Surgeon specializes in trying innovative treatments New method used on woman's sinuses HOWARD COUNTY/HEALTH

February 02, 1993|By Deidre Nerreau McCabe | Deidre Nerreau McCabe,Staff Writer

As Dr. Lewis Newberg operated on the sinuses of a Pasadena woman last week, two trademark characteristics became apparent -- a desire for innovation and a quirky sense of humor.

Using a new instrument for the first time in the United States, Dr. Newberg removed infected tissue from the woman's sinuses, opening up passages to alleviate chronic headaches and allow her to breathe freely again.

The work was slow going -- the operation took four hours instead of two, as originally expected.

When the procedure, performed at Harbor Hospital Center in South Baltimore, was finally finished, the veteran surgeon turned to an observer and asked: "So, did you enjoy watching me pick a patient's nose?"

Just a little surgical humor, Dr. Newberg-style.

During his 22-year career, the 53-year-old surgeon who commutes from Chester County, Pa., to his office in Ellicott City, has pioneered several new techniques in ear, nose and throat surgery, including a procedure in 1989 to implant a prototype hearing aid. He was the first Maryland doctor to perform the surgery.

His reputation for trying new things is well-known among his peers.

"Overall, I'd say he's a little controversial," said Dr. Paul Meyer, a neurosurgeon at Harbor Hospital, who labeled his colleague "aggressive" about trying new advancements.

Wednesday marked Dr. Newberg's debut with the new surgical microscope whose light source the manufacturer -- Zeiss Inc. of Germany -- says is five times more powerful than that used by other surgical microscopes.

The light source was developed for use in neurosurgery; working with Zeiss, Dr. Newberg helped advance its use for sinus surgery.

"It's much safer," Dr. Newberg said of the new procedure. "There's much less chance of complications."

The most common surgical procedure used on thousands of patients suffering from acute, chronic sinusitis -- inflammation of the sinuses -- is endoscopy, where an instrument about the size of a straw, with its own light and viewing channel, is inserted into the sinus cavities.

Dr. Newberg said the disadvantages of endoscopy is that a surgeon must hold the machine and look through it with one eye, causing monocular vision and tying up one hand.

He believes endoscopy does not allow a clear view of the area to be operated on because it causes optical illusions and distortion.

Although endoscopy is popular with ear, nose and throasurgeons, Dr. Newberg believes it poses too high a risk of injury to the eye or brain.

"There's a 1 to 2 percent risk [with endoscopy], whereas with this, it's virtually zero," he said.

But Dr. Mark C. Loury, an expert on sinusitis at Johns HopkinHospital who frequently performs sinus surgery with endoscopy, disagreed.

"It's not so much the technique, it's what you're accustomed to,he said, adding that skilled surgeons using endoscopy have complication rates of less than 1 percent. He agreed that complications were higher shortly after endoscopy was introduced in the mid-1980s, but those rates fell after surgeons became more skilled.

Last week, 47-year-old Phyllis Valec of Pasadena wasn't thinkinmuch about whether microscopic or endoscopic surgery was in the vanguard.

She was concerned about getting relief from a 10-year sinus condition that had gotten so bad she could no longer work.

In September, she developed an infection she couldn't shake, despite eight rounds of antibiotics.

Her symptoms included migraines, sore throats and stomach aches from constant postnasal drip and problems breathing and sleeping.

When the infection spread to her eyes, she knew she needed drastic measures.

"My eyes were literally purple," she said. "It was just terrible."

Her doctor recommended Dr. Newberg. Although she was somewhat leery about being the first patient of a new technique, she had faith in her surgeon.

"You're nervous about any surgery," she said. "But I knew Dr. Newberg was really good. I had all the faith in the world in him."

A day after the surgery, Mrs. Valec said she was amazed at how good she felt.

"I'm very surprised and very pleased with how it turned out. There was no pain, no bruising afterward. I didn't take a single pain pill."

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