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Richard Petty doesn’t normally write laudatory letters about his physicians, but after treatment for chronic rhinosinusitis (CRS), he sat down and penned one to Giuseppe Colasurdo, MD, president of The University of Texas Health Science Center at Houston and then dean of the UTHealth John P. and Kathrine G. McGovern Medical School. In the letter, he commended the skill and professionalism of Martin Citardi, MD, FACS, professor and chair of the Department of Otorhinolaryngology-Head and Neck Surgery at the McGovern Medical School.
商业流程工程师和精益六西格玛黑带Petty计算了他的幕后年度支出，以销售和处方为2,100美元。再加上该数字另外1200美元的医生就诊，口服类固醇和类固醇注射，总计每年约为3,300美元。佩蒂说：“自从圣安东尼奥搬到休斯顿以来，我已经有数千美元的感染了。”“此举之后我看到的第一个ENT将我的症状描述为他见过的最糟糕的症状。窦感染会感觉像是流感的病例。我会感到身体酸痛，发冷，可怕的头痛，会错过几天的工作。”佩蒂（Petty）在2014年1月被转介给Citardi博士之前，看到了四个Ent，并接受了三项外科手术 - 2008年的两项手术程序。。
Maxillary & ethmoid sinusitis CT
This sagittal sinus CT shows the opacified frontal sinus (indicated by the yellow arrow). At the time of surgery, the frontal sinus was filled with retained secretions and swollen tissue. During surgery, tissue obstructing the frontal sinus drainage in the frontal recess (indicated by the red arrow) was removed. During the dissection, care was taken to preserve tissue at the outer walls of the frontal recess so that the sinus could resume normal function.
“Just as one seasonal allergen was subsiding, another was peaking. I was living in a perpetual state of allergic reaction,” he says. “Even after three surgeries I was still having regular sinus infections, but they no longer knocked me completely out of commission. I could push through and go to work.”
Dr. Citardi performed revision image-guided functional endoscopic sinus surgery on Petty early in 2014. “The patients who benefit most from the procedure, like Richard, are described by a fairly typical clinical scenario,” he says. “Most have had relatively recent sinus surgery and did well for a while before their symptoms returned, or their symptoms worsened following the procedure. They typically have congestion and purulent nasal drainage. They’ve received multiple rounds of antibiotics and steroids, and have finally been told they’ll have to live with the condition. These are the patients we need to see.”
Dr. Citardi coupled the surgery with an aggressive regimen of postoperative care, including medical management and close endoscopic monitoring of the cavity until complete remission. “Sinus and nasal surgery has come a long way, but ongoing medical management continues to be important,” he says. “We don’t just sign off on a patient after a good surgery. We follow them for at least two or three years and sometimes longer. With continued treatment following surgery, CRS patients can expect major improvement in almost all cases. The key is continued management guided by endoscopic examination over long periods of time.”
After the surgery Petty had more than 6 infection-free months instead of the four-to-six-week respites he’d experienced over the previous six years. “I went from 10 to 12 episodes of CRS annually to two,” he says. “To me that’s an enormous success. Over the years I’ve been told that as long as I live in an environment where I’m allergic to so many things, my care would be more about managing the CRS to prevent further infections. I’d heard that same statement from four other doctors, but Dr. Citardi is the first one who delivered it.”
In his letter to Dr. Colasurdo, Petty wrote, “Dr. Citardi made me feel like a partner rather than a problem to be solved. His extreme professionalism was tempered with unpretentious jocularity. He increased my quality time with my wife and children, increased my productivity in the workplace and increased my positive attitude in general.”
Petty says he meant every word he wrote in that letter. “It was well warranted. Dr. Citardi quite literally changed my life.”
