If you’ve ever felt pressure, pain, or a plugged sensation in your ears during descent, you know how quickly a dive can go wrong. For many divers, this isn’t just bad luck — it’s Eustachian tube dysfunction (ETD), and it’s more common than most people realize.

As a DAN-affiliated ENT specialist who treats divers from across the country, I see this condition regularly. The good news: ETD is highly treatable, and in most cases, divers can get back in the water with the right intervention.

What Is the Eustachian Tube?

The Eustachian tube is a narrow channel connecting the middle ear to the back of the throat. Its job is to regulate pressure in the middle ear — equalizing it with the outside environment. In a healthy ear, this happens automatically. In ETD, the tube doesn’t open properly, leaving the middle ear unable to equalize with the increasing pressure of descent.

The Treatment That’s Changing Everything for Divers

For divers with chronic or moderate-to-severe ETD, the most effective treatment is Eustachian tube balloon dilation — a minimally invasive, in-office procedure. No general anesthesia. No hospital stay. Most patients are back to normal activity within days — and many are cleared to dive within weeks.

Start with a Telehealth Consultation

Because I see diving medicine patients from across the country, I offer telehealth consultations as a first step. Geography should never be a barrier to getting the right care.

Nasal obstruction is one of the most common complaints I hear in my office every week. Patients describe it differently — one nostril always blocked, worse at night, can’t breathe through both sides — but the frustration is always the same. The good news is that in the vast majority of cases, we can fix it.

The Most Common Causes

Deviated septum is the most frequent culprit. The septum — the wall of cartilage and bone dividing your nasal passages — is rarely perfectly straight. When the deviation is significant, it narrows one or both airways and makes breathing difficult. This is correctable with a septoplasty, a straightforward procedure performed under general anesthesia.

Turbinate hypertrophy is another major cause. The turbinates are small structures inside the nose that humidify and filter the air you breathe. When they become chronically swollen — from allergies, irritants, or hormonal changes — they block airflow. Turbinate reduction is a quick, minimally invasive procedure that can dramatically improve breathing.

Chronic sinusitis causes nasal congestion, pressure, and obstruction that can feel permanent. When medications fail, balloon sinuplasty or functional endoscopic sinus surgery (FESS) can restore drainage and open the sinuses permanently.

Nasal polyps are soft, noncancerous growths that develop in the lining of the nose or sinuses. They rarely cause pain but can completely obstruct airflow. New biologic medications and surgical options have transformed how we treat them.

When to See an ENT

If you’ve had nasal obstruction for more than a few weeks and over-the-counter medications aren’t helping, it’s time to see a specialist. A nasal endoscopy — a quick, in-office procedure — gives us a clear view of exactly what’s causing the blockage. From there, we can build a treatment plan specific to your anatomy.

Difficulty breathing through your nose affects your sleep, your energy, and your quality of life. You don’t have to just live with it.

A growing body of research is establishing one of the most compelling connections in medicine today: untreated hearing loss significantly increases the risk of cognitive decline and dementia — and treating it with hearing aids may meaningfully reduce that risk.

What the Research Shows

A landmark study tracking adults with moderate hearing loss over seven years found that hearing aid prescription was associated with a significant reduction in dementia risk — even though cognitive function itself didn’t improve during the study period. What this tells us is that hearing intervention may be protective long before cognitive symptoms appear.

The mechanism isn’t fully understood, but several theories are compelling. Hearing loss forces the brain to work harder to process incomplete auditory signals, diverting cognitive resources. Social isolation from untreated hearing loss is itself a major dementia risk factor. And some researchers believe that the auditory cortex may begin to atrophy when it stops receiving adequate stimulation.

What This Means in Practice

As an ENT surgeon, I believe hearing health deserves to be treated with the same urgency as blood pressure or cholesterol. We don’t wait until someone has a stroke to treat hypertension — we intervene early. The same logic applies to hearing loss.

If you or a family member is struggling to hear in conversations, turning up the TV, or asking people to repeat themselves regularly, a hearing evaluation is the right next step. Treatment options range from hearing aids to surgical interventions depending on the cause and degree of loss.

Don’t wait. Your hearing and your brain are connected in ways we’re only beginning to fully understand.

Chronic sinusitis affects over 37 million Americans and is one of the most common reasons patients end up in my office. When medications have failed and the symptoms keep coming back, surgery becomes a real conversation. The two most common options are balloon sinuplasty and traditional functional endoscopic sinus surgery (FESS) — and choosing between them isn’t always straightforward.

Balloon Sinuplasty

Balloon sinuplasty is a minimally invasive procedure in which a small, flexible balloon catheter is inserted into the sinus opening and gently inflated to widen the drainage pathway. No tissue is removed. It can often be performed in the office under local anesthesia, with minimal downtime — most patients return to normal activity within 24 to 48 hours.

It works best for patients with mild to moderate chronic sinusitis affecting the frontal, maxillary, or sphenoid sinuses, without significant polyps or anatomical abnormalities.

Traditional FESS

Functional endoscopic sinus surgery is performed under general anesthesia and allows the surgeon to remove obstructing tissue, polyps, and bone — opening the sinuses more extensively. It is more appropriate for patients with significant anatomical blockages, nasal polyps, or disease that balloon sinuplasty cannot adequately address.

Recovery typically takes one to two weeks, but the results can be transformative for the right patient.

Which Is Right for You?

The honest answer: it depends on your anatomy and the severity of your disease. A CT scan and nasal endoscopy give us the information we need to make the right recommendation. I’ve performed both procedures extensively and believe strongly that the decision should be individualized — not driven by what’s technically easier or faster.

If you’ve been told you need sinus surgery, or if you’ve been suffering from chronic sinusitis without relief, come in for an evaluation. We’ll review your imaging together and discuss what makes the most sense for you.

Tinnitus — the perception of ringing, buzzing, hissing, or clicking in the ears without an external source — affects over 50 million Americans. For most, it’s an occasional nuisance. For roughly 20 million, it’s chronic. And for about two million people, it is severe enough to interfere with daily life. As an ENT surgeon, I want to set the record straight on what tinnitus is, what causes it, and what actually helps.

What Causes Tinnitus?

Tinnitus is a symptom, not a disease — which means it has many possible causes. The most common is noise-induced hearing loss, where damage to the hair cells of the inner ear triggers abnormal electrical signals that the brain perceives as sound. Other causes include ear infections, earwax buildup, Eustachian tube dysfunction, Meniere’s disease, certain medications, and in rare cases, vascular or neurological conditions.

What Actually Works

I want to be direct with patients: there is currently no FDA-approved cure for tinnitus. But there are effective management strategies. Sound therapy — using external noise to reduce the contrast between the tinnitus and the surrounding environment — is one of the most widely used approaches. Cognitive behavioral therapy has strong evidence for reducing the distress associated with tinnitus. And for patients with underlying hearing loss, hearing aids frequently reduce tinnitus perception significantly.

If tinnitus is occurring in only one ear, is pulsatile (beats in rhythm with your heart), or is accompanied by hearing loss or dizziness, an evaluation is urgent. These presentations can indicate underlying conditions that require prompt attention.

When to See an ENT

If your tinnitus has persisted for more than a few weeks, or if it’s affecting your sleep, concentration, or quality of life, come in. A thorough evaluation — including a hearing test and examination — can identify treatable causes and help us build a management plan that actually works for you.