COVID-19 Response
In compliance with Governor Sisolak’s COVID-19 guidelines, we are taking the following steps in the interest of the safety of our patients, staff, and physicians for onsite appointments. We appreciate your understanding as we work to provide the highest standard of care in the safest environment possible. Our staff is available immediately to take appointments for either in-office or telehealth visits.
- All patients will be screened for symptoms of COVID-19 at the time of appointment booking, and also on both the day prior to, and the day of the visit. This screening will include a temperature check at the time of entry.
- The number of patients in the building at one time will be limited and extensive decontamination efforts in exam areas will be taken after each visit.
- All staff will wear masks at all times and we ask that patients do the same when visiting our office.
- If any patient has had symptoms consistent with COVID-19 in the 3 weeks preceding the visit, we will ask that they arrange for a telemedicine visit or see their PCP.
- We ask that those accompanying patients to our office be limited to one in the case of minors or those who need assistance only. Otherwise, we ask that only the patient themselves enter our building.
Dr. Josh Meier was featured on KTVN’s Ask The Doctor segment to discuss the loss of smell. Watch more below!
KTVN Channel 2 – Reno Tahoe Sparks News, Weather, Video
Dr. Josh Meier was featured on KTVN’s Ask The Doctor segment. Watch more below!
KTVN Channel 2 – Reno Tahoe Sparks News, Weather, Video
We are honored to be a top 10 finalist in the Hospital & Healthcare category of the Best in Business awards by the Northern Nevada Business Weekly! Thank you to our community for your support and acknowledgment.
Featured in the Northern Nevada Business Weekly – Keely Chevallier joins Nevada ENT and Hearing Associates. Read the full announcement below!
RENO, Nev. — Nevada ENT and Hearing Associates announced Aug. 3 that Dr. Keely Chevallier joined the Reno-based practice. 
According to an Aug. 3 press release, Dr. Chevallier, a Nevada native, comes from David Grant Medical Center at Travis Air Force Base, where she served as an Active Duty Air Force officer for four years, most recently as the Officer in Charge of the combined ENT, Audiology and Speech Language Pathology Clinic, and the Surgical Champion for the Hospital’s Informatics Steering Committee.
She served a tour in Afghanistan in 2018 as the only NATO forces ENT in the country. During this time, she took care of patients including U.S. Service Members, NATO forces and Afghan troops, providing care for traumatic injuries, respiratory failure and all diseases of the ears, nose, and throat.
Dr. Chevallier received a Bachelor of Arts in integrative biology from University of California, Berkeley. She received her Doctor of Medicine degree from University of Colorado, School of Medicine in Aurora, Colorado and completed her residency in Otolaryngology/Head and Neck Surgery at University of Utah Hospital in Salt Lake City, Utah.
Dr. Chevallier has been a member of the Alpha Omega Alpha Medical Honor Society since 2009 and has been board certified with the American Board of Otolaryngology since 2017.
Septal deviation is a common condition, with a significant portion of the population having their septum deviate to one side or the other. Commonly some degree of nasal trauma may cause a deviated septum. Many people are asymptomatic from this, however a few can have nasal obstruction symptoms on the side that is deviated. In these patients, septoplasty (i.e straightening the septum), can be performed. It is usually an outpatient procedure, performed under general anesthesia. After the operation, the patient can breathe better on the affected side. If the deviated septum is more posteriorly placed, endoscopic septoplasty is a good option for the patient. This approach can be done without packing or splints afterwards, and the recovery is easier. Commonly an inferior turbinoplasty is performed concurrently because the turbinates can be swollen due to allergies, or to compensate for the extra space on the non deviated side.
Josh Meier, M.D. F.A.R.S
Endoscopic septoplasty is a newer technique where an endoscope is used to visualize the nasal cavity to straighten the nasal septum. Most people’s septum will be deviated to one side or the other, which is not a cause for concern. However in some people the deviation is significant enough that it results in nasal obstruction. If this is the case, then they would be a candidate for septoplasty. The incision is made on the side of the deviation, 1-2cm back from the most forward part of the septum. The mucosa is lifted up on this side, then the cartilage is incised and the flap is lifted on the other side. Deviated bone and cartilage is removed, and the deviation is reduced. The flaps are stitched together with an absorbable mattress suture. The vast majority of the time, stents and packing are not required. This results in minimal post op pain, and Tylenol is adequate for postoperative pain control. Neilmed rinses are begun the next day. Not all people are candidates for endoscopic septoplasty, namely those with significant forward deviations, where a traditional approach is indicated. Please see the link below for an intraoperative video. Frequently endoscopic septoplasty is performed concurrently with endoscopic sinus surger.y In fact, inadequate septoplasty can be a reason for failure of surgery due to limited visualization of the sinuses while performing endoscopic sinus surgery.
Josh Meier, M.D. F.A.R.S.
http://www.sinusvideos.com/endoscopic-septoplasty-for-posterior-deviation/
Tumors of the nasal cavity and paranasal sinuses are not common in the general population, but are commonly encountered in a rhinology practice. When unilateral symptoms such as nasal obstruction, smell loss and epistaxis are present then evaluation by an otolaryngologist would be prudent.
The most common sinonasal tumor is an inverted papilloma. These are also known as Schneiderian papillomas. Fortunately these are benign tumors, but they can turn into squamous cell carcinoma eventually if not excised. They can occur throughout the nasal cavity and paranasal sinuses. Inverted papillomas can be quite large, but usually will have a distinct attachment site that can be identified on CT imaging by looking for an area of hyperostosis. MRI imaging is helpful to further define the extent of tumor and to distinguish between tumor and blocked secretions. Most tumors can be excised using traditional endoscopic sinus surgery techniques, and extended endoscopic approaches such as frontal sinus drillout and endoscopic medial maxillectomy can be used to remove tumors without external incisions. Treatment of the attachment site should be treated with excision, drilling or cauterization to ensure complete removal of all of the tendrils of tumor to prevent recurrence.
Allergic fungal sinusitis can mimic a tumor with its unilaterality, however it is uncommon in the West.
Sinonasal malignancies are thankfully rare (1:500,000 to 1:1,000,000), but prompt diagnosis and management are key to ensure survival. Squamous cell carcinoma, melanoma, sinonasal undifferentiated carcinoma, esthesioneuroblastoma, lymphoma and adenocarcinoma are the most common sinonasal malignancies. For most sinonasal malignancies, except lymphoma, treatment is usually surgical resection, and depending on the tumor pathology, post operative radiation and chemotherapy.
Josh Meier, M.D. F.A.R.S.
We are pleased to announce that we are reopening our office for patient visits effective Wednesday, May 13th. Our staff is available immediately to take appointments for either in office or telehealth visits. As we reopen, we are taking the following steps in the interest of the safety of our patients, staff and physicians for onsite appointments. We appreciate your understanding as we work to provide the highest standard of care in the safest environment possible.
· All patients will be screened for symptoms of COVID-19 at the time of appointment booking, and also on both the day prior to, and the day of the visit. This screening will include a temperature check at the time of entry.
· The number of patients in the building at one time will be limited and extensive decontamination efforts in exam areas will be taken after each visit.
· All staff will wear masks at all times and we ask that patients do the same when visiting our office.
· If any patient has had symptoms consistent with COVID-19 in the 3 weeks preceding the visit, we will ask that they arrange for a telemedicine visit or see their PCP.
· We ask that those accompanying patients to our office be limited to one in the case of minors or those who need assistance only. Otherwise, we ask that only the patient themselves enter our building.
Dr. Meier and Dr. Marshall Tolbert of Sierra Neurosurgery attended the University of Pittsburgh’s Endoscopic Endonasal Skull Base Course in December of 2018. This four day course discussed the state of the art techniques involved in endoscopic management of cranial base disorders such as benign and malignant nasal tumors, CSF leaks, pituitary and other ventral skull base tumors. The course involved lectures, prosections, live surgery and hands on dissections. This meeting was attended by dozens of rhinologists and neurosurgeons from around the world. Dr. Meier and Dr. Tolbert are excited to return to Reno with the latest techniques to treat pituitary tumors in a minimally invasive fashion.
