Breath of Fresh Air After Sinusitis Treatments

Burdened for decades by severe sinusitis, Salvador Barba is now living life to the fullest thanks to a USC Caruso otolaryngologist and rhinologist.

For most of his life, Salvador Barba has struggled with something others might take for granted: being able to easily breathe through his nose.

“I’ve always had sinus issues,” says Salvador, 51, a Rancho Cucamonga resident and part owner of a fruitimporting business. “It started getting bad in my late 20s. My nose was almost always stuffy. I had headaches, continuous mucus when it wasn’t stuffy and asthma flare-ups. I couldn’t play baseball as much as I wanted because I had trouble breathing when I ran.”

It also took an emotional toll.

“I felt terrible because when I was speaking to people, both as a child and as an adult, they made fun of the way I sounded,” he says.

Salvador turned to community ear, nose and throat (ENT) physicians, who diagnosed him with allergic rhinitis and chronic sinusitis with polyps.

Medical therapy, including medications and other nonsurgical treatments, were tried first with no improvement. Per his doctor’s recommendations, Salvador then underwent two endoscopic sinus surgeries.

Unfortunately, his condition continued to worsen.

Specialized sinusitis treatment approach

About 10 years ago, with no significant improvements, Salvador was referred to Bozena Wrobel, MD, an otolaryngologist and rhinologist with the USC Caruso Department of Otolaryngology – Head and Neck Surgery, part of Keck Medicine of USC, who is highly experienced in treating difficult sinus conditions with the latest techniques.

There was new hope on the horizon for Salvador, but it would not be a quick fix.

It took three more surgeries, including a highly specialized sinus frontal drill-out (also known as the modified endoscopic Lothrop procedure) as well as endoscopic medial maxillectomies to achieve stabilization of Salvador’s disease.

Management of Salvador’s severe inflammatory disease also required the involvement of a Keck Medicine allergist and immunologist, who provided treatment both with allergy immunotherapy and two different biologic injections.

Unfortunately, Salvador ended up being in the very small percentage of patients who did not benefit from either of these treatments.

Dr. Wrobel determined that the highly specialized surgical interventions, along with providing maximum access to his sinuses for treatment with topical medications and close surveillance, would be the most sustainable solution to Salvador’s aggressive and recalcitrant chronic sinusitis and polyps.

Salvador now has office visits with Dr. Wrobel about six times a year in the rhinology clinic at Keck Medical Center of USC.

The large, surgically created spaces in his sinuses allow for full in-office management of his flare-ups. Dr. Wrobel is able to do debridements — clearing of his sinuses — as well as endoscopic placement of steroid-diluting dissolvable stents, if needed.

“It’s wonderful,” Salvador says, “because she’s able to suction out anything stuck in my sinuses, and if she sees an infection, can treat it right away. I appreciate that Dr. Wrobel is very passionate about making me healthy, and that her staff have the same attitude.”

Lifestyle improvements after sinus debridements

Successful treatment has enabled Salvador to do things he never before could.

“Now, I can fly anywhere in the world and not be afraid of my ears popping or sinuses acting up,” he says. “My family and I are big soccer fans. In 2022, for the first time I went to the World Cup in Qatar. I can also go to parks and be out in the open.”

Other new activities include working out with weights and buying a ranch in Riverside County, which he plans to turn into a retirement property where he will go horseback riding, care for cattle and grow an avocado farm.

Dr. Wrobel, who describes Salvador as very personable, warm and kind, says his case shows that “even for patients with very difficult disease, there’s a way to help manage it and improve their quality of life.”

She also recommends that patients with chronic and severe sinus disease seek a rhinologist’s help sooner rather than later, as traditional surgical approaches might not be sufficient for management of this rare yet severe and debilitating disease.

“What she did for me was life-changing,” Salvador says. “When I have an appointment with her I always look forward to walking out of there feeling better.”

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