Awake laryngeal voice surgery
Many vocal fold procedures can be safely performed awake in office using local anesthesia. These include vocal fold injection augmentation, targeted biopsies, laser treatment with the advanced TruBlue laser, and botulinum toxin (Botox) injections. Awake surgery allows real-time voice assessment, avoids general anesthesia, and enables rapid recovery
Laryngeal voice surgery with general anesthesia
For select voice and airway conditions, surgery is performed endoscopically under general anesthesia. This approach allows precise treatment of vocal fold lesions while preserving surrounding tissue. Traditional mini “micro” tools and advanced laser technology enable accurate treatment with a focus on voice quality and long-term function.
R-CPD “Can’t Burp” Botox
Retrograde cricopharyngeal dysfunction (R-CPD) is characterized by an inability to burp, often associated with bloating, chest pressure, and discomfort. Botulinum toxin injection into the cricopharyngeus muscle can restore normal relaxation and allow belching. The procedure usually requires just several minutes of general anesthesia. Cricopharyngeal myotomy can be considered in select patients with CO2 laser.
Vivaer
Vivaer is a quick, awake, in-office procedure that treats nasal valve collapse, a common cause of nasal obstruction. Using radiofrequency energy, the nasal airway is gently reshaped without cutting, packing, or external incisions. Patients experience meaningful improvement in breathing with minimal downtime.
Rhinaer
Rhinaer is a minimally invasive treatment for chronic runny nose caused by vasomotor or non-allergic rhinitis. Radiofrequency energy is applied to overactive nerves at the back of the nose to reduce excessive mucus production. The procedure is performed in the office and does not alter normal nasal structure.
Balloon Sinuplasty
Balloon sinuplasty is a minimally invasive treatment for chronic sinusitis or recurring sinus infections when medical therapies are not helping. A small balloon catheter is used to gently dilate blocked sinus drainage pathways, improving airflow and mucus clearance. The procedure is performed in the office using high resolution endoscopic cameras. This can be done wide awake or with relaxing medicine such as valium.
Endoscopic Sinus Surgery
Endoscopic sinus surgery is performed under general anesthesia, with specialized cutting tools passing through the nostrils. No external cuts or scars are involved. Sinus surgery (“ESS”) is designed to restore normal sinus drainage and ventilation while preserving healthy tissue. This approach is used when medical therapy is insufficient or when more advanced sinus disease is present. Most patients will have dissolving foam packing during the first postop week, which slowly disintegrates and is flushed out by the saline sinus rinses.