The spectrum of issues the average otolaryngologist deals with is vast and ranges from sinus trouble to hearing impairments to ailments of the vocal cords. For this reason, when seeking treatment for any of those problems, it is important to seek out a doctor who is not only experienced but also one who has kept up to date with the latest advances in the field.
One such professional is David Goldfarb, D.O., FACS, of Princeton Ear Nose and Throat. While procedures and technology have taken great leaps forward since he started his career, Dr. Goldfarb, who has been Chairman of the Otolaryngology-Head & Neck Surgery Department at the University Medical Center of Princeton since 1994, has stayed abreast of the latest and greatest advances in his profession. He’s even added one of his own—the laryngeal pacemaker, a patented device that senses the movement of one’s own healthy vocal cords, then stimulates paralyzed vocal cords to mimic that movement.
One procedure that is wholly different in today’s ENT field is the once dreaded tonsillectomy, which is no longer a procedure to fear. “There isn’t anything we do today that is the same as 20 years ago,” Dr. Goldfarb says. “Something as simple as a tonsillectomy is done differently.”
At Princeton Ear Nose and Throat, “differently” now means a far less invasive technique than the traditional “knife and cauterize” method of old; rather, today’s procedure is done using ultrasound via a tool called a harmonic scalpel.
Sinus surgery, too, has been revolutionized, according to Dr. Goldfarb. Utilizing the Fusion ENT Navigation System, a means of imaging for the purposes of computer guidance during procedures of the skull and sinus, doctors are able to perform procedures with the most accuracy possible. On the minimally invasive side, many sinus surgeries can now be replaced with what is called a balloon sinuplasty, a procedure that utilizes a balloon versus the traditional scalpel. This procedure can provide relief to sufferers of chronic sinusitis as well as other issues.
Related to sinus ailments are allergy problems, which many face this time of year as the weather grows cold and activities and pets move indoors for the winter. Dr. Goldfarb, who completed ENT training at Thomas Jefferson University Hospital in Philadelphia, says that oftentimes determining allergens specific to a person can be achieved through a simple blood test, though other means of testing exist to help diagnose very specific allergens. Most allergies are quite treatable through antihistamine nasal steroids and leukotriene inhibitors. Dr. Goldfarb collaborates with other offices to offer allergy shots to those who need them.
As the first medical director of the Voice Center at the University Medical Center at Princeton, Dr. Goldfarb is also extremely well versed in matters pertaining to voice. One revolutionary technology he uses often to assess voice-related problems is computer video stroboscopy. A person’s vocal cords, on average vibrate, at a frequency of 250 vibrations per second, and it is difficult to pick up information on the voice when observing movement at that speed. This technology, which utilizes a strobe light to capture stop-motion images of a patient’s vocal cords, “allows us to see things on the vocal cords we normally otherwise wouldn’t notice,” says Dr. Goldfarb.
Then, of course, there is Dr. Goldfarb’s revolutionary laryngeal pacemaker. The device, which “restores the normal physiology,” is still in its experimental phase but will soon begin human trials at Thomas Jefferson University Hospital. Of his dual roles as doctor and inventor, Dr. Goldfarb says “having a background in both medicine and electronics allows me to fuse the thinking from two different areas into something that can help people.”
The laryngeal pacemaker, Dr. Goldfarb says, can also be used to help people suffering from sleep apnea, another problem Princeton Ear Nose and Throat sees often. Sleep apnea has the potential to be quite serious because it results in irregular breathing. This can cause a person to snore loudly and wake feeling unrested even after a full night’s sleep.
In addition to the electrical stimulation from a pacemaker, which can be used to keep the tongue from falling into the wrong position during sleep, there are other options for sleep apnea sufferers. This includes the utilization of a CPAP (continuous positive airway pressure) and AutoPAP machines to force air into the nose and throat so a person does not stop breathing during sleep. Sleep apnea can also be addressed surgically, but thanks to advancements in self-adjusting AutoPAP titration, many people can have their sleep apnea treated in their own homes.
Another major component of the work done at Princeton Ear Nose and Throat relates to hearing. One common issue is tinnitus, or ringing in the ears. “Everyone has that once in a while, but some people have it all the time and it can really be debilitating,” Dr. Goldfarb says.
Jaime Goldfarb, Au.D., an audiologist with Princeton Ear Nose and Throat and also Dr. Goldfarb’s niece, explains that while the causes of tinnitus remain nebulous in the field, there are therapies and means of addressing the problem that can ease patients’ suffering. Individuals can try myriad approaches including a lowered sodium diet, listening to white noise for 20 minutes each day and even iPhone apps. Certain individuals can also benefit from a special hearing aid that has “the ability to mask the ringing,” she says.
Dr. Jaime Goldfarb, who is certified by The American Institute of Balance in vestibular testing and vestibular rehabilitation, is also extremely well versed in issues pertaining to balance. Via a technology called VNG testing (short for videonystagmography), a patient can receive a state-of-the-art balancing diagnosis using goggles that record eye movements. “What we’re able to do is track what’s causing the dizziness,” she explains. The technology allows Princeton Ear Nose and Throat to evaluate the three separate parts of the balance system, including the eyes, ears and how the information from them travels to the brain.
No matter the problem, Dr. David Goldfarb says one facet is common to all treatment provided by Princeton Ear Nose and Throat: “I treat people the way I want to be treated.”
Dr. David Goldfarb | Princeton Ear Nose and Throat
10 Forrestal Road South, Suite 206
Princeton, NJ 08540
609-917-7181
lddg.co/PrincetonENT
