Dr. Kotler’s Breakthrough Invention Revolutionalizes Nasal and Sinus Surgery
By A. Norman Enright
Medical Writer
It’s described by a colleague as “the greatest advance in patient comfort and safety in nasal and sinus surgery since the utilization of general anesthesia”. A unique and new device from Robert Kotler, MD, FACS, UCLA teacher and author, allows patients to breathe through the nasal passages continually after cosmetic plastic nasal surgery, nasal septoplasty and turbinate reduction for breathing and even sinus surgery. Air flow despite the nose being completely packed to prevent bleeding and promote healing.
“This is a huge victory for patient comfort. And, for safety”, notes Dr. Kotler. The days of patients reluctantly tolerating their nose completely stuffed, like a Thanksgiving turkey, with that pounding pressure, ear-popping, and claustrophobia should now be a thing of the past”, notes Kotler a veteran facial surgeon with over 33 years of private practice and over 4,000 nasal cases under his belt in both his military and civilian careers. A man who knows a bit about noses.
“Our patients are the best advocates for this new breathing system. Ask them. But, there are probably millions of prospective patients who know they need and want the operation to unclog their eternally blocked nasal passages because they are tired of constant nose and sinus stuffiness, even sometimes with headaches. Plus, allergy sufferers have even more problems during the allergy high season.
The dilemma for such unfortunates is that they’ve heard all the war stories of the misery from ‘that horrible packing’. They have heard the unhappy reports of the dry, sore throat and the anxiety that comes with 100% nose passage blockage – worse than any cold and allergy attack”, says Kotler who has written two category best-seller books for the public and one medical textbook.
“Because of all the bad press, the afflicted just soldier on with nose sprays, pills, anti-histamines, homeopathic drugs and even acupuncture hoping that somehow their nasal passages will, someday, miraculously, just open up.
Unfortunately, some noses will never work well until they are fixed. After all, broken noses cannot be repaired with a pill. The operation is an hour or so, performed in an outpatient surgery center or even properly accredited surgeon’s office operating facility. At that time, the internal nasal passages are opened; akin to widening a two-lane highway to a four-lane highway. That’s the ‘inside operation’, the nasal septoplasty and turbinate resection. If desired, cosmetic rhinoplasty – the ‘outside operation’ – can be done at the same time.
Frankly, I am surprised it took me nearly 30 years for the light-bulb to switch on for me to invent a device that delivers patient comfort which seemed to have been forgotten about in our zeal to develop new technology and better surgical techniques. Think of putting a soft, drinking straw along the floor of the nose and you have the idea. The soft silicone plastic tube allows air to pass through the channel nature intended it to, for one to five days after surgery. Takes away a huge negative that has long plagued the procedure.
What inspired me to get to the workbench and devise something better for patients was a single patient. The young man was very displeased with the appearance of his nose and the still-blocked air passages after nasal surgery, elsewhere, years earlier. While I told him I could give him good breathing and a nose that he wanted, he refused surgery stating ‘If I have to have that (expletive deleted) packing, no way. I am out of here’.
That frank statement had told me we needed to create something better for our patients.
That patient, Todd, was the first patient to have the system installed. It worked perfectly and from that first case, we knew we had struck ‘patient comfort gold.’”
Below, Todd shares his experience with you:
I put off having nasal revision surgery for 7 years because the nasal packing from my first surgery was such a bad experience. The cotton packing in my nose did not allow me to breathe which caused me extreme anxiety.
I sat up the first night after surgery because I could not breathe when I lay down. My mother sat with me the entire day and night until the packing was removed. I could not eat food or drink because the pressure in my ears was so bad that I felt I wanted to pull the packing out of my nose.
I heard about the nasal splints and told Dr. Kotler who then showed me the alternative of using nasal tubes.
Dr. Kotler demonstrated how the nasal tubes worked and assured me that air would pass through allowing me to breathe air.
After surgery, I went to an aftercare facility where my mother was amazed to see me eating a full meal two hours after surgery, drinking liquids, being mentally comfortable and looking relaxed compared to my first experience of wanting the packing taken out ever minute.
The nasal tubes are the only way to go!
TLR
Here are some photos and sketches to help you visualize and understand this
practical and safe product. It is made of FDA-standard soft, medical grade silicone plastic. The same material used in artificial joints and replacement heart valves.
The device is placed by Dr. Kotler at the very end of the operation. It is quickly and easily removed in the office using a liquid anesthetic dribbled into the nose to make it virtually painless.
Assorted views of nasal airway tube
Sketch of the tube nested inside the nasal passages and the painless home irrigation to relieve any clogging by mucous or blood
Airways in place at conclusion of operation
