December 18, 2014
Visitor Restrictions Related to Influenza Enforced at BDHS
Effective Thursday, December 18, 2014, visitor restrictions at Bozeman Deaconess Hospital are in effect due to the influenza virus. Children under the age of 18 are asked not to visit the hospital, as they are most susceptible to this virus. Children are, however, allowed in physician clinics on the Highland Health...
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October 21, 2014
National Study: Bozeman Deaconess Health Services Named America’s 100 Best for Pulmonary Care
Bozeman Deaconess announced today that it has been recognized by Healthgrades as one of America’s 100 Best Hospitals for Pulmonary Care. Healthgrades, a leading online resource helping consumers compare physicians, hospitals and care, evaluated nearly 4,500 hospitals nationwide for 33 of the most common inpatient procedures and conditions and identified the...
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September 12, 2014
Bozeman Deaconess Hospital re-verified as Trauma Center by American College of Surgeons
Bozeman Deaconess Hospital (BDH) has been re-verified as a Level III Trauma Center by the Verification Review Committee, an ad hoc committee of the Committee on Trauma of the American College of Surgeons. This achievement recognizes the trauma center's dedication to providing optimal care for injured patients. In a recent review of...
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August 21, 2014
Notice Regarding Unwanted Solicitation Calls Appearing to Originate from BDHS
Recently individuals throughout the U.S. have been receiving unwanted calls soliciting personal and financial information from phone numbers associated with the Montana area code (406). Caller ID spoofing is a malicious technique where a caller masquerades as someone else by falsifying the number that appears on the recipient's caller ID. Some...
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August 13, 2014
Free and Reduced Cost Health Screenings Coming to Big Sky
Annual Health Screening Day serves adults The annual Bozeman Deaconess Health Screening Day in Big Sky is coming on Thursday, August 28, from 8 am to 1 pm. Free screenings available will include blood pressure, body mass, glucose and bone density, along with other health education materials. Additionally, reduced-cost lab work will...
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August 4, 2014
Say Hello to our New Physicians
We would like to welcome Drs. Zachary Meyers and Holly Omar, who are now seeing patients at Bozeman Deaconess Health Group. Zachary Meyers, MD, joins Bozeman Deaconess Family Medicine. Dr. Meyers graduated from Oregon Health & Science University in Portland and completed his internship and residency at Montana Family Medicine Residency...
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July 25, 2014
Dr. John Patterson is retiring!
Happy Retirement Dr. Patterson! After 39 years, Dr. John Patterson is retiring as Bozeman Deaconess Health Services medical staff's longest serving physician. Please help us wish him well! Please Join Us! Tuesday, July 29 :: 5 pm—7 pm Bozeman Deaconess Atrium :: 915 Highland Blvd.
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June 26, 2014
Bozeman Deaconess Named One of 100 Great Community Hospitals
Bozeman Deaconess Hospital has been named of the nation’s “100 Great Community Hospitals” by Becker’s Hospital Review, based on the hospital’s accolades, quality of care, and services provided to patients. Hospitals named to the list all have fewer than 550 beds and minimal teaching programs, and many are located in rural areas....
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June 26, 2014
The Buzz About Autoimmune Disease by Dr. Melissa Reily
“Autoimmune disease” is a buzz word these days, but are you left wondering what it’s all about? Have you thought you might have an autoimmune disease? Or, have you been diagnosed and wondering about treatment options? Melissa Reily, MD, of Bozeman Deaconess Rheumatology will discuss what constitutes an autoimmune disease, common...
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May 14, 2014
New Guidelines for Hypertension
When uncontrolled or poorly controlled, hypertension, or high blood pressure, can lead to heart attacks, strokes and chronic kidney disease. Dr. Gerald Groggel of Bozeman Deaconess Nephrology will explain the new treatment guidelines for hypertension, how it alters treatment options and what that could mean for your health. Thursday, May 15, 2014 5:30 pm Bitterroot...
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May 7, 2014
Spring Into Good Health with Weight Loss Strategies
If you're ready for weight loss strategies that work, join physicians Todd Harris, DO, and Melissa Wolf, MD for a great discussion on lifestyle strategies for weight loss and long-term weight maintenance. Well discuss individualized weight loss plans that can be customized just for you and answer your weight loss questions. Come...
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April 17, 2014
Advanced Care Planning for Serious Illness
Advance Care Planning is an important part of your health care experience. Dr. Kathryn Borgenicht of Bozeman Deaconess Internal Medicine Associates and staff from Bozeman Deaconess Palliative Care and Spiritual Care will talk about advanced care planning and the new POLST forms that went into effect on March 1, 2014. There will...
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March 25, 2014
Montana Chapter of the American Academy of Pediatrics Award
The Montana Chapter of the American Academy of Pediatrics (AAP) recently was selected as the winner of the AAP 2014 Outstanding Small Chapter Award at the annual meeting in Chicago. “This is a really great accomplishment for our chapter,” said vice president of MT AAP Pepper Henyon, MD, of Bozeman Deaconess Pediatrics....
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March 24, 2014
Annual Health Screening Day at Bozeman Deaconess Health Services this Saturday
As part of its mission “To improve community health and quality of life,” Bozeman Deaconess Health Services once again is holding its annual Health Screening Day on Saturday, March 29, from 7 am-1 pm, offering free and reduced price health screening and wellness tips for the whole family. Many of the...
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March 5, 2014
Bozeman Deaconess Hospital Named One of the Nation's 100 Top Hospitals
Bozeman Deaconess Hospital was named one of the nation’s 100 Top Hospitals® by Truven Health AnalyticsTM, a leading provider of information and solutions to improve the cost and quality of healthcare. Bozeman Deaconess Hospital is one of only 20 hospitals to earn this award in the Small Community Hospital category out...
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February 5, 2014
Gallatin Heart Rescue Celebrates Successes of Unsung Heroes Performing Hands Only CPR
What began two years ago as a local effort to help heart attack victims survive while waiting for medical attention has grown into a state-wide program in which 12,000 individuals have been taught to perform the life-saving technique of Hands Only CPR. Gallatin Heart Rescue (GHR) will celebrate its second anniversary on...
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February 4, 2014
A Day for Us: Workshops for Women hosted by Bozeman Deaconess Womens Center
Taking care of family, work and community takes a lot of a womans time. Every woman deserves to stop occasionally to take care of herself. In 2014, women of all ages will have four opportunities to take a Saturday morning off, just for themselves, at A Day for Us: Workshops for...
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January 13, 2014
The Weight of the Nation
In the United States, 68 percent of adults age 20 and older are overweight or obese, while 31.7% of the nation’s children and adolescents ages two to 19 are overweight or obese. Obesity contributes to five of the 10 leading causes of death in America, including heart disease, type 2 diabetes,...
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January 9, 2014
New Bozeman Deaconess Health Group VP
Chris Darnell left sunny South Carolina to become the new Bozeman Deaconess Health Group vice president during the coldest week yet of winter, but the weather hasn’t chilled his enthusiasm for the new job. “Everyone has been so warm in welcoming me,” Darnell said. “I am impressed with the talent, teamwork and...
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December 4, 2013
Visitor Restrictions Related to Influenza Enforced at Bozeman Deaconess Hospital
Effective Wednesday, December 4, visitor restrictions at Bozeman Deaconess Hospital are in effect due to the influenza virus. Children under the age of 18 are asked not to visit the hospital, as they are most susceptible to this virus. Children are, however, allowed in physician clinics on the Highland Health Park/Bozeman...
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November 26, 2013
New Medical Office Building in the Works
Bozeman Deaconess Health Services is expanding its facilities due to increases in providers and staff and demand for their services. A new medical office building, Highland Park 5, will be built directly south of Highland Park 2, and will consist of 50,000 square feet in three stories to house existing and new...
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October 25, 2013
Bozeman Deaconess Earns Top Award For Quality
Bozeman Deaconess Health Services has earned the Quality Achievement Award from Mountain-Pacific Quality Health for the sixth year in a row. BDHS was one of only three hospitals in the state to win Mountain-Pacific’s highest award this year. “This honor recognizes the continuous commitment of all our employees and medical staff to...
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October 23, 2013
Bozeman Deaconess Health Services Recognized By Healthgrades
Bozeman Deaconess Health Services today announced that it has received the Healthgrades Pulmonary Care Excellence Award for 2014 and has been recognized by Healthgrades for clinical excellence in Orthopedic, Pulmonary and Gastrointestinal Care. Bozeman Deaconess is currently the only hospital in Montana to receive the2013 Healthgrades Outstanding Patient Experience Award. Bozeman Deaconess...
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October 11, 2013
MJ Murdock Charitable Trust Grants $250,000 to Bozeman Deaconess Cancer Center
Bozeman Deaconess Foundation is proud to announce the approval of a $250,000 top-off grant from the MJ Murdock Charitable Trust of Vancouver, WA to expand radiation oncology services at Bozeman Deaconess Cancer Center. This grant is designated toward the special vault which will house the new, state-of-art Linear Accelerator. ...
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October 9, 2013
Bozeman Deaconess Health Services Offers Mammo Day
To mark National Breast Cancer Awareness Month, Bozeman Deaconess Health Services is designating October 17th as Mammo Day to promote the importance of getting regular mammograms. Mammograms can identify breast cancer in its earliest stages, when chances of successful treatment are greatest. Mammo Day stations will be located throughout the Bozeman...
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October 7, 2013
Bozeman Deaconess Celebrates Women
Busy women often don’t take the time to take care of themselves. To change that, Bozeman Deaconess Women’s Center is encouraging women to take the morning or afternoon of Saturday, October 12, and participate in a new women’s wellness day, All About Women, in the BDHS conference rooms. “Our goal is to...
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June 26, 2013
Bozeman Deaconess Earns Five-Star Rating for Community Value
Bozeman Deaconess Hospital has earned a 2013 Five-Star Award for Community Value for scoring in the top 20% among more than 1400 similar hospitals nationwide in an evaluation by Cleverley + Associates, a leading healthcare financial consulting firm. The Community Value Index, created in 2003 to provide a measure of the...
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June 12, 2013
Rheumatoid Arthritis Support Group
Patients suffering from rheumatoid arthritis can join a new support group at Bozeman Deaconess Health Services. Meetings will be held once every quarter, beginning Wednesday, June 12.
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June 6, 2013
A warm welcome to Family Practice Associates
FAMILY PRACTICE ASSOCIATES JOINS BOZEMAN DEACONESS HEALTH GROUP ON JUNE 1. Welcome to the physicians and staff of Family Practice Associates. Doctors Peder Anderson, Tracy Fairbanks, Thomas Hildner, Cathy Grace, Colette Kirchhoff, and Luke Omohundro and their staff have served the Gallatin Valley for over 30 years and will continue to provide...
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May 16, 2013
Osteoporosis Screening, Prevention and Treatment by Melissa Reily, MD
Osteoporosis is a silent disease. Its important to know the risks and when to be screened for this disease. Medications are sometimes indicated, and lifestyle changes can reduce ones risk. Dr. Melissa Reily of Bozeman Deaconess Rheumatology will review the latest recommendations for screening, treatment, and prevention of osteoporosis. Join Dr. Reily...
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May 15, 2013
Bozeman Deaconess Earns STAR Program Certification
Today, Bozeman Deaconess Health Services announced it has earned its STAR Program Certification from Oncology Rehab Partners, leading experts in the field of survivorship care. By becoming STAR Program Certified, Bozeman Deaconess Rehabilitation Services is recognized as offering excellent cancer rehabilitation services to its patients who suffer from debilitating side effects...
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May 6, 2013
Skin Cancer Prevention
Summer is coming and the tendency is to shed some layers and feel the sunshine. Its warmth can boost our spirits, but remember, it comes with a dangerous trade-off. The Skin Cancer Foundation recommends using a sunscreen SPF 15 or higher along with these other prevention tips: • Do not let your...
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April 10, 2013
Bozeman Deaconess Hospital among the Top 15% in the Nation
Today, Bozeman Deaconess Hospital announced it has been named one of a select group of hospitals identified as providing outstanding performance in the delivery of a positive experience for patients during their hospital stay, as measured by Healthgrades, the leading online resource that helps consumers search, evaluate, compare and connect with...
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March 29, 2013
Bozeman Deaconess Turns Blue in April for Autism Awareness
Nearly one child in 90 in the United States has been identified with an autism spectrum disorder according to estimates from the Center for Disease Control’s Autism and Developmental Disabilities Monitoring (ADDM) Network. Autism spectrum disorder affects more than two million people in this country and is almost five times more...
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January 4, 2013
New Emergency Department Set to Open at Bozeman Deaconess
Phase II of the expansion and remodel of Bozeman Deaconess Health Services Emergency Services Department is complete and ready to open. Before the first patients arrive, however, members of the public are invited to see how their generous contributions helped create this state-of-the-art facility. A community open house will be held on...
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November 30, 2012
CNOR Strong and Growing Stronger
Operating room nurses can make all the difference to a patient undergoing surgery, so Bozeman Deaconess Health Services is pleased to announce it has earned the CNOR® Strong designation from the Competency & Credentialing Institute (CCI). The CNOR Strong designation is given to facilities in which at least 50% of its...
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September 4, 2012
Wildfires Effects on Breathing

“The decrease in ambient air quality associated with the wildfires in our mountains has brought on runny noses, coughing and eye irritation in many people in our community,” says Anders Persson, PHD, MD, of Bozeman Deaconess Pulmonary Disease/Critical Care. “The smoke can induce bronchospasm in people with asthma or COPD, making

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September 4, 2012
Bozeman Deaconess Foundation’s Historic Cornerstone Campaign Exceeds $9 Million Goal
Four years ago, Bozeman Deaconess Foundation (BDF) began the process of organizing an ambitious capital campaign in support of a new, expanded Emergency Services Department. Today the foundation announced that the campaign has exceeded its $9 million goal, successfully concluding the most significant fundraising effort in the 101 year history of...
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August 1, 2012
Bozeman Deaconess Board of Trustees Announces Davidson as Interim CEO
Today the Board of Trustees of Bozeman Deaconess Health Services announced that Gordon Davidson has been appointed interim CEO of the organization. Davidson has held the position of Chief Financial Officer of BDHS for 25 years and previously served as the organization’s interim CEO during an executive search phase in the...
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July 19, 2012
Bozeman Deaconess Awarded an “A” for Patient Safety by Hospital Safety Score
Bozeman Deaconess Health Services was honored with an “A” Hospital Safety Score by The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits. The Hospital Safety Score was calculated using publicly available data on patient injuries, medical and medication errors, and infections. U.S. hospitals...
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July 9, 2012
Phase I of Emergency Department Opens July 10
Walls are up, floors are finished, equipment is in place. Phase I of the newly constructed Bozeman Deaconess Emergency Department is ready to receive patients in 19 state-of-the-art examination rooms, most of which are dedicated to specific medical needs. “With the new Emergency Department, we can deliver better care through increased efficiency,”...
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June 25, 2012
Bozeman Deaconess To Recognize Extraordinary Nurses
Nurses at Bozeman Deaconess Hospital are being honored with The DAISY Award for Extraordinary Nurses. The award is part of the DAISY Foundation's program to recognize the super-human efforts nurses perform every day. The first award recipients are Anna Dennis, LVN, and Janie Sukut, RN, both of whom were nominated by a...
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June 1, 2011
Memo to Men: To Live Longer, Take Better Care of Your Body
As a general rule, men take lousy care of their health. They shrug off injuries. They hate going to the doctor for anything. They pay little heed to warning signs for major health issues. And the results of all that manliness are evident in the statistics. According to the U.S. Department of Health...
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As a patient of Bozeman Deaconess Health Group, you can now access important information in your medical record, request an appointment, and communicate with your medical office team online, with the click of a button, anytime of the day or night.
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Ear, Nose, Throat (Otolaryngology)


Things that make allergies or asthma worse are called triggers. Dr. Hetherington at Bozeman Deaconess Ear, Nose & Throat can help with all types of allergies including seasonal allergies,...


Respiratory allergies affect approximately 20 percent of the population. They can contribute to many other disorders of the ears, nose, throat and respiratory system. Symptoms can include: Nasal drainage, usually clear Stuffy nose Sneezing Watery, itchy eyes Chronic cough Headache Asthma Ear infections What causes allergies? Airborne pollens produced by trees, grasses, and weeds usually cause seasonal hayfever symptoms.  Year round symptoms can be caused by pets, dust and insects such as cockroaches and dust mites.  Molds are frequently an under recognized and therefore under treated source of allergies.  Recent studies have demonstrated that even low level mold allergies may be a significant cause of chronic sinus disorders.Allergies are caused by tiny particles called antigens which react with our immune systems.  Antigens are found on pollens, pet dander, dust, molds and other substances.  The immune system may react by producing a variety of antibodies.  IgE antibodies are the most relevant to allergies.  In allergy, an abnormal quantity of IgE antibodies are produced in response to common antigens.  This results in an abnormally reactive immune system.  When an antigen attaches to an IgE antibody, inflammatory mediators are released.  These inflammatory mediators cause localized reactions such as swelling, irritation, inflammation and wheezing.  If the allergic reaction is severe enough, life threatening systemic anaphylactic reactions can occur which require immediate medical attention.Treatment options:AvoidanceAntihistaminesNasal SpraysLeukotriene InhibitorsImmunotherapyTypes of tests for allergies include:Prick testingIntradermal testingSkin endpoint titration (SET)Blood testing
Ear Infections
Ear infections commonly occur in either the middle ear or in the ear canal. Otitis Media The middle ear is located behind the eardrum and contains a chain of tiny bones which connects the eardrum to the inner ear. This space normally contains air. The presence of fluid can interfere with hearing. Middle ear infections are very common in small children. The peak incidences are at ages 2 and 5 years. The air containing middle ear space is ventilated by the eustachian tube. The eustachian tube connects the middle ear with the throat. Its function is to ventilate the middles ear space and equalize the pressure with the outside. When this tube is obsructed, a vacuum develops in the middle ear. The vacuum is then replaced by fluid. This fluid frequently interferes with hearing. The fluid also may become infected. If the infection is not treated, the eardrum will usually rupture, thus allowing the ear to drain. Once the pus drains, the immune system will usually resolve the infection. Occasionally, complications such as facial paralysis, neck abscess or even brain abscess may result from untreated infections. Most middle ear infections are treated with antibiotics. If the infections are frequent or if fluid does not clear from the middle ear after an infection and interferes with hearing, placement of tubes may be considered. In children this operation is done under a light general anesthesia. In adults, it is frequently done as an office procedure under local anesthesia. An incision is made in the eardrum and a small tube is inserted into the incision. Without the tube, the eardrum would heal within a day or two. Depending on the design of the tube, it may stay in several months to several years before the eardrum heals underneath it and extrudes the tube. The tube functions to bypass the eustachian tube and ventilate the middle ear space preventing the accumulation of fluid and the ensuing infection. The tube mimics the body’s natural process of perforation of the eardrum to ventilate the middle ear and drain the infection. Otitis Externa The ear canal which extends from the opening down to the eardrum is occasionally infected. This is usually associated with the prolonged presence of moisture in the ear canal. It is more common in diabetics or in immunocompromised patients. Careful cleaning of the ear canal and antibiotic ear drops usually suffice to clear the infection
Fractures of the facial bones, diseases of the mouth.
Tumors of the thyroid and parathyroid glands, saliva-producing glands, and other neck tumors.
Allergy, sinus infection, breathing, tumors, cosmetic surgery and reconstruction, and disorders of taste and smell.
Sinusitis is a leading health care problem. It is believed to be increasing in both incidence and prevalence. It has been estimated that bacterial sinusitis complicates 0.5 to 2% of viral upper respiratory infections (colds). This translates to 20 million cases of bacterial sinusitis in the U.S. every year. The chronic form, lasting more than 12 weeks, has been estimated to affect more than 31 million individuals. This makes it the most common chronic health problem in the United States. The disease frequently presents as "the cold that won't go away."What are the sinuses? The sinuses are cavities inside the head, which are connected to the nose. They are lined with a mucus membrane. The mucus membrane has mucus glands, which secrete mucus. The mucus membrane is also covered with tiny hairs, which actively push the mucus from the sinuses into the nose through tiny openings known as ostia. The mucus contains antibodies and other infection fighting substances. It is also sticky and its function once inside the nose is to trap particles in the inspired air and thus it forms part of the nose's filtration system. What causes sinusitis? Sinusitis is caused by obstruction of the ostia. When the ostia become obstructed, the mucus backs up in the sinus. When mucus collects it easily becomes infected since there is a large variety of bacteria, which colonize a normal nose. Things, which can cause sinus outflow obstruction, include allergies, viral upper respiratory infections ("the common cold,") and non-specific nasal irritants such as dust and noxious chemicals. In addition, an individual may be predisposed to sinus infections because of anatomic obstructions such as a deviated septum or enlarged turbinates. What are the symptoms of sinusitis? Primary: * Facial pain and pressure in the sinus area * Facial congestion and fullness * Nasal or postnasal drainage, usually yellow or otherwise discolored * Nasal obstruction and blockage * Loss or reduced sense of smell * Fever Secondary: * Headache * Bad breath * Ear pain, pressure or fullness * Sore throat * General malaise or fatigue * Dental pain * Cough Any of these symptoms may be present however; it usually takes at least one primary and at least two secondary symptoms to consider the diagnosis. They may be quite severe or relatively mild and may be mainly a nuisance. In chronic sinusitis, these symptoms may be present for years. Frequently, chronic sinusitis is described as "the cold that won't go away." How is sinusitis diagnosed? The history of the disease process is the most important factor in making the diagnosis. Physical examination may reveal the presence of nasal discharge, nasal polyps, inflammation of the throat, tenderness of the sinuses and swelling of the lymph nodes in the neck. In chronic cases, nasal endoscopy (looking up the nose with a special scope) is usually performed to fully evaluate the deeper passageways of the nose and look for the presence of contributing factors such as polyps, tumors and anatomic abnormalities. Computerized tomography or CT scanning is used to define the anatomy and help determine the extent of disease. How is sinusitis treated? In most cases, a ten-day course of antibiotics will clear up a sinus infections. If the infection does not clear with a short course of antibiotics, or if the symptoms have been present a long time, a longer course of antibiotics of four to six weeks may be used. Frequently, steroid nasal sprays and systemic corticosteroids are used in conjunction with the antibiotics to reduce the inflammation and swelling in the nose and sinuses. This is frequently successful in opening up the sinus drainage pathways and restoring normal ventilation of the sinuses. Decongestants are often used for similar reasons. The key to restoring the sinuses to health is to unblock the drainage pathways. Allergies and other medical problems may contribute to recurrent and chronic sinusitis.  Appropriate testing and treatment should be pursued if allergies are suspected to be a contributing factor.   When medical treatment is unsuccessful in clearing the sinus infection or when the infections become so frequent, protracted or severe that they affect the individuals quality of life then surgical treatment is considered. Surgery is aimed at making the sinus drainage pathways larger to eliminate obstruction. Any anatomic factor, such as deviated nasal septum, which may contribute to sinus obstruction, is corrected also. Sinus surgery Sinus surgery is performed as an outpatient. The procedure is called endoscopic sinus surgery. It is technically demanding and very precise work. The surgery is performed in close proximity to the eyes, optic nerves, brain and carotid arteries. The procedure is quite safe however when performed by an experienced surgeon.  At Bozeman Deaconess Ear, Nose & Throat, we have successfully performed over a thousand sinus operations. After surgery, packs are left in the nose for a variable period of time depending on the extent of the surgery. The purpose of the packs is to control bleeding and to stent the sinus outflow passages open during the initial phase of healing. During the post-operative period, debris and crusting must be cleaned from the sinus passages. This is to prevent recurrent infection, prevent scarring with closure of the drainage pathways, and it also makes the patient more comfortable. This is performed in the office on several occasions over the initial four to six weeks after surgery. It is important to realize that sinus surgery is only part of the process to rehabilitate the sinuses. By the time most patients undergo surgery, the sinus mucus membranes have been sick a long time. Continued medical management after the surgery is very important. Underlying problems such as allergies must be treated to prevent the infections from recurring. In addition, any recurrence of the sinus infection, which occurs, must be promptly treated to prevent it from becoming chronic.
Cancer, cosmetic surgery (face lift, skin resurfacing, eyelid surgery).
Sleep Apnea & Snoring
Snoring and sleep apnea are common problems. They are both caused by excess tissue in the throat. The primary obstructed areas are the soft palate and the base of the tongue. A long palate vibrating while breathing causes most snoring. Apnea is the cessation of breathing and may be due to an obstructive cause or to a central cause. Central sleep apnea results when the brain fails to tell the body to breathe. Obstructive sleep apnea results from excess soft tissue in the palate, base of tongue, and rarely, the sides of the throat collapsing in and blocking breathing. Obstructive sleep apnea occurs in the deeper stages of sleep when the body becomes very relaxed. Both types of apnea are relieved when the oxygen concentration in the blood drops low enough that the person feels starved for air and wakes up to breath. These brief waking episodes may occur hundreds of times a night and are not usually remembered by the patient. The result is a poor night's rest. Symptoms include daytime sleepiness, morning headaches, falling asleep at the wheel, irritability and short temper, and problems with concentration and memory. There is also an association with health problems such as high blood pressure, heart attack, and stroke. Treatment Options Medical Treatment Medical treatment is generally recommended as the initial treatment for all but the most severe cases of sleep apnea. For obstructive sleep apnea, continuous positive airway pressure (CPAP) is used as the initial treatment. In this form of treatment, a mask is worn at night and a machine blows air into it. This creates pressure in the airway thus supporting the tissues and preventing blockage. CPAP is an effective treatment for those patients who tolerate it. If CPAP is not effective or if the patient does not tolerate it surgery may be considered. LAUP The laser-assisted uvulopalatoplasty is an office procedure performed under local anesthetic. It is a highly effective treatment for snoring. At this time, it does not have a role in the treatment of sleep apnea. In this procedure, excess tissue is trimmed off the soft palate and uvula with a laser. This reduces or eliminates snoring by reducing the amount of tissue, which can vibrate. This procedure is repeated in the office until the desired result is obtained. It may take from two to five treatments to alleviate the problem. The treatments are spaced 6 to 8 weeks apart. It is performed in a serial fashion to avoid taking to much palate. This increases the safety of the procedure.  In our practice, this procedure has been replaced by injection snoreplasty. Injection snoreplasty This is the latest procedure used to treat snoring.  It is performed in the office using local anesthesia and results in minimal discomfort after the procedure.  A small amount of sclerosing solution (sodium tetradecyl sulfate) is injected into the soft palate.  This causes scarring and stiffening which in turn results in less noise being produced. UPPP Uvulopalatopharyngoplasty is also an operation to trim excess tissue from the palate and also from the tonsil area. It is similar to the LAUP except that tissue is also removed from the sides of the throat. The tonsils are removed in conjunction if they are still present. This is an effective operation for snoring and is effective for obstructive sleep apnea resulting from obstruction at the level of the palate. This operation requires overnight hospitalization. Tongue base advancement In cases where collapse of the tongue base is obstructing breathing, operations may be performed to pull the tongue forward. The tongue is attached to the lower jaw in the midline just below and behind the front teeth. If this attachment is separated or loose, the tongue can flop backwards and block the airway. The genioglossus advancement is a surgical procedure designed to pull the tongue forward towards its attachment to the lower jaw.  The very lowest part of the base of tongue is pulled forward in a procedure known as the hyoid suspension. In this procedure, the base of the tongue is pulled forward and suspended over the top of the voice box. This prevents collapse of the base of the tongue. These two procedures are usually performed together to maximize suspension of the tongue. Bimaxillary Advancement This procedure pulls both the upper and lower jaw forward, thus pulling both the tongue and the palate away from the back of the throat. It is a very effective procedure for sleep apnea however it is quite extensive and is usually reserved for those cases which fail more conservative approaches. In this procedure, the teeth bearing portions of the upper and lower jaws are cut free and surgically suspended in a more forward position.  Evaluation and management protocol The patient with a snoring and/or sleep apnea problem is evaluated in a systematic fashion. The patient's history is the most important indicator of problems. A complete ear, nose and throat examination is performed. A sleep study, also known as a polysomnogram, is usually obtained. The sleep study may be screening test which can be done at home if the suspicion of sleep apnea is low and treatment of snoring is all that is desired. A more detailed sleep study, performed in a sleep lab may be required if the screening test is abnormal or if sleep apnea is strongly suspected. Once sleep apnea is ruled out in the snoring patient, an injection snoreplasty may be performed for snoring. Sometimes chronic nasal obstruction contributes to snoring and/or sleep apnea and may require medical or surgical treatment. Once sleep apnea is documented to exist with a sleep study the initial treatment is usually medical. This treatment takes the form of Continuous Positive Airway Pressure (CPAP). If CPAP is not effective or if the patient does not tolerate it surgery may be considered. When surgery is considered, the object of the evaluation is to determine the level where the obstruction is occurring. A complete head and neck examination is performed. In addition, a small flexible scope is passed through the nose to evaluate the base of the tongue. An x-ray is also obtained of the base of the tongue region.
Throat & Voice Box Problems
Swallowing and breathing problems, infections, tumors, birth defects, speech and voice diagnostics and therapy.
Tonsils & Adenoid Disorders
The tonsils and adenoids are a normal part of the immune system.  Large numbers of white blood cells which fight infections are located there.  They are located in the throat so that they can respond to infectious agents entering the body by priming the immune system.  Fortunately, there are redundant systems which can take over if the tonsils become chronically infected or enlarged and need to be removed. The tonsils and adenoids can become chronically infected and themselves become a source of recurrent infections.  The tonsils and adenoids can become can also enlarge to the point that they obstruct normal breathing, swallowing and speech.  Enlarged tonsils and adenoids are the most common cause of obstructive sleep apnea in children. The initial treatment for tonsillitis is antibiotics.  If the tonsils become chronically infected or are constantly becoming reinfected tonsillectomy is usually recommended.  The adenoids are usually removed at the same time. 


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