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Breathe Free

Nov 15, 2021, 17:05 PM by GoodHealth Magazine

Sansum Clinic’s ENT Department Enhances Patient Care with New Treatment

Take a deep breath through your nose and mouth. Let it out. Listen to the sounds around you. Smell the air. Make a vocal sound. We may sometimes take these abilities for granted. But people of all ages can develop conditions that affect

ENT Providers

normal functioning of the ears, nose and throat. Medical conditions that affect these areas impact the quality of life for patients and for those around them. An otolaryngologist, also known as an ear, nose and throat doctor or ENT, treats these conditions. Many common disorders can be successfully treated in the office or in outpatient surgery facilities without hospitalization or general anesthesia.

Rabindra A. Braganza, MD, FACS has been practicing as an ENT doctor at Sansum Clinic since 1992. Dr. Braganza and a team of physicians, audiologists and staff provide patient care at the ENT/Otolaryngology Department and at Sansum Clinic Foothill Surgery Center at Sansum Clinic in Santa Barbara.

Dr. Braganza and his family immigrated to the United States from Goa, India when he was 11. At age 18, a return trip to India to visit his grandfather who was a doctor there shifted his focus from engineering to medicine. “I had been accepted into the college of engineering at U.C. Berkeley,” he says. “I was interested in knowing how mechanical things work. But as I browsed through my grandfather’s medical books, I felt it would be much more interesting to learn how human physiology and biology work. That motivated me to shift my educational path.”

A double major in biochemistry and psychology at Berkeley, he graduated with highest honors. In his first year, the intricate anatomy of the head and neck got him interested in ENT. Later at medical school, Dr. Braganza learned about different specialties. When he did his clinical rotation in otolaryngology, he saw the wide range of patients who were helped by ENT specialists, which further motivated him to become an ENT surgeon.

Dr. Braganza estimates that he has performed more than 9,000 surgeries in his career. New techniques and technological advances improve outcomes and help surgeons provide minimally invasive approaches to treatment. “We treat children and adults for a wide variety of conditions,” he says. “In pediatrics, we treat chronic ear infections with ear tubes and perform tonsillectomies and adenoidectomies when they are blocking a child’s airway or causing recurrent infections. We also treat a lot of surfers’ ears where cold water and cold air cause bony growths known as exostoses that block the pathway of the ear canal. We drill those off using a microsurgical drill under an operating microscope to restore the normal ear canal. This prevents water trapping and recurrent infections.”

The doctors at the ENT department also treat tumors of the head and neck, which can be life threatening if cancerous. Many of those require a surgical procedure such as a biopsy or removal of a cancerous growth to initiate treatment. They work closely with colleagues at the Ridley-Tree Cancer Center as patients may have to go on to receive chemotherapy or radiation therapy.

New Techniques Improve Outcomes Chronic Nasal Congestion

Sinusitis and allergic rhinitis involve inflammation of the mucous membranes that line the sinuses, and are among the most common conditions for which people see their primary care doctors. Most people have experienced these conditions, and know them as chronic nasal congestion, post-nasal drip, or simply a chronically runny nose. Nasal congestion is commonly caused by allergies, but there are non-allergic causes as well. Exposure to cigarette smoke, perfumes, fuel fumes, and other irritants can cause a runny nose, sneezing, and other symptoms. Allergy testing in those situations would show negative results, despite symptoms.

New technologies vastly improve today’s treatment options for chronic nasal congestion. “We have benefitted from a new technique called image-guided surgery,” Dr. Braganza explains. “The sinuses are located between the eyes and the brain and are operated on with an endoscope. These days a high-resolution CT scan performed on the patient prior to surgery and used during surgery with a tracker device tells us exactly where the bony partitions that separate the eye and the brain from the sinuses are located. It allows us to perform more complete sinus surgeries with a greater margin of safety.”

Other technological advances in the treatment of nasal congestion and drainage include radio frequency (RF) therapy and cryotherapy. With RF therapy, surgeons use heat generated by RF to shrink the tissues in the nose to open breathing pathways. RF is similar to microwave energy, but in a different area of the electromagnetic spectrum. RF therapy can also be used to ablate or block specific nerves along the brain/nose communication pathway to stop signals that generate mucus production. This can also be performed with cryosurgery, which uses very cold temperatures to zap the target nerves and change the communication pathways so less mucus is produced. Success rates for these new techniques are generally high, with approximately two-thirds of patients experiencing significant benefits.

Dr. Braganza says these procedures can often be done in the office, depending on the specifics of the patient’s anatomy. “Since the COVID-19 pandemic, we have moved more procedures into our office setting, with all the proper precautions,” he explains. “Because of the pandemic, many operating rooms were shut down for months. For many procedures, patients don’t necessarily have to go to a hospital operating room or undergo general anesthesia. This is more cost effective for the patients, and they can get back to their usual activities within a few days.”


Snoring is another common disorder that can be treated with an in-office procedure. “This is a surgery that has a very high success rate for improving the quality of life for a patient and also for the people around them,” Dr. Braganza says. “Patients thank us because they can return to sleeping in the same bed with their partner and both can get a good night’s rest.”

Snoring surgery is focused on the soft palate and the uvula. “Patients must be selected appropriately,” Braganza continues. “Most snoring comes from the palate and uvula, the flimsy narrow piece of soft tissue that hangs at the back of the throat. Under local anesthesia, we use a carbon dioxide laser to make cuts that decrease the size of the uvula and create cuts in the soft palate that generate beneficial scarring to stiffen the palate. For properly selected patients, we get about an eighty-five percent success rate from this technique."

Balloon Sinuplasty

Patients diagnosed with chronic sinusitis may be candidates for balloon sinuplasty, an innovative procedure used for the treatment of blocked sinuses. Balloon sinuplasty does not require incisions or the removal of bone and tissue. “A medical balloon is used to dilate the opening between certain sinuses and the nose to allow the sinuses to drain better,” Dr. Braganza explains. “In selected patients it may be done as an office procedure in an outpatient setting, using local anesthesia. However it can’t be used in all the sinuses nor is it used if there are polyps.” The success rate for this procedure is similar to that of traditional endoscopic sinus surgery that is performed in an operating room


Photo caption: Dr. Andrew Mester, Dr. Ashley Dunn and Dr. Rabindra Braganza