Procedures We Perform



Fiberoptic endoscopy is performed in order to evaluate areas of the head and neck that are not otherwise able to be visualized. CT and MRI scans provide static views and not functional views (how things move or work over a continuous period of time). Prior to the examination, the nose is decongested and anesthetized with nasal sprays. These exams are performed without any sedation and are easily tolerated by patients as young as 5 years of age if fully cooperating.



Septoplasty is an operation to correct a deformity of the nasal septum.  It is sometimes referred to as submucous resection of the septum (SMR) or septal reconstruction.  The usual purpose is to improve nasal breathing, but it may also be performed to allow adequate examination of the inside of the nose for treatment of polyps, inflammation, tumors, or bleeding. When the nasal septum is deformed, there is no medicine that will cause it to be straightened, so surgery is the only solution to this problem.



What Are Adenoids?

The adenoids (say: add-eh-noids) are lumpy clusters of spongy tissue that help protect kids from getting sick. They sit high on each side of the throat behind the nose and the roof of the mouth. Although you can easily see your tonsils by standing in front of a mirror and opening your mouth wide, you can't see your adenoids this way. A doctor has to use a small mirror or a special scope to get a peek at your adenoids.


Endoscopic sinus surgery - is a procedure used to remove blockages in the nose and sinuses (the spaces filled with air in some of the bones of the skull). These blockages cause sinusitis, a condition in which the sinuses swell and become clogged, causing pain and impaired breathing.

A thin, lighted instrument is inserted into the nose, and the doctor looks inside through an eyepiece. Surgical instruments can then be used along with the endoscope to remove the blockages and improve breathing.

This surgery does not involve cutting through the skin, as it is performed entirely through the nostrils. Therefore, most people can go home the same day.

Endoscopic sinus surgery is designed to increase the amount of air flowing through the sinuses and allow mucus to drain properly out of the nose. The procedure can:

    • Relieve nasal blockages
    • Relieve facial pain
    • Improve breathing
    • Improve the sense of smell and taste 

Endoscopic sinus surgery is an effective procedure to correct:

    • Sinusitis
    • Deviated septum, in which the partition separating the left and right sides of the nose is crooked
    • Polyps, a noncancerous water-filled swelling
    • Tumors, a swelling caused by an uncontrolled growth of cells



Why are tubes recommended or inserted? 

Two reasons are common: 1) Fluid that has not cleared for a long period of time...usually at least 3-4 months.  The fluid, especially if on both sides, always causes some degree of hearing loss.  2) Multiple ear infections that have not been adequately controlled with medical treatment or that are particularily severe. Other less common reasons include:  severe retraction or distortion of the ear drum, pressure problems (barotrauma) - such as seen in patients undergoing hyperbaric oxygen treatment, or a "patulous eustachian tube".

What do tubes actually accomplish? 

Since fluid is usually removed at tube placement, hearing is immediately restored.  Most experts feel that the aeration of the ear reduces the likelihood of acute otitis media (ear infections).  Infections become more reliably detected, since they will drain out through the tube...and the infectious material can be cultured, if necessary.

How are they placed? 

Typically, a small incision is made in the ear drum (called a myringotomy), fluid is suctioned out, and a tube is placed.  Antibiotic ear drops may be placed. In young children, this is usually done under a light general anesthesia, although there are some other options that are occasionally used.  Adult patients may tolerate the procedure under local anesthesia. 


Uvuloplasty or Uvulopalatopharyngoplasty (UP3)

Uvuloplasty (YOU-view-low-plas-tee) or uvulopalatopharyngoplasty (you-view-low-pal-it-tow-far-in-go-plas-tee) is surgery to remove or shorten the palate and/or the uvula---the small piece of tissue that hangs at the back of the throat. (When a laser is used, doctors call this surgery LAUP for short.) The procedure is done to help stop snoring or sleep apnea. If you still have your tonsils, the doctor may remove them as well.



The surgical procedure to remove tonsils is called a tonsillectomy. The doctor may suggest tonsillectomy if your child has one or more of the following:

          • persistent or recurrent tonsillitis or strep infections
          • swollen tonsils that make it hard to breathe
          • difficulty eating meat or chewy foods
          • snoring that might be affecting the child's daily activities
          • obstructive sleep apnea (a condition in which your child may stop breathing for a few seconds at a time during sleep because enlarged tonsils are partially blocking the airway



Dr. Richard Ruiz MD
27403 Ynez Rd., Suite 107
Temecula, CA 92591
Phone: 951-467-4986
Fax: 951-541-9466

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