UAMS Helps Clear College Student’s Head

By Spencer Watson

Nicholas Hardin visits UAMS for a follow up appointment after having a blockage removed from his sinuses, eliminating his headaches.

“If I was unfortunate enough to get one of these headaches during the day, I’d have to skip class and miss a couple days of work,” said Hardin, a mechanical engineering major at the University of Arkansas, Fayetteville. “I actually had my grades in a couple of my harder classes go down because I missed some of the important class periods where they covered the major topic for that unit. I fell way behind.”

The worst pains — “pressing on the back of my eyes, I would describe it as a stabbing pain in my head” — left him unable to do much other than lie in bed and try to sleep them off.

“It was really frustrating knowing I couldn’t do anything about it. I tried different kinds of headache medicines, but because it wasn’t like an actual, normal headache, that didn’t help.”

Fearing the pain might indicate an aneurysm, doctors ordered a CT scan. But they didn’t see anything in the scan and sent him home. It wasn’t until Hardin saw his primary care doctor in Batesville that the answer became clear: a blocked passage had created a growing mucus buildup and an infection in his sinuses.

“He pulled the scan up on his computer and showed me where it was at and how it was growing…. But the only procedure he knew to fix it was really

Alissa Kanaan, M.D., uses an endoscopic camera to conduct a follow up exam on Hardin.

invasive and would’ve put me out of school for at least the rest of the semester. I was not looking forward to that, and he really didn’t want to do that because it’s such a major thing.”

Instead, Hardin was sent to otolaryngologist Alissa Kanaan, M.D., at UAMS.

“On the scan we saw that he had some disease in his frontal sinus, and that is one of the sinuses that is not easy to access,” she said. “So the way we did the surgery was endoscopic, a more straightforward way to approach the sinus and a much less invasive way.”

The alternative, said Kanaan, would have been a bicoronal approach, an incision from ear to ear along the hairline, pulling the skin down and cutting into the sinus from above. It’s a procedure with significant recovery time and potentially extensive scarring.

Kanaan displays the results of Hardin’s initial CT scan, with the sinus infection indicated in gray above the nose and eyes.

“But today, with the advances in endoscopic techniques and the presence of what we call a navigation system, which is basically like a GPS systemthat lets us follow our instruments in the nose, it makes it safer. Sinus surgery can be tricky because the area where the sinuses are located are around the eyes and the brain, so we have to be really careful not to injure any of these important structures, and this navigation system allows us to be much safer.”

For Hardin, who hasn’t had a headache since surgery, the result has been like night and day.

“I don’t think I really can compare how I felt before to how I feel now, because one was debilitating pain and the other is just, I don’t even think about it because I don’t notice it at all,” he said. “It’s like it wasn’t even there.”