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Ed Bush, 76, has lived with chronic sinusitis for most of his life. He was 16 when sinus congestion and headaches became part of his life and he met his first ear, nose and throat (ENT) specialist, an otolaryngologist who practiced in the small town where he grew up.

Over the years, Ed, an attorney based in Appleton, had seen several otolaryngologists and tried different strategies, including nasal irrigation (rinsing his sinuses with a saline solution) and regular use of pseudoephedrine and ibuprofen to stop the pain.

“There’s nothing like a full-blown, unrelieved sinus headache,” he said.

Ed is not alone. Chronic sinusitis, or the inflammation of the sinuses for 12 weeks or more, is relatively common, affecting nearly 29 million U.S. adults.

Over time, Ed grew more adept at managing his symptoms with pain relievers and hot packs on his forehead, but he still needed help. Several years ago, an otolaryngologist in Appleton performed an endoscopic sinus surgery to open Ed’s blocked sinus cavities. The procedure was a success and it gave him relief. But in 2019, Ed started having headaches that felt different. He returned to the otolaryngologist to determine if the pain was sinus related. Diagnostic imaging revealed an obstruction in Ed’s sinuses.

Given the complexity of Ed’s condition, the doctor gave him a choice: a referral to an otolaryngologist in Madison or one from the Froedtert & the Medical College of Wisconsin health network. Ed opted for the latter and ultimately chose Todd Loehrl, MD, otolaryngologist and MCW faculty member, who practices at Froedtert Hospital and Froedtert Menomonee Falls Hospital.

Accurate Diagnosis Leads to the Right Treatment

Dr. Loehrl studied the CT images of Ed’s sinuses and noted that his surgery in Appleton was appropriate and technically well executed. But Ed still had a blockage high in his left front sinus, located behind the forehead, which was impeding sinus drainage.

Because Froedtert Hospital is an academic medical center, Dr. Loehrl and his ENT colleagues often see patients with complex cases of sinusitis. Sometimes, these patients — unlike Ed — have received incorrect diagnoses and treatment before coming to the Froedtert & MCW health network.

“Sinusitis tends to be overtreated, so we work really hard to make an accurate diagnosis before determining treatment,” Dr. Loehrl said, adding that his team ensures all nonsurgical options are explored first in an effort to avoid unnecessary surgeries. If a surgery is needed, Froedtert & MCW experts work to tailor it to the severity of the patient’s disease.

Dr. Loehrl told Ed he would likely benefit from an endoscopic sinus surgery with computer guidance, in which endoscopic instruments are guided through the nose and into the sinuses to remove excess tissue or bone. He encouraged Ed to take his time deciding if he wanted to proceed with the surgery. After just a few days, Ed scheduled the procedure for January 2020.

Surgical Solution

The anatomy of Ed’s sinuses was unusual, involving particularly thick bone. Dr. Loehrl needed to remove more bone than is typical to allow Ed’s sinus to drain. But after the outpatient surgery at Froedtert Menomonee Falls Hospital, Ed felt well enough to eat lunch with his wife before returning home. He didn’t need pain medication in the days after surgery and was surprised he didn’t experience any bleeding.

When Ed returned to Froedtert Hospital for a follow-up appointment several weeks later, Dr. Loehrl was pleased to see he was healing well. His body was starting to reestablish the mucous membrane that was disturbed when the bone was removed.

Ed said he’s glad he had the surgery, which granted him “significant demonstrable improvement,” including less congestion and sinus pressure. And he’s happy he chose the Froedtert & MCW health network.

“I was in good hands with Dr. Loehrl,” Ed said. “He’s the epitome of a professional doctor. I always had the sense he was being totally straightforward and honest with me.”

Ed is also enthusiastic about the convenient and compassionate care he received at Froedtert Menomonee Falls Hospital. “The logistics were never a problem,” he said “You’re in, you’re out, you’re done. And I thought the staff were just marvelous. They’re very patient focused.”

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