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Medical Forum / Diseases and Disorders / Sinusitis / September 2005New treatment option for chronic sinusitis
I'd like to hear comments on this one... http://www.news-medical.net/?id=13333 >I'd like to hear comments on this one... > >http://www.news-medical.net/?id=13333 Bolger used to be at U. Penn and has often done surgery with Dr. Kennedy. I think he helped Dr. Keneedy with my surgery. Anything he does is going to be fine if he does it himself. I would let him do it, but not someone else who is inexperienced with the ballon technique. until it is better proven. He is one of the owners of Acclarant. Also if the doctors at U. Penn (especially David ennedy) have not picked up on it, there may be a reason why. >> I'd like to hear comments on this one... >> [quoted text clipped - 11 lines] > Also if the doctors at U. Penn (especially David ennedy) have not picked up on > it, there may be a reason why. I don't understand it. What do they do, just expand the balloon then remove it? What keeps the tissue from moving right back when the balloon is removed? >I don't understand it. What do they do, just expand the balloon then >remove it? I think so. >Wat keeps the tissue from moving right back when the >balloon is removed? Maybe it does move back - perhaps someone else knows. At least it allows momentary drainage, whcih is all they seem to refer to. There have been other appraoches along this line too (e.g the Yakik catheter http://app.american-rhinologic.org/programs/ARS-Fall-2001-program.pdf If all it is for is to allow momentary drainage, it may not really amount to much Irrigation might be as effective in most cases..... I can't understand why the sinus doesn't close back up after the balloon is removed. Do they put a stent in the sinus to keep it open (like what they do for heart patients)?--r3 >I can't understand why the sinus doesn't close back up after the >balloon is removed. It probably does. They say that the procedure is to allow *drainage" of infected fluid (preumably on a one-time basis).. Maybe once that occurs, the ostia will open up on their own. It doesn;t say anything about long-term results. >Do they put a stent in the sinus to keep it open >(like what they do for heart patients)?--r3 >>I don't understand it. What do they do, just expand the balloon then >>remove it? [quoted text clipped - 6 lines] > Maybe it does move back - perhaps someone else knows. At least it allows > momentary drainage, whcih is all they seem to refer to. I had an infected pus-filled mucocele in an ethmoid sinus. The sinus itself wasn't blocked but the mucocele contained pus and had to be removed. This procedure doesn't sound like it would have done anything for me.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > >I'd like to hear comments on this one... > > [quoted text clipped - 6 lines] > do it, but not someone else who is inexperienced with the ballon technique. > until it is better proven. I wouldn't let anyone do it to me now. Too new. Probably no insurance covers it yet either. > He is one of the owners of Acclarant. I'm a little concerned about that, doctors having financial interests in a certain procedure or product. (Same with Dr. Vaughan, a very prominent ENT, head of the department at Stanford.) If a doctor has a financial interest in equipment for a particular procedure--if he recommends to his patients that they have that procedure, his opinion cannot be taken objectively, as it should be taken, because he has a financial interest in promoting that procedure. (Not just the money he would make from performing it as a doctor, which of course is always the case, but a financial stake in promoting that particular procedure.) Also, if he recommends that procedure to other doctors at professional conventions, etc., no one would know how they should take his recommendation, or the results of his research, since he is part owner of the corporation making the equipment for that procedure. There will always be some suspicion of his motives in recommending it, of the research results, etc. I would suggest that physicians find other ways to invest their money, so as not to create a perceived (or real) conflict of interest in their promotion of a particular procedure. So I find this trend, of doctors investing in products in their own specialty, to be rather troubling, as it could erode patients confidence in doctor's treatment recommendations. (I believe I have also seen Dr. Vaughan's name associated with SinuNeb.) > Also if the doctors at U. Penn (especially David ennedy) have not picked up on > it, there may be a reason why. Well. there's an obvious reason to that--it's still very new. No doctor can be on top of every new experiment or procedure. If it proves with time to be successful and valuable, he would quite likely "pick up on it" in the future. Don Brady wrote: > > He is one of the owners of Acclarant. > I'm a little concerned about that, doctors having financial interests in a > certain procedure or product. (Same with Dr. Vaughan, a very prominent ENT, [quoted text clipped - 17 lines] > patients confidence in doctor's treatment recommendations. (I believe I have > also seen Dr. Vaughan's name associated with SinuNeb.) I'll take that (partially) back. I guess I was following up on Don's comment. I just looked at the Acclarant web site. Neither Dr. Bolger nor Dr. Vaughan are listed under "Board of Directors" or "Management Team". (Where did you get that Dr. Bolger was one of the "owners" of Acclarant, Don?) (Of course they could quite possibly own stock in it, which we don't know about.) They are however, both listed under "Scientific Advisory Board". That isn't really the same as being an "owner". It could be a gray area though. Of course the company would like experts in the field to be advisors. If they pay those doctors to be on that board, however, that in itself creates a conflict of interest, whether real or only perceived. (I don't really know how such boards work though.) (Money can certainly be a corrupting influence, as it is in politics. Politicians are wined and dined by lobbyists, given all kinds of expensive gifts, of course the corporations want something in return for these expenditures. If something similar is occurring in medicine, that is more troubling. (No one trusts politicians anyhow. But if one cannot trust one's doctor, with the suspicion he or she might be making a recommendation based on a financial stake in a product, that is rather scary. Or similarly, if doctors cannot trust each other's recommendations and research at professional gatherings, in literature, etc., due to suspicion that the recommendation is being made for financial reasons, that also could be very damaging to the whole field of medicine.) I think doctors should be very careful about that, to avoid anything that could possibly even give anyone the slightest suspicion of a financial stake in recommending something. >I'll take that (partially) back. I guess I was following up on Don's >comment. I just looked at the Acclarant web site. Neither Dr. Bolger nor Dr. >Vaughan are listed under "Board of Directors" or "Management Team". (Where >did you get that Dr. Bolger was one of the "owners" of Acclarant, Don?) "The following faculty/presenters have indicated these disclosures: William Bolger, MD - The authors serve as members of the Scientific Advisory Board for and have an equity holding in Acclarent Inc., the company that developed the devices studied and reported in the presentation." http://app.american-rhinologic.org/programs/2005ARSAnnualProgram080905.pdf > >I'll take that (partially) back. I guess I was following up on Don's > >comment. I just looked at the Acclarant web site. Neither Dr. Bolger nor Dr. [quoted text clipped - 9 lines] > reported in the presentation." > http://app.american-rhinologic.org/programs/2005ARSAnnualProgram080905.pdf OK. The web site says he is on the advisory board, but this also says he has an equity holding. (Of course, that could mean just a few shares of stock, or he could own a major chunk of the company.) Good at least that this was disclosed at the presentation, so the medical professionals at the conference would know he had a financial stake in promoting the product. I wouldn't be surprised if this sometimes happens without such a disclosure. In any case, I think this is a troubling trend, all too common these days. I think doctors should find other ways to invest their money, than in products that they recommend for use in their specialty. Even though a doctor might be completely sincere in recommending that product and procedure, a financial stake in that product creates a cloud over that recommendation, and makes it look like less than a totally objective medical opinion. (And such a financial stake could even unconsciously affect a doctor's recommendation for that product, even if consciously he thinks it has no effect on his statements.) > The web site says he is on the advisory board, but this also says he > has an equity holding. (Of course, that could mean just a few shares > of stock, or he could own a major chunk of the company.) [ . . .] > In any case, I think this is a troubling trend, all too common these > days. I think doctors should find other ways to invest their money, [quoted text clipped - 3 lines] > product creates a cloud over that recommendation, and makes it look > like less than a totally objective medical opinion. In most of the cases you're referring to, some of the doctors will likely be the inventors of the technology and hold the patents. In that case they will have an interest in the success of the new method even if they hold no equity in the company that markets it. You might not like this system, but who besides doctors would develop new medical technologies? And doesn't allowing inventors to profit from their creations encourage innovation? SignatureAlison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Predators fail often; prey fail only once. -- Tom Evslin > I'd like to hear comments on this one... > > http://www.news-medical.net/?id=13333 Looks interesting. Of course still very new and untested. It might take years before we know more about it. I'm not sure whether it is supposed to replace surgery, in some cases perhaps an adjunct to surgery, or whether it is considered a type of surgery itself. (If "no tissue is removed", it couldn't be considered "surgery", could it?) I doubt it could completely replace surgery for all patients being considered for surgery, as some might need actual surgery. But if it helps some who might otherwise need surgery to recover without it, that would be great. I think most of us who have had sinus surgery see that it is certainly no panacea, that it can have negative effects as well. In my case, for instance, after having had a couple of sinus surgeries (actually, I think 4, but the first two were only turbinates, the 3rd and 4th sinus, turbinate, and septum), there is certainly not the same kind of blockage I would get before, where sometimes I could not breathe through my nose at all, as it felt as if it was sewn shut. (When in that condition, the only thing that would help at all was Afrin.) After the surgeries, that has improved. However, my rhinitis, which has always been bad, is now worse than it has ever been-always filled with huge quantities of extremely thick mucus. (Anyone else noticed that mucus production has been worse since surgery?) (And, as mentioned in another thread, the septoplasty that was performed in my third surgery created a septal perforation!) It's not at all clear whether there is any permanence in the effects of this balloon procedure, or whether the cited results are temporary. Time will tell. It will probably take several years before we know more about it, before it becomes more widespread, etc. > I'd like to hear comments on this one... > > http://www.news-medical.net/?id=13333 From the description, it sounds like it would *NEVER* have worked for me. I had a pus-filled mucocele that had to be removed. The pus was inside the mucocele, which in turn was inside the sinus cavity. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. |
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