Minimally Invasive Thyroidectomy (MIT) methods were introduced in the late 1990s as a way to circumvent the undesired side effects of traditional methods. A traditional thyroidectomy left the patient in a considerable amount of pain from an incision site of up to four inches in length. This large incision coupled with the pain made for extensive recovery times that used to last up to three weeks. The Minimally Invasive Thyroidectomy (MIT) technique reduced the size of the incision down to one inch, which facilitates a faster recovery time (just over a week in most cases) and less post-operative pain.

The reason that the Minimally Invasive Thyroidectomy (MIT) technique became a possibility is through the use of endoscopic tools that allow surgeons to see the thyroid and its surrounding tissues via a small camera inserted into the small incision. Traditional methods didn’t use these cameras, which is why a much larger area of the neck had to be opened to allow surgeons access to the gland and greater visibility. Today, patients who have the Minimally Invasive Thyroidectomy (MIT) done usually only stay overnight in the hospital whereas some may even go home the same day.

As with most surgical procedures and conditions, there are some patients that a Minimally Invasive Thyroidectomy (MIT) might not work for. This could be true for several reasons, including underlying conditions as well as the placement of the mass to be removed. In instances such as these, traditional or alternate methods of removing the thyroid gland may be necessary. Only a qualified surgeon can make this decision, based on the findings of a pre-operative consultation. The consultation will include various tests and other exams to identify the cause of the patient’s thyroid condition and identify its underlying cause so that the most effective method of treatment can given.

Salivary gland surgery can be very precarious for an unskilled surgeon because of their close proximity to important facial nerves. The parotid gland poses the greatest risk for facial nerve disruption because the nerve that controls the movement of the eyes, nose and lips runs through the middle of this gland. Even if no permanent damage to the nerve occurs, patients may still experience weak facial muscles while the incision (made along the jawline near the earlobe) is healing. Surgery on the sub-mandibular gland is not as risky in regards to damaging the facial nerve as surgery on the parotid gland is. While the risk of nerve damage remains, during the sub-mandibular gland procedure, the nerve can be moved away from the incision site for the duration of the procedure. Surgeries involving the sub-lingual gland are performed through incisions in the mouth, not the jaw or face, so the potential for facial nerve damage is considerably less than with the other procedures.

Depending on the reason the salivary gland was affected, additional treatments may be required even after having the affected gland removed. If the gland had a cancerous growth, radiation and/or chemotherapy is often administered to the location in case any cancerous cells remain in the surrounding tissues after the removal of the affected glands. It is very possible that the patient can lose some facial nerve function, even with the most successful of salivary gland surgeries. Physical therapy or other facial reanimation techniques may be needed to regain control over the lost functions. Having an an otolaryngologist (head and neck surgeon) with experience in this area is imperative for achieving the best outcome after salivary gland surgery.

There are a wide variety of symptoms that may occur when cancer is present in the head and neck. People with throat cancers may have trouble swallowing or recurring sore throats. Those with oral cancers may have mouth sores that do not heal or experience difficulty eating. People with sinus cancers may have sinus infections that do not respond to treatment or recurring, severe headaches. However, some types of head and neck cancers produce no symptoms at all – even in their latest stages.

Regular family physicians do not have the skills, equipment or experience required to diagnose potentially deadly cancers. Since cancer symptoms can mimic symptoms of other less serious conditions, a life threatening situation may end up being brushed off as something as simple as a common cold. Aside from physical exams, head and neck tumor specialists utilize CT scans, MRIs and biopsies along with other specialized testing procedures to not only diagnose the cancer, but to also create the best treatment plan available to the patient, based on their findings and the options available to them.

Head and neck cancers are multifaceted diseases which must be met with a multifaceted approach in order to be treated effectively. Effective treatment often involves the expertise of just more than just one specialist. Most head and neck cancer patients are treated by a team of specialists, in addition to head and neck tumor specialists. Medical oncologists, radiation oncologists, physical therapists and language pathologists are just a few of the many specialists that a head and neck cancer patient may encounter.

Although the best defense against head and neck cancers is still early detection, the best weapon to combat the cancers is a qualified head and neck tumor specialist versed in the most effective treatment options that deliver a course of treatment specifically designed for each patient on a case by case basis. If you or a loved one has been diagnosed with head or neck cancers or if you suspect you may have cancer, schedule a consultation with our head and neck tumor specialists to discuss your personalized treatment options.

There are three types of sinus surgery – endoscopic sinus surgery, image guided sinus surgery and the Caldwell Luc operation. The endoscopic method utilizes small cameras to guide surgeons during the process. These cameras are fitted on tubes and inserted into the sinus cavities through the nose. Because the sinus cavities are near the brain, eyes and major arteries, these cameras are an extremely important and necessary part of the surgical process. The  image guided sinus surgery works much the same way as the endoscopic method, but uses CT scans, real-time information and infrared signals instead of the cameras. This method is used most often when a patient’s sinus anatomy has been severely altered by previous surgeries or is hard to navigate. The Caldwell Luc operation is the most invasive of the three and is generally used when there is a malignancy in the sinus cavities. Its purpose is to drain the maxillary sinus cavity beneath the eye, which is accessed by going through the upper jaw.

What to expect after the surgery:

Because the majority of sinus surgeries are performed through the nostril, there is typically no scarring involved and only minor swelling and discomfort accompany the procedure. Patients will usually have their sinuses packed with gauze or some other material after the procedure. Some has to be removed while other types dissolve over time. Bad breath is common when the packing is in place. Drainage from the nose is possible 3-6 days after the procedure. A follow-up with your doctor will be needed within a week of the procedure and saline irrigation will be recommended ten days post-op.

To find out if you are a candidate for sinus surgery, schedule a consultation with our staff for a complete diagnostic work up of your sinuses. Based on the findings of the consultation, our staff will inform you of the best method of treatment for your condition.

While an enlarged parotid gland in itself isn’t much cause for concern, bear in mind that it is usually a symptom of an underlying condition and not a condition itself. Some of these can be rather serious, if left untreated. Here are some symptoms that are commonly associated with an enlarged parotid gland and what they could be indicative of.

Growths and tumors on the parotid gland usually present in the form of a lump or nodule somewhere in the cheek, jaw or neck. Some may be painful while others may not. The growths can obstruct the body’s ability to produce saliva, making chewing and swallowing difficult. If the growths are cancerous and not removed, the cancerous cells can spread to other areas of the head, neck and body. Cysts, which are tiny, fluid filled sacs, can also present on the parotid gland after an injury or infection.

Infections are another common reason that a parotid gland may enlarge. Sialadenitis is an infection of a salivary gland itself, usually caused by bacteria. Even infants can have this condition in the first weeks of life. Viral infections, like mumps, can cause swelling of the parotid gland. Systematic infections that settle in surrounding lymph nodes can also contribute to the enlargement of the parotid gland. When an infection of either type is present, it’s usually marked by painful, swollen glands, difficulty swallowing and a high fever.

Other conditions, not related to an infection, are also known to cause an enlarged parotid gland. Sjogren’s syndrome is a chronic auto-immune disorder that causes the body’s immune defenses to attack the salivary glands, the tear glands and sweat glands. Aside from a swollen parotid gland, this syndrome can produce dry mouth and dry eyes. Sialolithiasis is a condition where small, calcium-rich stones form inside the salivary glands. Although the stones themselves are harmless, some of them may cause pain and swelling along with a decreased production of saliva.

Without a throughout exam, it is not possible to determine the cause of an enlarged parotid gland. Some of these conditions may resolve on their own while others may need surgical intervention to correct. Dr. Larian performs a battery of specialized tests to determine not only the source of the enlarged gland, but also to formulate a treatment plan that will alleviate the patient’s symptoms and deter further progression of a benign condition into a more serious one. If you are experiencing swollen glands, whether or not they are accompanied by any of the aforementioned symptoms, schedule a consultation as soon as possible.

Center (NWHIC), 20 million Americans are living with some kind of thyroid disorder. This estimate includes those who do not know they have a thyroid condition or those who have yet to be diagnosed. The most common thyroid conditions affecting Americans today are tumors, enlargement, hyperthyroidism and hypothyroidism.

The thyroid is a small gland in the neck that produces hormones that help regulate the body’s circulatory system and metabolism – the rate at which food is converted into energy. When the thyroid does not produce enough of the hormones, it is referred to as ‘hypothyroidism’. This condition causes the body’s functions to slow down and can lead to fatigue, weakness and the inability to lose weight. When the thyroid gland produces too many of the hormones, it is referred to as ‘hyperthyroidism.’ This condition causes the body’s functions to go in to a “hyperactive” state, which can produce rapid heart rate, unintentional weight loss, sleeplessness, and anxiety.

Thyroid cancer is the seventh most common cancer found in women and produces no symptoms. The first inking that something may be amiss within the thyroid often comes when a nodule or lump is found in the neck during routine physical exams. Even if the nodule or lump turns out to be benign (non-cancerous) after testing, it can still indicate a problem within the thyroid. Growths on the thyroid or an enlarged thyroid itself can cause difficulties in breathing and swallowing in addition to other adverse and possibly dangerous effects.

If medications do not work to correct a thyroid condition, doctors will often recommend a thyroidectomy, which is a surgical procedure to remove part or all of the thyroid gland. Traditional, invasive thyroidectomies left patients in a considerable amount of pain afterwards, in addition to a 2-4 inch scar on the neck. A recovery time lasting 2-3 weeks was not uncommon with these invasive procedures. Due to advances in technology, Dr. Larian a pioneer in the Minimally Invasive Thyroidectomy is now able to perform that require only a one half to one inch incision and leave the patient in only a minimal amount of pain post-op. Our surgeons use specially designed endoscopes to view the intricacies of the neck area, allowing them to operate with more precision than was possible during traditional thyroidectomies. MITs also have a considerably shorter recovery period than traditional ones, lasting about ten days on average.

While MITs are the better choice overall for patients who are facing a thyroidectomy, there are some conditions and tumor characteristics for which MITs cannot be performed. To find out if you could potentially benefit from an MIT or to discuss other treatment options for thyroid conditions, schedule a consultation with our surgical team.

There are no medications available that effectively treat these thyroid conditions. Because a diseased or malfunctioning parathyroid gland will not get better on its own, surgical removal is often a patient’s only recourse. The procedure, known as a parathyroidectomy, will remove some or all of the parathyroid glands, depending on the severity of the condition and which glands are affected.

Traditional parathyroidectomies were extremely invasive procedures that often required the surgeon to make a large incision in the neck in order to explore the area of the parathyroid to look for the problematic gland or glands. This invasive technique caused the patient a considerable amount of pain post-op and made for an extended recovery time. Complications from the procedure were also more common with the traditional methods.

Thanks to the implementation of new techniques, specialty surgeons like Dr. Larian are now able to perform a Minimally Invasive Parathyroidectomy (MIP). The newer method utilizes advanced technology imaging tools such as a high resolution ultrasound to locate the problematic gland before making the first incision. Dr. Larian also incorporates intra-operative hormone testing to ensure that the patient is responding to the procedure and that hormone levels are dropping appropriately.

Because a MIP allow the surgeon to operate with more precision that before, parathyroidectomy procedures can now be performed via an incision of only a few centimeters, as opposed to several inches in traditional parathyroidectomies. Some MIPs can even be performed under local anesthesia, allowing some patients to return home the same day.

If you think you may be experiencing symptoms of hyperparathyroidism, schedule a consultation with Dr. Larian today for testing and a diagnosis. If a problematic parathyroid condition is found, he can discuss various treatment options with you and determine whether you may be good candidate for an MIP.