3D-image guided sinus surgery provides a breath of fresh air

April 30, 2019
Kristina Mitchell rides her horse, Jazz.
Kristina Mitchell and Jazz. Photo courtesy Mitchell family.

Chuck and Suzi Mitchell describe their 14-year-old daughter, Kristina, as someone with a huge heart.

“She’s very kind and funny,” said Suzi. “She’s passionate about animals and goes out of her way to help people.”

But a few months ago, it was Kristina asking for help.

“She said, ‘Mom, please help, I can’t stand this,’ ” recalled Suzi. “We knew then that it was time to explore other treatment options for her chronic sinusitis.”

Impacting more than breathing

Kristina had dealt with chronic sinusitis for years. Pain, discomfort, headaches.

“Most mornings, I woke up with a blocked nose,” she said. “I couldn’t run for long distances. I also had really bad ear pain, and I felt like I always had a headache.”

Kristina Mitchel sprays snow while skiing in this photo.
Kristina Mitchel was a junior coach with Steamboat Springs Winter Sports Club last winter. Photo courtesy Mitchell family.

“It was starting to impact her life,” said Chuck. “She kept having headaches and was missing school because she couldn’t focus. She started to struggle a bit. Going over the pass was difficult with the pressure changes and how it made her head and ears feel.”

The condition started to have social impacts, too.

“We noticed her being at home a little more,” said Suzi. “She was spending more time feeling unwell instead of being with her friends. There started to be fewer invitations to friends’ houses and sleepovers because they knew there was a good chance she’d start to not feel well or would need to leave early.”

Over the last 18 months, it got to the point of monthly visits to the pediatrician’s office.

“We tried every over the counter and prescription option possible. Dr. [Sheila] Fountain couldn’t keep her on antibiotics any longer,” recalls Suzi. “Allergy testing didn’t lead to anything. Even nebulizer treatments didn’t help.”

It was about that time that Fountain learned of the impending arrival of Dr. Jason Sigmon, an otolaryngologist, at UCHealth Ear, Nose and Throat Clinic in Steamboat Springs.

“A referral to an ENT for surgical evaluation is appropriate if the patient’s symptoms are refractory, or not responding, to treatment; if swelling in the nasal passages is severe enough to create obstruction; or polyps are suspected,” said Fountain. “Kristina met the first two criteria.”

Kristina ended up being one of Sigmon’s first patients. After learning of her medical history and continued struggle with sinusitis, he recommended a CT scan.

“It was important to understand if there were any anatomic or functional sinus changes that might be contributing to Kristina’s sinus and nasal symptoms,” said Sigmon.

Following the scan, Sigmon recommended 3D image-guided sinus surgery, something he had performed for 14 years at a previous hospital. While the surgery had been performed at YVMC in the past, the 3D aspect was a first.

“She was experiencing so much discomfort and pain, we said, ‘Let’s do it,’” said Suzi. “Kristina wanted it. She wanted to be out of pain.”

Dr. Jason Sigmon traces a “mask” on Kristina’s face that matches up with her CT scans. Photo by UCHealth.

Guiding the way

After discussing the option of surgery, the family agreed it was the necessary next step.

“I was very nervous,” said Kristina. “I didn’t know if it would work and if it would be worth it.”

The day before the surgery, Kristina had another CT scan to see if there had been any changes since the first scan.

On the morning of the procedure, Kristina and her parents arrived at YVMC.

“I feel really strongly about trying to use local doctors and medical services,” said Suzi. “We’ve lived here a long time and always try to have things done here if possible.”

Dr. Sigmon then uses the 3D images to guide the probe, identified in the image by the dot on Kristina's nose, through the nasal cavity. Photo by UCHealth.
Dr. Sigmon used the 3D images to guide the probe, identified in the image by the dot on Kristina’s nose, through the nasal cavity. Photo by UCHealth.

Once in the OR, Sigmon used a “pencil” to trace an imaginary mask around Kristina’s eyes and nose. That mask then electronically matched up with the CT scans, giving Sigmon a very clear view of Kristina’s sinus cavity and the area in which he needed to perform the procedure.

“The 3D component is incredibly helpful,” said Sigmon. “It allows me to more safely navigate to the sinuses while protecting the eyes and brain structures during surgery. Recovery is quicker and less painful as it doesn’t require painful packing in the nose.”

The procedure went well, and after a few hours in recovery, Kristina was discharged home the same day.

Inhale, exhale

More horseback riding and sleepovers with friends top the list of things Kristina is anxious to do.

“There’s a lot of dirt and dust in the arena, so I couldn’t be in there long,” she said. “I’m not so worried about getting a migraine at a sleepover and having to go home early.”

Chuck and Suzi continue to monitor Kristina’s recovery at home, following a post-op appointment with Dr. Sigmon.

“We’re glad Dr. Sigmon is in our medical community now,” said Suzi. “And we’re glad our daughter is on the road to being able to breathe easier.”

This is a photo of the Mitchell family.
(R-L) The Mitchell family – Roo, Ellie, Suzi, Kristina and Chuck. Photo courtesy Mitchell family.


About the author

Lindsey Reznicek is a communications specialist at UCHealth Yampa Valley Medical Center in Steamboat Springs, Colorado. She has spent the last ten years working in marketing and communications in health care, an industry she never considered but one to which she's contributed through her work in media relations, executive messaging and internal communications. She considers it an honor to interact with patients and write about their experiences; it’s what keeps her coming back to work each day.

A native of Nebraska, Lindsey received a Bachelor of Arts degree in journalism, with a focus on public relations, from the A.Q. Miller School of Journalism and Mass Communications at Kansas State University – she bleeds purple.

She could see a Broadway musical every week, is a huge animal lover, enjoys a good shopping trip, and likes spending time in the kitchen. Lindsey and her husband have two daughters and enjoy hiking in the summer and skiing all winter long.