Hill Country Ear Nose & Throat: Charles F. Lano, Jr, MD, FACS

Many advancements have been made in sinus surgery recently to improve the results, reduce the risks and improve the patient comfort and outcomes. Dr. Lano will make every effort to reduce discomfort during and after surgery. In most sinus surgery, no nasal packing will be used, instead, a soft gel or soft absorbable felt may be placed. Maxillary sinus (The sinus inside the cheek area of the face) Balloon Sinuplasty: Using a balloon designed to enlarge the sinus opening to improve its function. Nasal Antrostomy Window: Creating an improved opening in the maxillary sinus to improve function. Caldwell Luc: Surgical opening of the sinus under the lip to access severe disease or tumor. Frontal Sinus (The sinus inside the forehead/brow area) Balloon Sinuplasty: Using a balloon designed to enlarge the sinus opening to improve its function Frontal sinusotomy: Creating an improved opening in the frontal sinus to improve function. Frontal sinus trephination: a surgical opening thru the brow area into the frontal sinus Ethmoid sinus (The sinuses between the eyes) Ethmoidectomy: Opening and /or cleaning out the sinuses between the eyes External ethmoidectomy: Surgical access to the sinus by making a small incision by the nose Sphenoid Sinus (The back most sinus) Balloon Sinuplasty: Using a balloon designed to enlarge the sinus opening to improve its function. Sphenoidotomy: Creating an improved opening in the sphenoid sinus to improve function. Care of the nose after the procedure You will have some fatigue after the procedure so rest for about 5 days. Expect a small amount of bleeding for 2-3 days, use drip pad as needed. You can use a few puffs of afrin if there is any bleeding. Avoid blood thinning medications (i.e. aspirin, Motrin, ibuprofen, etc.) You may have antibiotics or pain medications to take. Keep head elevated for one week, use 2-3 pillows at night. DO NOT BLOW NOSE; if you sneeze leave your mouth open to avoid high nasal pressure Don’t do activities that are strenuous, require bending or lifting, or dusty, or dirty. Use a nasal saline spray (ocean or ayr) in the nose 3 times daily. Use a bit of Neosporin ointment or Vaseline or ayr gel in the nose 3 times daily. Arrange a follow up appointment with our office within 5-10 days and 2-3 weeks after the procedure. You may have some crusting in the nose or sinuses removed at follow up (take a pain tab if you want to 30 min prior to the appointment). Risks of the procedure: Bleeding, infection, scarring of the sinus opening, recurrent sinus disease, anesthetic risks, need for further procedure. Extremely rare risks: Numbness, spinal fluid leak, eye complications, or other unforeseen problems.

Your runny nose, congestion, and headache might not be a cold, but rather could be a sinus infection. Charles F. Lano, Jr., MD, and his experienced team at Hill Country Ear, Nose & Throat offer the most advanced care for acute and chronic sinus infections in New Braunfels, Texas. Whether you need relief from your symptoms, or innovative and minimally invasive treatments like Balloon Sinuplasty, Hill Country Ear, Nose & Throat has solutions. Call or schedule an appointment online today. Sinus Infection What is a sinus infection? Sinus infections, or sinusitis, occurs when your nasal cavities become swollen and inflamed. Sinusitis often follows a common cold, causing pain and pressure in your face and head. In chronic sinus infections, your infection or inflammation doesn’t completely go away for 12 or more weeks. Symptoms of a sinus infection include: Fever Headache Bad breath Pain in your teeth A productive cough Sinus infections also reduce your sense of taste or smell. What causes a sinus infection? The same virus that causes the common cold also causes most sinus infections. Viral infections cause inflammation and swelling of the lining of your nasal passages, resulting in viral sinusitis. This swelling prevents the normal drainage of fluid from your sinuses into your nose and throat. Over time, it builds up, and bacteria or fungi might grow. When bacterial or fungal infections develop, they cause more pain and swelling. They can also last longer and worsen over time, becoming chronic. Sinusitis can also develop because of nasal allergies and other blockages that allow fluid to build up in the sinuses. How is a sinus infection treated? Antibiotics are ineffective against viral infections, which typically resolve on their own within 10-14 days. To ease your symptoms, Dr. Lano might recommend: Drinking plenty of fluids Breathing warm, moist steam Over-the-counter medications Applying a warm compress to your face If a bacterial or fungal infection is present, medications like antibiotics, antifungals, and steroids are prescribed to treat your specific condition. For sinus infections that don’t resolve or their own or respond to medication, Dr. Lano might recommend Balloon Sinuplasty (BSP). What is Balloon Sinuplasty? Dr. Lano and his team at Hill Country Ear, Nose & Throat are proud to offer BSP to safely and effectively treat their patients who have sinus conditions that are chronic or unresponsive to medications. During this minimally invasive procedure, Dr. Lano opens your inflamed sinus cavity the same way a heart surgeon opens a blocked artery during balloon angioplasty. Performed without the cutting or removal of bone or nose tissue seen in traditional sinus procedure, BSP effectively relieves symptoms of chronic sinusitis and allows you to resume your normal activities quickly. If you’re suffering from the acute or chronic sinusitis, call Hill Country Ear, Nose & Throat or schedule an appointment online to learn more.

If you're one of the 50 million Americans affected by nasal allergies, you don't have to suffer any longer. The experienced team at Hill Country Ear, Nose & Throat can provide relief. Charles F. Lano, Jr., MD, founded his practice to provide the highest standard in ear, nose, and throat health care to the New Braunfels community in Texas. If you want to put an end to your sneezing, runny nose, and itchy, watery eyes, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Allergies What is allergic rhinitis? Also known as allergies or hay fever, allergic rhinitis occurs when your immune system overreacts to harmless particles in the air. When you inhale these allergens, your body tries to protect itself and produces symptoms like sneezing, a runny nose, or rashes and inflammation. Allergic rhinitis is often triggered by: Pollens from trees, grasses, and weeds Dust mites and animal dander Mold and cockroaches People can have allergic reactions to things in their workplace as well, including: Cereal grain Wood dust Chemicals Lab animals Allergies are increasing in the United States. They affect as many as 30% of adults and 40% of children. What are the symptoms of allergies? Allergy symptoms can be chronic, or may simply flare up at certain times of the year. It’s common to sneeze repeatedly, especially upon waking. You might also experience: A runny nose Postnasal drip Itchy and watery eyes Itchy ears, nose, and throat Allergies can also lead to other conditions like sinusitis and ear infections. How do you test for allergies? Hill Country Ear, Nose & Throat offers comprehensive allergy testing to identify your triggers. At your appointment, Dr. Lano or his team conduct a physical examination and review your symptoms. Based on this information, they might recommend a skin test or lab tests. Skin tests are simple procedures where your doctor applies a small amount of an allergen to your skin to see if it causes an allergic reaction. Lab tests look for substances in your blood that indicate the risk of allergies. How are allergies treated? There isn’t a cure for allergic rhinitis, but Hill Country Ear, Nose & Throat provides treatment solutions to reduce your symptoms, including: Steroid injections for severe flare-ups Prescription nasal sprays or leukotriene inhibitors Medications like antihistamines and decongestants Allergy shots or sublingual drops to reduce allergen sensitivity The Hill Country Ears, Nose & Throat team also educate you regarding the allergic disease process and provide strategies for both eliminating and avoiding allergens. These include tips on cleaning your house to reduce dust, animal dander, or molds, and avoiding the outdoors when pollen counts are high. To learn about treatment options for your allergies, call Hill Country Ear, Nose & Throat or schedule an appointment online today.

It’s estimated that one in five people over the age of 12 -- and as many as one in three people over age 65 -- suffer from hearing loss in the United States. A licensed Audiologist at Hill Country Ear, Nose & Throat in New Braunfels, Texas, can help evaluate your hearing loss and offer hearing aids that fit every lifestyle. Don’t miss another sound, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Hearing Aids Why is it important to treat hearing loss? Untreated hearing loss can negatively affect your quality of life. As communication problems increase, you might find yourself excluded from conversations or growing more isolated and withdrawn. You’re also at risk of cognitive decline, as well as: Feelings of helplessness Frustration or depression A loss of independence In addition to hearing aids, Hill Country Ear, Nose & Throat provides rehabilitation techniques and education to support family members as well. How is hearing loss evaluated? Hill Country Ear, Nose & Throat uses the latest in computerized, digital technology to assess and serve both adult and pediatric patients. Hearing tests include: Word recognition testing Tympanometry to test the function of the middle ear Pure-tone air and bone conduction threshold testing Following your comprehensive diagnostic audiology assessment, a licensed audiologist discusses your personalized treatment plan and hearing aid options. This discussion takes into consideration the nature and degree of your hearing impairment, as well as your activity level, socialization, dexterity, and financial resources. What types of hearing aids are available? Hearing loss and hearing aid experiences are highly individual and can’t be treated with a “one-size-fits-all” approach. Hill Country Ear, Nose & Throat works with the industry’s best hearing aid manufacturers to provide devices that fit every lifestyle, and even offers hearing aids that are iPhone and Bluetooth compatible. Hearing aid options include: Receiver-in-canal (RIC): sits snugly behind the ear and connects to the ear with a nearly invisible thin wire connecting to a tiny speaker in the ear canal Open behind-the-ear (BTE): attaches to a slim tube which directs sound into the ear Behind-the-ear (BTE): amplified sound travels down a tube to a customized earmold that fits securely into the ear Full shell (ITE): custom-made to fit securely in your outer ear Half shell (ITE): custom-made to fit securely in your outer ear, smaller than full shell ITEs In-the-canal (ITC): nearly unnoticeable, custom-made to fit inside the external ear canal Completely-in-the-canal (CIC): one of the smallest hearing aids available, the CIC fits deeply inside the ear canal, making it almost invisible Hill Country Ear, Nose & Throat offers a 75-day trial period to fine-tune your device and see if it fits your needs. During the trial period, if you’re not satisfied with your hearing aids, they can be returned for a refund of nearly the entire purchase price. It’s never too late to start enjoying communication that’s important to you again. Call or schedule an appointment online today.

Ignoring sleep disorders like sleep apnea can increase your risk of heart attack and stroke. If you suspect you may have a sleeping disorder, Charles F. Lano, Jr., MD, at Hill Country Ear, Nose & Throat offers sleep apnea diagnosis and treatments in New Braunfels, Texas. Take the steps needed to get a good night’s sleep, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Sleep Apnea What is sleep apnea? Sleep apnea occurs when your breathing starts and stops during your sleep. This disrupted breathing causes the oxygen levels in your blood to drop, straining your cardiovascular system and leading to potentially dangerous health problems like high blood pressure, heart attack, and stroke. Types of sleep apnea include: Obstructive sleep apnea: occurs when throat muscles relax Central sleep apnea: muscles that control breathing don’t receive signals from the brain Complex sleep apnea: a combination of obstructive and central sleep apnea Several factors can cause sleep apnea, such as being overweight, having a narrowed airway, and nasal congestion due to anatomical problems or allergies. You’re also more likely to develop sleep apnea once you reach middle age. What are the symptoms of sleep apnea? Common symptoms of sleep apnea include: Loud snoring Daytime fatigue Morning headaches Lack of focus or irritability Sore or dry throat upon waking Sleep apnea not only disrupts your own sleep, it can disturb those around you, causing loved ones to also become sleep deprived. How do you treat obstructive sleep apnea? At Hill Country Ear, Nose & Throat, Dr. Lano specializes in sleep apnea diagnosis and treatment. For mild cases, he recommends lifestyle changes like weight loss and smoking cessation. In moderate to severe cases, Dr. Lano might suggest a variety of treatments, including: CPAP CPAP (continuous positive airway pressure) machines use a mask placed over your nose to supply air pressure while you sleep to keep your upper airway passages open. BiPAP Similar to a CPAP, a mask is worn while sleeping. A BiPAP (Bilevel Positive Airway Pressure) uses continuous positive airway pressure to automatically adjust inhaling and exhaling pressure while you sleep. Oral Appliances These devices keep your throat open by adjusting your jaw placement into a forward position. Surgery Surgical procedures remove tissue or blockages that cause snoring or impede breathing. How do you treat obstructive sleep apnea? Central and complex sleep apnea requires a variety of approaches, including better managing existing medical conditions that include the heart or neuromuscular disorders. Dr. Lano might also recommend supplemental oxygen, CPAP or BiPAP therapy, or adaptive servo-ventilation (ASV), which is a recently approved airflow device that records your normal breathing pattern and stores it in a computer. Once you fall asleep, ASV uses pressure to normalize your breathing pattern. Call or schedule an appointment online today to learn more about sleep apnea treatments.

Sore throats can be painful and annoying, especially when they don’t go away on their own. At Hill Country Ear, Nose & Throat, Charles F. Lano, Jr., MD, and his team of specialists provide personalized treatment solutions for men, women, and children in New Braunfels, Texas. If you’re experiencing a sore throat that continues to linger, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Sore Throat What causes a sore throat? Viral or bacterial infections usually cause sore throats. Examples of viral infections include the common cold, laryngitis, mononucleosis, or the mumps and flu. When bacterial infections cause a sore throat, it’s often due to: Strep throat: infection of the throat and tonsils Tonsillitis: inflammation or infection of the tonsils Peritonsillar abscess: infection of the tissue around the tonsils Epiglottitis: inflammation of the leaf-shaped tissue over the windpipe Uvulitis: inflammation of the small finger-shaped tissue that hangs down from the soft palate in the back of the throat Sexually transmitted diseases like gonorrhea or chlamydia Can other conditions cause a sore throat? Sore throats lasting longer than a week might be due to irritation. Possible conditions include: Breathing through your mouth because of nasal allergies or congestion Postnasal drip, dry air, smoking, air pollution, or yelling Acid reflux associated with gastrointestinal reflux disease (GERD) Injuries to the back of the throat like cuts or punctures A sore throat is also a common symptom of chronic fatigue syndrome. How are sore throats treated? Effectively treating your sore throat depends on the cause of your condition. Viral infections are the most common cause of sore throats and don’t respond to antibiotics, so Dr. Lano and his team might recommend home treatments like drinking plenty of fluids, over-the-counter medications, and throat lozenges to ease your symptoms. When a bacterial infection is present, they might prescribe antibiotics to treat your condition. If Dr. Lano suspects allergies are a factor in your having a sore throat, Hill Country Ear, Nose & Throat offers comprehensive allergy testing and treatment to relieve your symptoms. Sore throats due to chronic infections might require tonsillectomy or adenoidectomy surgery. What is tonsillectomy and adenoidectomy surgery? This surgical procedure removes your tonsils and adenoids to reduce the frequency and severity of sore throats. Typically performed as an outpatient procedure under general anesthesia, Dr. Lano removes your tonsils and adenoids through your mouth. After your surgery, Dr. Lano and his team at Hill Country Ear, Nose & Throat closely monitor your recovery from sedation. When you’re doing well, you’re released from the clinic to continue your recovery at home. Pain medication might be necessary during your recovery, and you’re encouraged to drink plenty of fluids and to avoid strenuous activity. If you’re suffering from a sore throat or chronic infections, call or schedule an appointment online today.

Thyroid and throat cancers demand the specialized care and treatment offered at Hill Country Ear, Nose & Throat in New Braunfels, Texas. With more than 18 years of experience, Charles F. Lano, Jr., MD, provides the most advanced surgical and nonsurgical treatments for conditions affecting the ear, nose, and throat. If you have a throat cancer diagnosis or throat symptoms that won’t go away, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Throat Cancer Q & A What is throat cancer? Your throat runs from your nose to your neck and includes your esophagus, windpipe, voice box, tonsils, and epiglottis. Cancer can develop in any of these areas. Several factors can increase your risks of developing throat cancer, including: Tobacco use High alcohol consumption Human papillomavirus (HPV) A diet low in fruits and vegetables Gastroesophageal reflux disease (GERD) Are there different types of throat cancer? There are several types of throat cancer. The general term for throat cancer is pharyngeal cancer, but the type is further differentiated depending on where it originates. Types of throat cancer include: Nasopharyngeal: the area behind the nose, including the openings leading to the ears Oropharyngeal: includes the soft palate, base of the tongue, and tonsil area Hypopharyngeal: the top of the esophagus and area surrounding the voice box Laryngeal: the second most common type of head and neck cancer; begins in the voice box Cancer can also develop in the thyroid gland located below the voice box. Your thyroid is in the front of your neck. This small butterfly-shaped gland makes hormones that regulate how your body uses energy. Thyroid cancer is relatively uncommon and very responsive to treatment. If Dr. Lano suspects you may have thyroid cancer, he performs a biopsy and reviews it for cancer. Treatment often includes surgical removal and radioactive iodine. What are the symptoms of throat cancer? Common symptoms of throat cancer include: A lump in your neck Changes in your voice Pain in your neck or ears Pain or difficulty swallowing A sore throat that doesn’t go away Breathing problems or wheezing A cough that isn’t due to cold or illness How is throat cancer diagnosed and treated? In addition to physical examinations of the throat, Dr. Lano diagnoses throat cancer through a variety of tests, including: Biopsies Bone scans Barium esophagography CT scans, PET scans, or MRIs Endoscopy, esophagoscopy, or bronchoscopy Your treatment options depend on the stage of your cancer; your ability to eat, breath, and talk; and your general health. Dr. Lano and his team at Hill Country Ear, Nose & Throat are trained to surgically treat both benign and malignant tumors affecting the throat, head, and neck. Additional treatment options might include radiation therapy, chemotherapy, and targeted drug therapy. Call or schedule an appointment online today to learn more about throat cancer treatments offered at Hill Country Ear, Nose & Throat.

If you have a ringing or roaring in your ears that won’t go away, you could have tinnitus. Charles F. Lano, Jr., MD, established Hill Country Ear, Nose & Throat to provide the highest quality ENT services to women and men in New Braunfels, Texas. To learn more about the cause of your tinnitus and to find an effective treatment, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Tinnitus What is tinnitus? Experiencing an occasional ringing in your ears is normal, but when it doesn’t improve or go away, you have a condition known as tinnitus. Tinnitus symptoms include hissing, roaring, buzzing, or clicking noises in your ears that aren’t coming from your surroundings. These sounds can come and go, or remain constant, and they can keep time with your heartbeat or breathing. You might also experience dizziness. Tinnitus is more common in men than women and often occurs after age 40. Are there different types of tinnitus? There are two main types of tinnitus, pulsatile and nonpulsatile. Pulsatile tinnitus Sounds are created in the ear by muscle movements near the ear, changes in the ear canal, or blood flow problems in the neck. You might also hear your own pulse or the contractions of your muscles. Nonpulsatile tinnitus This type of tinnitus is the result of nerve problems involved in your hearing. Often described as hearing sounds coming from inside your head, you may hear such sounds in one or both ears. What causes tinnitus? The most common cause of tinnitus is hearing loss due to age. Nerve cells in the inner ear may begin declining as early as age 30, but hearing loss usually isn’t noticed until after age 55. Acoustic trauma from living or working around loud noises can also lead to hearing loss. Additional causes of tinnitus include: Earwax buildup Certain medications Dental or mouth problems Blood flow (vascular) problems Ear infections or eardrum ruptures Severe weight loss from malnutrition Neurological disorders like migraines Rapid changes in barometric pressure Traumatic injuries like whiplash or blows to the ear or head Certain conditions like anemia, otosclerosis, acoustic neuroma, and thyroid diseases can also cause ringing in the ears. How is tinnitus diagnosed and treated? The specific sounds you’re hearing, and your examination, can help Dr. Lano and his staff provides treatment strategies. In addition to examining your ears, head, and neck, they might recommend imaging tests like CT scans or MRIs. Hill Country Ear, Nose & Throat also provides comprehensive audiology services to evaluate your hearing. When a physical problem like earwax buildup, vascular issues, or medications causes tinnitus, Dr. Lano and his team resolve those issues to treat your condition. If there’s no obvious cause, Dr. Lano might recommend sound suppression therapies like white noise machines for your environment, or devices you wear such as hearing aids. If you also have hearing loss, hearing aids might effectively treat your tinnitus. Call or schedule an appointment online today to learn more about tinnitus treatments at Hill Country ENT.

The fine lines and wrinkles that come with aging can keep you from looking and feeling your best, but the talented team at Hill Country Ear, Nose & Throat are here to help. Nurse Practitioner Dawn Schuster and Katie Lano, RN, BSN are trained injectors and offer innovative aesthetic treatments like Botox® and Juvederm. If you’re looking for nonsurgical options to preserve and enhance your beauty, call Hill Country Ear, Nose & Throat or schedule an appointment online today. Botox Q & A What causes wrinkles? Two substances play an important role in keeping facial skin looking smooth and supple: collagen and hyaluronic acid. Collagen is a protein that provides skin with structural support. Hyaluronic acid is a natural sugar found in all living cells that keeps skin hydrated and adds volume. As you age, collagen and hyaluronic acid in your skin diminish due to exposure to environmental pollutants and the sun’s ultraviolet rays. This causes your skin to lose structure and volume. Creases, lines, and wrinkles appear on your skin without this structural support. Wrinkles are also caused by the repeated and involuntary contractions of muscles in your face. As the skin becomes less elastic, excessive contractions of muscles may cause visible, deep wrinkles to form, even when the face is relaxed. Lines in your face can negatively affect your facial appearance by creating a sad, angry, or tired impression. How does Botox treat wrinkles? The medical formula Botox is made from is a naturally occurring bacteria that produces botulinum. Botox targets your nervous system. When a small amount is injected into your facial muscles, it paralyzes them and causes them to relax. Botox has more medical uses than treating fine lines and wrinkles; it’s also an effective treatment for other conditions like overactive bladder, muscle spasms, and migraines. What can I expect during my Botox appointment? Botox treatments at Hill Country Ear, Nose & Throat are relatively painless and take a matter of minutes. You begin seeing results a few days after your appointment as your facial muscles begin to relax. After a week, fewer lines, creases, and wrinkles are present in the area. The results from Botox treatments last between three to six months. Benefits last longer if you get regular Botox treatments. Does Botox treat all fine lines and wrinkles? Botox is most effective at reducing fine facial lines, but Dr. Lano and his team at Hill Country Ear, Nose & Throat offer additional facial plastics rejuvenation services, including: Juvéderm®: used for filling deeper facial lines Radiesse®: a volumizing filler with collagen stimulation Restylane®: injectable gels to add volume and fullness Dysport®: an injection to treat moderate to severe frown lines Call or schedule an appointment online to learn more about Botox and other aesthetic treatments to improve your complexion.