BREATHING EASIER - AND THEN SOME.

Byline: Phil Davis Daily News Staff Writer

Imagine breathing with marbles shoved up both nostrils.

That's how Thomas Fox, a 41-year-old engineer from Corona, felt for most of his life - thanks to severely blocked sinuses that began developing when he was only 13. Prescription drugs couldn't shrink the swollen tissue and nasal polyps, a benign form of tumor, that clogged his sinus passages.

And the only thing a corrective surgery at age 15 gave him was scar tissue that made the blockage worse.

``It's painful,'' Fox said. ``For more than 25 years, I probably haven't been able to pull any air through my nose. It got to the point I couldn't taste or smell my food and I was lucky if I got three or four hours of sleep a night.''

On May 28, Fox finally lost those marbles.

That morning, Northridge surgeon Marc Kerner guided a thin instrument called a microdebrider up Fox's nose and suctioned away 28 years of blockage.

What makes his surgery stand out among the roughly half a million other sinus operations performed each year in the United States is the equipment: a new computer system called InstaTrak, the first of several new devices designed to make sinus surgery safer.

The InstaTrak computer provides the surgeon with an unprecedented, personalized road map to a patient's sinuses and real-time tracking of the surgical tool - vital information considering the honeycomb of sinuses in the skull are separated by mere fractions of an inch from the eyes and brain.

Here's how it works: A computer scan of the patient's sinuses - called a Computed Tomography (CT) scan - is downloaded into the InstaTrak computer, which displays the images on a monitor in the operating room. A plastic headset - worn by the patient during the scan and the surgery - provides a frame of reference for the computer to track the microdebrider, which has a tiny electromagnetic homing transmitter on its tip.

The doctor follows the instrument's progress by watching a set of crosshairs moving across the CT scan. An endoscope, a small 4-millimeter-diameter telescope, provides a live, close-up view of the progress of the surgery.

``You can see exactly where you are,'' said Kerner, the surgeon who brought the equipment to the San Fernando Valley and is training other surgeons to use it. ``Sinus surgery can be very dangerous. It basically used to be done blind. You'd go in there and kind of pluck around and hope you're OK. This has allowed us more precision. There's less guesswork involved, and I can go right for the specific area that's blocked.''

Best of all, the surgery requires no incisions and the patient can go home after only a few hours. Without the computer, surgeons enter hard-to-reach spots in the sinuses through an incision between the eye and the nose.

InstaTrak surgery costs under $2,000 and should be covered by medical insurance, Kerner said. That's about the same as more traditional sinus surgeries, except that they sometimes also require a night in the hospital.

The technological breakthrough is good news to people like Fox and 59-year-old Gene Brundage of Granada Hills, who suffer from a severe sinus infection called acute sinusitis. The infection, common among those who suffer serious allergies, leads to swollen tissues that prevent mucus from draining from the sinuses, which can lead to complications ranging from constant, agonizing headaches to loss of the ability to hear, smell or taste.

Sinusitis feels like an allergy attack that won't go away, Brundage said.

``It's like a cold, you're sniffling a lot,'' he said. ``But it doesn't go away. It just gets worse.''

About 35 million Americans suffer from sinusitis, according to the American Society of Otolaryngology - Head and Neck Surgery. Many people dismiss the infection as a typical allergy attack or cold, but there are some differences.

The society suggests seeing a doctor if: headaches and sinus pressure last more than a few days; nasal discharge is a yellow-green color (compared to more normal clear or white discharge); or coughing and congestion last more than 10 days. Bad breath and a fever also can indicate sinusitis instead of allergies or a common cold.

Fortunately, most cases can be treated with prescription drugs. But more than half a million people a year seek surgery to correct the malady - often because the blockage is preventing medicine from reaching the infected area.

That's what happened to Brundage, a singer and actor in musicals who can't afford to have the constant sniffles that accompany chronic sinusitis. Unlike Fox, Brundage's blockage - a combination of infected sinuses and benign nasal polyp tumors - wasn't painful, but it was a nuisance.

``It's so gradual as it happens to you, your body just compensates,'' Brundage said. ``I thought I just had another sinus infection. I've had sinus infections for a million years because I live in L.A., and I live in the Valley, which I've been told is the worst place on Earth to live if you have bad allergies.''

Kerner convinced a reluctant Brundage to try InstaTrak Surgery.

``I'm fine. I've noticed it's a little easier to breath,'' Brundage said. ``When the doctor first told me about it, I said, `Oh, I don't think so.' But when I did it, it was nothing. Of course, I was out at the time.''

Fox's blockage was worse - so the aftereffects of the surgery have been much more painful. It took about two days for the pain to turn to discomfort.

``I feel fine,'' Fox said three days after his surgery. ``I can get air through my nose now. If this is an indication of what my nose will be like at the end of the healing process, I should be feeling really good. I can actually feel a difference inside my nose. It's bigger inside, as odd as that sounds.

``I'm sure this will absolutely change my life, and I'm grateful for that,'' he continued. ``Dr. Kerner was the first doctor who looked up my nose and said, `I can fix this.' I just wish I'd known about this sooner.''

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3 Photos

Photo: (1--Cover--Color) UNPLUGGED

New medical device improves safety of sinus surgery

(2) Surgeon Marc Kerner of the Ambulatory Surgery Center in Northridge, uses a CT scan to show blocked sinuses. An operation to correct the problem now utilizes a computer to enhance safety.

(3) Kerner looks at the InstaTrak monitor, which gives him a detailed view, while operating on patient Thomas Fox's sinuses.

David R. Crane/Daily News