Hudson ENT - Ears, Nose, Throat Doctor | Red Hook & Kingston NY
Driven by personalized care, Hudson ENT utilises high-tech diagnostic evaluations in order to gain a more comprehensive understanding of each patient's issues. Find information about ear, nose and throat surgery and more for adults and kids in this blog.
It seems rare to see many patients for whatever they come in with as a chief complaint who do not also say they “have post-nasal drip”. It would not be a stretch to wonder if it is a normal symptom of aging, but we believe it should have a proper assessment. Firstly, it needs to be clarified as a symptom: does this mean there is a “sensation in the throat? Do you hear something in the throat? Do you feel phlegm? Is it a sense of throat clearing? Is it not something you can feel at all, but a medical provider saw mucus? We believe post-nasal drip is a feeling, described by the patient, of mucus in the throat. Meaning, the mucus may be seen or unseen: it is a symptom and not a sign (ie not the name of the sight of mucus in the throat by an examiner). Secondly, it should be looked for. Sometimes, the mucus is not there at all during the medical visit, or there really is no mucus and it is a sensation of mucus alone (without mucus physically present). If it is seen, the color and consistency often play a role in what diagnoses underlie the symptom. Thirdly, there are many diagnoses that can relate to mucus. Allergies, rhinitis, sinus problems, and yes acid reflux all come to mind. The last one seems so strange to many, but is very often the cause. (c.f. https://www.hudsonent.com/single-post/2017/10/11/Why-Do-I-Clear-My-Throat-and-Cough) Perfect treatment of any kind would be complete eradication, but sometimes patients are quite happy when it can at least be tamed in some way. To that end, allergy treatments, nasal medicine, sinus treatments (e.g. sinuplasty), acid reflux medicines or diet can all help and they depend on your specific diagnosis. Sometimes, we see patients with ALL of these diagnoses at once! Lately, there is a new procedure where, for thirty seconds per side, liquid nitrogen is used to freeze the nerve that controls much of the mucus production. The statistics on success are very good across nearly all diagnoses, and this is typically a one-time procedure done here in the office by Dr. Michael Kortbus. (c.f. https://www.hudsonent.com/single-post/2018/12/14/Office-based-minimal-procedures-for-the-nose-and-sinuses) Do you or someone you know have post- nasal drip? Allergy problems? Do you carry a box of tissues or one in the sleeve? Give us a call at 845-758-1456.
At hudsonENT, we dispense hearing aids. There is an unfair stigma associated with hearing aids, though. This includes the fact that when baby boomers were young, they saw their peers who used them as disadvantaged or “slow”. And nowadays, they are seen as too expensive. However, you should know that New York is the only state of the fifty that disallows any major mark up on hearing aids if they are sold at a practice run by a physician. HudsonENT is run by a physician, Dr Michael Kortbus. Therefore, the price of hearing aids dispensed here will be lower than almost anywhere else. In other words, we are a medical practice that happens to dispense hearing aids- not a hearing aid dispenser who might look into your ears someday. Also, great studies are being done to reveal how good hearing aids work, how well people can hear in noise, how well the hearing aids mask tinnitus, and also in devices known as “PLD”, or personal listening devise. The benefits of hearing aids are many. These include:
Increased earning powerSlower cognitive declineReduced annoyance related to tinnitusSatisfaction with hearing aid performanceDeveloping a better relationship with your family through communication improvementImproved feeling of contentment with yourselfImproved mental health and moodImproved situational awarenessImproved physical well beingBetter concentrationFeel more independent and secureFeel less tired / exhausted / fatiguedBetter participation at social gatheringsIncrease social contactsBetter balance, less “vertigo”
…and many more. Hearing aids are not large in size and most people do not even notice them. In fact, when our providers are discussing hearing aids, Drs. Kortbus and Lynch-Rinaldi are often wearing them ourselves and the patient is surprised to see them AFTER they are pointed out in our ears! Dr. Lynch-Rinaldi manages audiology at hudsonENT, and has been in the business for more decades than she would like to admit. Many insurances cover hearing aids, or might include a “rider policy” for them. We accept especially CDPHP and MVP-TruHearing for dispensing hearing aids. Come see the experts at hudsonENT today, and discover how your quality of life can take off! Call 845-758-1456
Many patients who come to Hudson ENT need to have a hearing test (c.f. Blog from 2/18). Sometimes, those hearing tests show discrepancies in one ear versus the other. Meaning one ear has better hearing than the other. If there is a significant difference in hearing between the ears, the standard of care is to order special imaging test called MRI (which is magnetic resonance imaging). Many times people wonder if this has radiation, but it does not. This test is a specialized test that will allow the doctor to see the structures of the inner ear. Because any provider cannot "see the inner ear", this is the best test to use to rule out any problems there. More specifically, we are looking to make sure a person does not have a benign growth called an acoustic neuroma. There is a structure in the inner ear that carries nerve input back and to the cochlea and semicircular canals and the brain and this conduit is called the internal auditory canal. Within that canal, four nerves travel and these nerves are surrounded by cells which helped the impulses get to the brain faster. In fact, it is those cells that can make a benign growth which, if not found, could create great problems such as a balance problems, further hearing problems and if not cared for, deeper brain problems. Otolaryngologists order MRI tests frequently, since many patients have a significant discrepancy in hearing between the ears, tinnitus in one ear, and sometimes the sensation or sound of a heartbeat in the ear. Do you have any such symptoms? Give us a call.
Patients occasionally present to Hudson ENT with “voice problems” and hoarseness, along with an ineffectual cough and breathiness, or “shortness of breath”. Otolaryngologists and staff, also known as ENT’s or “ear, nose and throat” specialists are well equipped to make the diagnosis, which in this case is often found to be “vocal paralysis”. Many times, patients will report that they developed this problem after a cold, or some stressful activities. Sometimes patients are not sure when it happened, or they come because a loved one has recommended them to after being hoarse for a time. We are well equipped to help here in Red Hook, since a laryngoscopy or nasal “scope” is all that is needed to visualize the voice box and the vocal cords that make our voices work. The standard of care after the visit usually entails an imaging test, to be sure that the nerve that goes to the vocal system is intact and there is nothing along it’s path that might make it not work. Thankfully, most patients who are found to have a vocal fold that does not work have (a) an otherwise normal exam; (b) normal imaging tests; (c) need no further “major work-up”; (d) benefit from voice therapy and (e) often get better spontaneously. Do you or a loved one have problems with the voice? At Hudson ENT, we pride ourselves on a small family-like atmosphere of caring, along with efficiency, painless testing, and concise trustworthy recommendations. Give us a call today at 845-758-1456 and let us help you and your family.
Hudson ENT, the office of Dr. Kortbus and staff, would like to announce the Hudson Valley’s launch of TruDi, a real-time, three-dimensional (3D) navigation system for ENT procedures performed in our office. The system was developed in collaboration with another Johnson & Johnson company, Biosense Webster, who develops technology used to treat heart rhythm disorders. TruDi leverages Biosense Webster’s advanced imaging system, which utilizes electromagnetic technologies to help electrophysiologists navigate the beating heart by generating an accurate map, and pinpoints the exact location and orientation of catheters used during diagnostic and therapeutic procedures. TruDi is an electromagnetic image-guided navigation system designed to offer Doctor Kortbus an accurate, simple, and reliable option for your endoscopic sinus office procedure. It is intended for use during intranasal and paranasal image-guided navigation for eligible patients, and TruDi enables the use of RELIEVA SPINPLUS® NAV, reportedly the “first 3D navigation-enabled” Balloon Sinuplasty System for the treatment of chronic sinusitis. “TruDi enables precise localization of the surgical device relative to the preoperative CT scan, facilitating the surgeon’s understanding of the complex anatomy of the narrow spaces of the paranasal sinuses. The system incorporates microsensor technology, innovative tracking hardware and software tools enabling the surgeon to easily and accurately confirm instrument placement during minimally invasive sinus procedures,” says a colleague of Dr. Kortbus. “The system incorporates microsensor technology, innovative tracking hardware, and software tools enabling the surgeon to easily and accurately confirm instrument placement during minimally invasive sinus procedures.” As patient’s sinus anatomy can be very challenging, being able to improve the efficiency during sinus balloon cases is imperative. As stated above, the procedure is available for select patients based on their symptom history, their treatments already had, the appearance of their CT scan imaging and such. Many patients believe if they don’t have a headache, it is not sinusitis. This is often not the case, so it might be time for you or your loved one to inquire about TruDi today. Call Hudson ENT’s Dr. Kortbus and staff at 845-758-1456.
Last month, I saw a patient with a chronic illness. We discussed various options for her condition. We discussed how physicians are trained to give many options and essentially “never give up”.
Most of the time, we can give at least three or four options. Patients typically then ask “What would you do?” (WWYD). And this is the essence of shared decision making.
As I was going through my concerns, the patient asked me “What if I just let it be”. It’s not that I had not heard this before, but for some reason I really thought hard about this.
A few days later, I saw an auto mechanic who also had a minor issue. And his words were: “Hey, Doc. If I see someone with a slipping transmission, one option is to drive with that…with a slipping transmission”. If I do that, would that be OK? Again, this was a safe option for this man. We discussed when the transmission was totally out, then it might need overhaul and he would call when that happened.
One thing I do very much like about shared decision making, though, is to always give hope. Many are told, for example, that “you’ve got ringing in the ears and that’s that”. That takes away from the patient’s sense of fullness and patients actually undergoing the grieving process.
As patient’s nowadays grow older that they used to, it’s time to rethink this conversation with each patient. Has someone told you news that did not fit with what you hoped for? Maybe it’s time to get a fresh set of eyes on the issue. Give us a call today (845) 758-1456.
Please join us in welcoming Lauren Dierlam, PA who just moved to the area with her husband and pets. Lauren is enjoying her first week with Dr. Michael Kortbus and staff.
What exactly is a mid-level practitioner? They are licensed medical professionals who practice medicine as part of a team, and they include Physician Assistants (PA) and Nurse Practitioners (NP). While there are differences in training and regulations between the two professions, both are dedicated to delivering high-quality patient care with compassion and understanding. You may have encountered a mid-level practitioner in many different medical settings including: hospitals, ambulatory surgery centers, outpatient primary care offices, and outpatient speciality offices. PAs and NPs may practice general medicine or specialize.
What are the benefits of a mid-level practitioner? Mid-level practitioners perform comprehensive physical examinations, order appropriate lab tests and imaging, interpret results, as well as diagnose and treat in the same manner as a Medical Doctor (MD). One major value that a mid-level will add to a practice is their ability to work in a team. This allows the PA or NP to coordinate care with every individual on the patient’s medical team in order to provide the highest quality care. Mid-levels excel in communication both between medical professionals and the patient. By providing their patients with easy-to-understand information they empower their patients and allow them to take control of their health. In summary, Physician Assistants and Nurse Practitioners are skilled medical professionals that are easily accessible in the community and are dedicated to providing quality and compassionate patient care.
Give us a call at 845-758-1456 for all your ear, nose and throat needs in the Hudson Valley.
Over the past few weeks, we have added TWO NEW in office procedures: Clarifix and Vivaer.
In the past, many would need to have rhinoplasty with a plastic surgeon to adjust the nasal valves, which are the very important air intake regions that are just inside of the nostrils. Now, with a less than half-hour procedure known as Vivaer®, was can improve your breathing with essentially no downtime.
For those with runny noses and post-nasal drip, we are offering a new tool called Clarifix®. Likewise, we find an 85% success rate at improving or eradicating runny nose and / or post-nasal drip. To date, no adverse effects have been described after > 5000 cases. Now, as I have written about in the past, it does require a thorough evaluation, as written here >> Throat-reflux
In the operating room at both Columbia Memorial Health and Northern Dutchess, Dr. Kortbus is offering more nasal valve treatment with the Latera® implant; sinus stents with Propel®; computer-guided surgery from Medtronic®, and all with relatively low downtimes as well.
In summary, Dr Kortbus and staff at hudsonENT are well equipped to help you find the problem and often, help you alleviate it. Give the office a call today at 845-758-1456 if you or a loved one could use help with their nasal and sinus concerns!
Acid reflux is diagnosed many times per day at ENT offices. Most people are surprised that it is definitely among the top few diagnosis received among those who complain of throat problems.
Common symptoms include:
cough hoarseness post nasal drip clearing of the throat throat mucus feeling of something caught in the throat, aka "lump in the throat" sometimes soreness of the throat food or drink "going down the wrong pipe"and rarely heartburn.
That last symptom leads a lot of people to have some skepticism healthy about it being acid reflux. Hence the phrase "silent reflux".
Physical exam is performed without pain at hudsonENT. At times, we can find mechanical problems such as thyroid nodules, but even these are not usually the cause and are asymptomatic. However, and sure enough, endoscopy and pH studies often times reveals reflux to be the culprit. In the past, archaic tests like barium esophagram were relied on to show reflux but it does not mean that you don't have reflux if it's negative.
In this autumn season, with school well underway, we are having more and more patients with runny noses. Most of the time, this is a seasonal problem. Primary providers may reassure parents that it is likely due to allergies. These days, nearly all of the medicine used to treat allergies are "over the counter" and don't need a prescription.
However, there are some children whose noses run through the year. There are several possible diagnoses, of course, and many of them tend to be of a surgical nature. For most parents, the idea of bringing a child to the operating room is usually daunting, so we try conservative management. Another term used for this approach is "medical therapy".
Some studies show that the same medicine that would treat nasal allergies will also treat enlarged mucous membranes and adenoids. For many reasons, and despite the literature suggesting otherwise, medicines are not always successful.
On inspection, sometimes the diagnosis can be seen easily (such as deviated septum). Often, a small scope is used to examine beyond the very front of the nasal cavity to make the diagnosis. There are some very rare anatomical abnormalities that can cause mucus to flow out of the nostrils instead of the usual route down the throat, but the most common diagnosis by far is enlarged adenoid. The team may then consider the procedure known as adenoidectomy.
One of the more interesting topics is what comprises chronic sinusitis in a child. The proverbial "snotty-nosed kid" actually, in all likelihood, might have more than "just allergies". If those discharge elements are cultured, they tend to be infectious - my approach to such children is more careful. Also, to prove allergies in a child can also be difficult due to the use of percutaneous investigation.
This procedure is done in an operating room under general anesthesia. There are no scars or incisions, and the adenoid tissue is removed through the mouth. (Please see social media posts for anatomy images as well). For the most part, this is a very well tolerated procedure and other than the day of surgery, there are actually very limited post-operative recommendations. An example might include no "PE" (aka gym class, or physical education) or extracurricular sports. We actually tend to give no dietary restrictions, although most parents give cool and soft food and drinks, since the anesthesia might cause a sore throat.
After the procedure we have a 3-month follow-up appointment and the overwhelming majority of patients / parents report that their child can breathe much better, sleeps better and has had less severe nasal discharge.
If someone you know has such issues, consider a thorough investigation: give Hudson ENT a call and schedule an appointment.