BackTable / ENT / Podcast / Episode #77

In-Office Procedures for Chronic Rhinitis

with Dr. Stan McClurg

In this episode, Dr. Stan McClurg, a private practice rhinologist at Ascentist Healthcare in Kansas City, shares his approach to diagnosis and treatment of chronic rhinitis patients using the in-office RhinAer procedure.

Sponsored by:

Aerin Medical
In-Office Procedures for Chronic Rhinitis with Dr. Stan McClurg on the BackTable ENT Podcast)
Ep 77 In-Office Procedures for Chronic Rhinitis with Dr. Stan McClurg
00:00 / 01:04

BackTable, LLC (Producer). (2022, November 15). Ep. 77 – In-Office Procedures for Chronic Rhinitis [Audio podcast]. Retrieved from https://www.backtable.com

Earn CME

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs.
Follow the button below to get started with CMEfy.

BackTable CMEfy button

Stay Up To Date

Follow:

Subscribe:

Sign Up:

Podcast Contributors

Dr. Stan McClurg discusses In-Office Procedures for Chronic Rhinitis on the BackTable 77 Podcast

Dr. Stan McClurg

Dr. Stan McClurg is a private practice rhinologist at Ascentist Healthcare in Kansas City.

Dr. Ashley Agan discusses In-Office Procedures for Chronic Rhinitis on the BackTable 77 Podcast

Dr. Ashley Agan

Dr. Ashley Agan is a practicing ENT and assistant professor at UT Southwestern Medical Center in Dallas, TX.

Dr. Gopi Shah discusses In-Office Procedures for Chronic Rhinitis on the BackTable 77 Podcast

Dr. Gopi Shah

Dr. Gopi Shah is a practicing ENT at UT Southwestern Medical Center in Dallas, TX.

Show Notes

First, Dr. McClurg talks us through his patient base. When he initially started as a rhinologist, he would get referrals for patients with persistent rhinitis after a procedure. Before in-office procedures for chronic rhinitis were developed, he recommended ipratropium bromide spray to patients and referred them for allergy testing. However, his recent patient referrals have been for isolated chronic rhinitis (defined by consistent rhinorrhea for more than 4 weeks) with no other ENT problems. With these patients, he performs allergy skin testing to make sure the diagnosis is not really allergic rhinitis that can be treated with desensitization therapy. He also uses a rigid nasal endoscope to check the patient’s nose for colored purulence and polyps, two clues that can point to a diagnosis other than chronic rhinitis. When he scopes his patient, he does not use a decongestant spray and uses a small endoscope to avoid patient discomfort. If he believes that a patient has chronic rhinitis, he will perform a ipratropium bromide challenge; he asks patients to use the spray for 1 month. If their symptoms are mitigated by the spray, then he is more optimistic that an in-office procedure will mitigate the chronic rhinitis. If the patient fails the trial, the secretions are probably coming from a source other than the nose, and the diagnosis is unlikely to be chronic rhinitis.

Next, Dr. McClurg speaks about different in-office treatments for chronic rhinitis. He first explains his experience with ClariFix, a procedure that uses cryoablation to freeze the posterior nasal nerve. He has found that 40% of his patients experience the known side effect of post-treatment headache. Additionally, some of them may have crusting in the sphenopalatine region that causes post-nasal drip. Since then, he has switched to using the RhinAer system, which delivers radioablation through a stylus to treat the posterior nasal nerve more aggressively. It also has the capability of treating the inferior turbinate. Dr. McClurg notes that patients with normal nasal anatomy and a good ipratropium bromide response are the best candidates for this procedure. 80% of his patients see a favorable result after surgery.

He then describes his RhinAer in-office procedure. He does these procedures in exam rooms in order to help with flow of his day and make his patients more comfortable. He only uses lidocaine to anesthetize the patient, as he has found that epinephrine causes tachycardia and anxiety. The procedure, including anesthesia time, takes him about 10 minutes. However, he adds that he has performed this procedure in the OR as an adjunct procedure after a septoplasty or a rhinoplasty.

Finally, he describes his recommendations for postoperative care. He encourages his patients to do daily saline rinses. He notes it takes about 6-8 weeks for the RhinAer procedure to show a good response. During this time, he recommends that patients use ipratropium bromide concurrently in order to obtain an optimal response.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

Earn CME When You Listen to BackTable CMEfy

Up Next

Allergic Fungal Rhinosinusitis with Dr. Amber Luong on the BackTable ENT Podcast)
Nasal vs. Mouth Breathing: Does it Matter? with Dr. Colleen Plein on the BackTable ENT Podcast)
The Ins and Outs of Ear Tubes with Dr. Ashley Murray and Dr. Gopi Shah on the BackTable ENT Podcast)
Keeping up with Technology for In-Office Sinus Procedures with Dr. Brian Weeks and Dr. Ashley Sikand on the BackTable ENT Podcast)
BackTable ENT First Year Podcast Anniversary! with Dr. Gopi Shah and Dr. Ashley Agan on the BackTable ENT Podcast)
In-Office Procedures for Nasal Valve Obstruction with Dr. Mary Ashmead on the BackTable ENT Podcast)

Articles

Topics

Learn about Rhinology on BackTable ENT

Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.