Save Your Life
The test, called a transnasal esophagoscopy, or TNE, is done by passing a flexible viewing tube through your nose and the back of your throat into the esophagus. The scope can even reach all the way down into the stomach without causing pain.

Once the tube is inserted, the doctor can literally see the cancer, if it exists there.

The simple test was performed on "Good Morning America" live and only takes about one minute.

"Our hope is that ... the heartburn may be throat burn," Columbia University's Aviv said. "We, hopefully, can detect these lesions very, very early and prevent disease."

Nick Tsaclas, the patient for the test on "Good Morning America," had been already diagnosed with Barrett's and a precancerous lesion in his throat was plainly visible during the test.

If a doctor discovers Barrett, the patient may have to go back for follow-up exams, "basically, for the rest of your life," "GMA's" medical contributor Dr. Tim Johnson said.

"Usually with a gastroenterologist, they will keep an eye on it, biopsy it," he said. "If it starts to change into early cancer, they will leap into action maybe with a surgical procedure."

Johnson said people can reduce their risk of cancer of the esophagus by watching their weight and their diet and by cutting back on excessive drinking and smoking.

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Cough, hoarseness and cancer
By Dr. Jay Adlersberg
February 09, 2009
To view the source article, please click here.
To view the accompanying video featuring Dr. Jonathan Aviv, M.D., F.A.C.S., please click here.

NEW YORK (WABC) -- A hoarse throat or a cough can be a sign of something more serious than just a cold. And a new device is helping doctors make the diagnosis.
If you had heartburn, you might think it's coming from the stomach and esophagus. But what about symptoms of cough or hoarseness? One study shows those symptoms are linked to the esophagus, too, ominously, to cancer there. Now, one doctor is using a quick and safe method to find the problem.

Through the nose? Why put a tiny scope through the nose when it sounds like Nick Tsaclas' symptoms are coming from his stomach and esophagus?
"About 12 years ago," he said, "I was starting to develop recurrent symptoms of heartburn along with cough.

For these symptoms, it turns out that a nasal approach to the esophagus is faster and safer than using a large stomach scope through the mouth, where, to prevent gagging, patients are anesthetized.

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"The most common complications are with breathing," said Dr. Jonathan Aviv, of the Columbia University Medical Center. "One can stop breathing, and problems with the heart, one can actually have a heart attack after the procedure."

Dr. Aviv admits the complications are rare, but says the nasal scope can avoid them completely. He says it's best for patients like Nick with an unexplained cough.
Even though people tend to associate heartburn with esophageal illness, it turns out that cough and hoarseness better predict one of the most serious illnesses of the esophagus, esophageal cancer.

But despite that, Nick appears comfortable. For him, all the way down the esophagus near the stomach, a bright salmon-colored area of abnormal cells is what was causing the problems. It is a precancerous area called Barrett's Esophagus, which is related to Nick's coughing symptoms. Because the nasal scope can't get all the way into the stomach, it doesn't replace the standard procedure. But if the standard method finds esophagus problems, Dr. Aviv thinks the tiny scope could replace the bigger one in follow-up visits.

And that is safer for the patient. Patients with stomach issues need the standard scope procedure. Nick's treatment is a daily antacid pill and regular checkups with Dr. Aviv. The nasal scope can also clearly see the vocal cords, as well as the esophagus.

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Making The SOUND Decision
by Richard Rosenberg, MD, FACS– ENT and Allergy Associates, LLP
Nov 16, 2007
Source: The White Plains Times – wptimes.com

Richard Rosenberg, MD, FACSHave you noticed your hearing is somehow ‘off’? Are your loved ones getting a bit frustrated when they try to talk to you, or even just get your attention?
Loss of hearing acuity can begin as early as age 25 – moving parts wear out-and the process is slow and ongoing. In fact, the process can occur so gradually that by the time we’re aware of a hearing loss, those attempting to communicate with us have already been frustrated for years. Hearing Loss is an invisible problem, and can be easily misinterpreted as lack of attention. Therefore, the right time to begin having your hearing evaluated is any time the suspicion first arises that hearing is somehow off, whether that suspicion is your own, or someone else’s. If no suspicion of hearing loss has surfaced, age 40 is a good time to start, followed by repeated evaluations every 2 years. This allows you the opportunity to monitor the progression of hearing loss (if any), and to develop a relationship with your Physician and Audiologist…so if, and when, the time comes for amplification use, trust has been established and you are ready to accept recommendations with less stigma than currently exists.

“Even a mild hearing loss can drive the most active person to retreat into their own world – feeling flawed, vulnerable and disconnected from family and friends.”

Hearing Aids have been perceived, in the past, as being un-fashionable, a statement of being old and flawed. Today, several manufacturers produce new unobtrusive, behind-the-ear hearing aids called “Open – Fit” Technology. These devices prevent the “bottled in” feeling of hearing aids of old, because this technology allows most of the ear canal to remain open. The new design is appealing to those who are normally hesitant to seek help, due to the smallness of the device and its ability to appear more like another wireless headset than hearing aid. Because let’s face it, while people don’t think twice about getting eyeglasses, hearing aids are a different story…but they shouldn’t be.

Take this quick test and check your ability to hear properly:
(Hearing test provided byOticon)

  1. Do people seem to mumble or speak in a softer voice than they used to?
  2. Do you feel tired or irritable after a long conversation?
  3. Do you sometimes miss key words in a sentence or frequently need to ask people to repeat themselves?
  4. When you are in a group or in a crowded restaurant, is it difficult for you to follow the conversation?
  5. When you are together with other people, does background noise bother you?
  6. Do you often need to turn up the volume on your TV or radio?
    Do you find it difficult to hear the doorbell or the telephone ring?
  7. Is carrying on a telephone conversation difficult?
  8. Do you find it difficult to pinpoint where an object is (e.g. an alarm clock or a telephone) from the noise it makes?
  9. Has someone close to you mentioned that you might have a problem with your hearing?

(Your answers to these questions only provide an early indication of whether your hearing is impaired or not. If you answered “yes” to just 1 of these questions you may not need assistance. If you answered “yes” to 2 or more of these questions, you may be experiencing some hearing loss. If you answered “yes” to 3 or more of these questions, you should call your physician and ask for a hearing screening.)

Millions and millions of Americans face some sort of hearing loss, especially as they get older. But with so many advancements now available in the hearing amplification field, there is just no reason to not help yourself hear better. And the first step is a simple one…just call your Physician for an appointment. It’ll not only improve your hearing, it’s likely to improve the overall quality of your life.

Dr. Rosenberg sees patients at his White Plains office, (914) 949-3888. For more information about ENT and Allergy Associates, please visit www.entandallergy.com.

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A diagnosis that can keep our roads safer
November 5, 2007
CAREN HALBFINGER
Source: The Journal News – Lohud.com


Now that we've switched to standard time, many of us are coming and going in total darkness. It's hard not to feel sleepy earlier, but for some, the struggle to stay awake even during daylight hours is a symptom of an undiagnosed medical condition.

Sue Ellen Mosa is one of the 18 million Americans - up to 20 percent of the population - who suffer from obstructive sleep apnea. Due to an airway that collapses when they lie down, those with the disorder stop breathing hundreds of times a night while they sleep. As they gasp for air, OSA sufferers awaken momentarily, as often as they stop breathing. This makes for a very restless night, which leads to daytime exhaustion and can put droopy-eyed drivers on our roads.

While traveling together, Mosa's daughter told her she kept stopping breathing all night long and she was snoring and gasping for air. After a visit to Dr. Jill Zeitland at ENT and Allergy Associates in Sleepy Hollow, Mosa spent a night at the sleep clinic hooked up to electrodes that measured her blood pressure, heart and breathing rates, blood-oxygen levels, muscle movement and brain activity.

Mosa, 52, was soon fitted for a continuous-positive airway pressure, or CPAP, mask and machine. The CPAP pumps air into her throat all night as she sleeps, through a mask that covers her nose. It keeps her airway open and lets her sleep peacefully.
Like Mosa, most people with this disorder don't even know they have it. Up to 90 percent of those with OSA go undiagnosed and untreated, struggling with the symptoms for years. Left untreated, people with OSA can lose the equivalent of several hours of sleep each night. This is akin to having a blood-alcohol level of 0.10 percent, a sleep disorders clinic in Elizabeth , N.J., says.

"I would wake up at 1 a.m. with splitting headaches," said Mosa, a nurse and mother of five whose condition was diagnosed as the disorder six years ago. "By 3 or 4 in the afternoon, I'd want to close my eyes. I would drive home from work with the windows rolled down to stay awake. It was really hard to push myself through the end of the day."

Most people whose conditions are diagnosed with OSA see a sleep specialist because their snoring is keeping family members awake. People who are overweight are more likely to have OSA, although men and women and children who are not overweight can have it, too, especially when their tonsils or adenoids are enlarged. Other risk factors include loud snoring, high blood pressure, having congestion caused by hay fever or other allergies and having a short, thick neck, or a family history of sleep apnea.
"They may have ear pain or a sore throat, and you see that they're obese or overweight," said Dr. Michael Bergstein, surgical director of the Phelps Memorial Hospital Center Sleep Lab in Sleepy Hollow, and an otolaryngologist who also treated Mosa at ENT and Allergy Associates. "They're sitting in your office, and they're asleep. It's enormously undiagnosed."

Mihael Bergstein, MD, FACSAnd yet this disorder is no laughing matter. The national Commission on Sleep Disorders Research reports that drowsy drivers cause more fatalities per accident than drunken drivers. Drivers with untreated obstructive sleep apnea are twice as likely to have a car crash and three to five times as likely to have a crash involving personal injury.

"It is the most common cause of traffic accidents and deaths of truck drivers," Bergstein said.

For some, it takes a crisis to act. Until then, people with OSA often suffer in silence through chronic symptoms such as daytime fatigue, depression, irritability, sexual dysfunction, learning and memory difficulties. The disorder is also associated with high blood pressure and heart disease. People with OSA can have up to a 30 percent greater risk of a heart attack, stroke or sudden death, Bergstein said.

"One patient drove his boat into a mooring," Bergstein said. "I have another patient who ended up in my office who got into one car accident and another accident. He kept falling asleep at the wheel. Finally, he had his license revoked."

Because this patient had mild to moderate sleep apnea, Bergstein was able to cure his symptoms with surgical implants to the man's palate, known as pillar implants. But most patients, especially those with more severe symptoms like Mosa, are first offered nonsurgical treatment.

Bergstein documented the man's condition and his treatment to help him get his driving privileges reinstated.

"Once the patient is treated, they feel like they have a new life," Bergstein said. "It transforms their sex life, their family life, their work life."

While Mosa conceded going to bed hooked up to a machine with a mask on isn't sexy and it takes some getting used to, she said she won't travel anywhere without her CPAP machine.

"If I don't have the CPAP, I can't sleep," she said. "It's amazing, what a difference it's made. I'm clearheaded, and I'm more ambitious to do things. At this point, it's part of my life."

"Going Places" runs Mondays. Please send your ideas and comments to Caren Halbfinger at chalbfin@lohud.com or 914-694-5004.

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Allergy Season Is Here!
By Cynthia Jerome, M.D., F.A.A.A.A.I., F.A.C.A.A.I.
April 19, 2007
Source: The White Plains Times – wptimes.com

Cynthia Jerome, M.D., F.A.A.A.A.I., F.A.C.A.A.I.Seasonal allergic rhinitis, often referred to as “hay fever,” affects more than 35 million people in the United States. Airborne pollens and mold spores are outdoor allergens that commonly trigger symptoms during the spring and fall. During these times, seasonal allergic rhinitis sufferers experience symptoms of sneezing, congestion, a runny nose, and itchiness in the nose, roof of the mouth, throat, eyes and ears.

Seasonal allergic rhinitis in the spring is usually triggered by tree pollen, followed by grass pollen in the late spring and early summer. In the late summer and early fall, pollen from ragweed and other weeds is prevalent. Each plant has a period of pollination that does not vary greatly from year to year. However, weather conditions can affect the amount of pollen in the air at any given time.

Mold spores float in the air like pollen, and are present throughout the year in many states. Unlike pollens, molds do not have a specific season, but are affected by weather conditions such as wind, rain or temperature. Molds are present in almost every possible habitat. Outdoors, they can be found in soil, vegetation and rotting wood. Molds can also be found indoors in attics, basements, bathrooms, refrigerators and other food storage areas, garbage containers, carpets and upholstery.

Pollen and mold counts measure the amount of airborne allergens present in the air. While many patients develop symptoms when pollen counts are 20 to 100 grains per cubic meter, one’s symptoms may also be affected by recent exposure to other allergens, the intensity of pollen exposure, and individual sensitivity. Pollen counts reported to the public are generally taken the preceding one to three days, and may vary widely from day to day during a season.

Weather can influence hay fever symptoms. Allergy symptoms are often minimal on days that are rainy, cloudy or windless, because pollen does not move about during these conditions. Hot, dry and windy weather signals greater pollen and mold distribution and thus, increased allergy symptoms.

If your seasonal allergy symptoms are making you miserable, your allergist can perform the appropriate tests to determine your allergic triggers. To lessen your symptoms, your allergist may prescribe an allergy nose spray, non-sedating antihistamine, decongestant or other medications.

If your symptoms continue or if you have them for many months of the year, your allergist may also recommend immunotherapy treatment, also called allergy vaccinations or shots. This treatment involves receiving injections periodically—as determined by your allergist—over a period of three to five years. This treatment helps your immune system to become more and more resistant to the specific allergen, and lessens your symptoms as well as the need for future medications.
Find out more information at the American Academy of Asthma, Allergy and Immunology Web site at www.aaaai.org .

Cynthia Jerome, M.D., F.A.A.A.A.I., F.A.C.A.A.I. is located at ENT and Allergy Associates, White Plains, N.Y.

Steps to Avoid Allergy Triggers
Following are some dos and don’ts that you may want to follow during the pollen and mold seasons to lessen your exposure to the pollens or molds that trigger your allergy symptoms.

Keep Windows Closed at night to prevent pollens or molds from drifting into your home. Instead, if needed, use air conditioning, which cleans, cools, and dries the air.

Minimize Early Morning Activity outdoors when pollen is usually emitted—between 5 and 10 a.m.

Keep Your Windows Closed when traveling.

Try To Stay Indoors when the pollen count or humidity is reported to be high, and on windy days when dust and pollen are blown about.

Don’t Mow Lawns or be around freshly cut grass; mowing stirs up pollens and molds.

Don’t Rake Leaves, as this also stirs up molds.

Don’t Hang Sheets or Clothing out to dry. Pollens and molds may collect in them.

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