Dr. Kotler’s Breakthrough Invention Revolutionizes Nasal and Sinus Surgery
By A. Norman Enright
“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 37 years of private practice and over 4,500 nasal cases under his belt in both his military and civilian careers. A man who knows a bit about noses.
“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 Beverly Hills’ 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.
How the Kotler Nasal Airway was Developed
Frankly, I am surprised it took me nearly 30 years for the lightbulb 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. For four or five days after surgery, the soft silicone plastic tube allows air to pass through the channel nature intended it to. This 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. A young man was very displeased with the appearance of his nose and the still-blocked air passages after nasal surgery performed 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.
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.
Patient home care instructions
Your surgeon has placed, inside your nasal passages, a double-tube airway. This device allows normal breathing after nose and/or sinus surgery, even if your nose has been “packed”.
To keep the two airway tubes open, you will take home a small syringe and plastic tip. You, or your caretaker, can easily and painlessly flush the tubes to clear any blood or mucus that may accumulate. Your recovery room nurse will attach the tip to the syringe and demonstrate, to you and your caretaker, how to flush the tubes.
Use 1 or 2 cc of room temperature tap water to irrigate the tubes. The water will pass into the throat and can either be swallowed or spit out. The flushing schedule is every 4 hours the day of surgery and once during that first night. For the second day, and beyond, generally, 2-3 flushes during the day are adequate. If you cannot clear the tubes, call your surgeon for further instructions.
The airway will be removed by your surgeon, in his office, in accordance with his particular post-operative timetable. The device is made of soft, latex-free, medical grade silicone that does not stick to the inside of the nose. Therefore, removal is quick and virtually painless.
If you have any questions, contact your surgeon.