(gentle piano music)
>> My wife and I have been married for,
in September, it will be 45 years.
She's been through this,
all of this with me every step of the way.
I don't think we'd been
sitting here talking right now
if he she hadn't been there.
>> When I first met Mr. Howe,
he relayed a history to me of
probably one of the most severe forms
of this particular type of sinus disease
which is sinusitis with
hypoplastic nasal polyposis,
and it's accompanied by severe asthma
but difficult to deal
with allergy to certain
nonsteroidal anti-inflammatories.
So when he had come to me,
he had had already
17 previous sinus surgeries.
>> The pain when those
frontal sinus problems flared up
was just, I can't even describe it.
>> Marty,
>> Hi.
>> how are you?
Good to see you.
>> Good to see you.
>> Yeah.
It was clear to me that
we almost needed to be
creative by thinking
very deep and very hard
at his progression of disease,
his longterm prognosis,
and what we could offer him
short-term in the acute setting
because he was recurring
with an acute infection
which was dangerous in terms
of spreading to his brain.
So we had to really look at this
from a different perspective.
So that's when we decided
to have a combined approach
with our facial plastics and
reconstructive colleagues
and with the help of our
head and neck surgeons,
that's when we involved Dr. Boahene.
His recommendation was really
that we should think about
major reconstruction of his forehead.
>> I began to suspect that
because of the multiple surgeries,
because of the multiple infections,
the bones over the sinuses
may be be chronically infected
and may have to be replaced.
But what I was going to do differently
which felt a little bit radical
is that I'm going to go
somewhere else in your body
and take tissue with new blood vessels
and transplant it into your sinuses
so that we can have new blood
and new tissue flow in that area.
>> As has been typical with me,
when they got in and
started looking around,
things were worse than they thought.
The piece of bone that they
took out of my forehead
had to be, they couldn't reuse it.
It was so heavily infected.
>> It become immediately
obvious that he had tiny holes
on the forehead through
which puss was coming out,
and the bones were just not viable.
So we took all those bones out,
and after that, we went into the sinus,
and fortunately, we were
able to find an area
where there was some hidden mucus cells
that kept on secreting.
So we were able to clear those things out.
Now with all the area cleaned out,
we had to rebuild the forehead.
But the most important
thing I think we did for him
was to bring tissue that had new blood
to feed the whole area.
So we went to his thigh
and have instead a flap.
We used that tissue to
fill the frontal sinus,
cover the new bone that we
used to rebuild the forehead,
and we connected the artery and veins
to artery and veins above his ears.
And with that, we can bring
new blood, healthy tissue
that has never been infected.
And now, should he get a sinus infection
just like anybody else, if we
treat him with antibiotics,
the antibiotics has a better chance
of getting to the sinuses.
>> And I'd say nothing
associated with the sinuses.
That's been, I'm amazed.
>> Perfect.
>> You know, when you're faced with
such a challenging patient like this,
it helps to have a team
that is there to support you,
and for me, it gave me courage
that we could actually overcome
something like this for him.
>> Things are way better.
I haven't felt this good in a long time.
I feel blessed.
Between Dr. Kim and Dr. Boahene,
I don't think I could've
gotten better care anywhere,
anywhere at all.
(serene instrumental music)
