Sinuses are empty spaces in the facial bones and forehead bone. They contain air and are lined with the same mucus membrane that lines the nasal passages. They connect with the nose passage through small openings called ostia. Typically these ostia are 1-2 mm in size and are they only means of clearing the sinuses into the nasal passage. The mucous membranes make mucus and kept the cavities moist and have small cilia or hair lining the mucus membranes that beat towards the openings.


Sinusitis is a term used for inflammation of the sinus mucus membranes. Inflammation may be caused by infection, allergies, smoke, pollution, bacteria, fungi or viruses. Some conditions such as HIV, immune deficiencies or connective tissue diseases such as sarcoidosis, Wegener’s granulomatosis or ciliary problems make it more likely to have sinus inflammation.

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Dr. Khetarpal is one of a limited number of sinus surgeons across the country performing comprehensive sinus surgery with balloon sinuplasty in the office and also pioneering the use of image-guided endoscopic sinus surgery in the office. Dr Khetarpal has performed complex endoscopic sinus surgeries for more than 20 years without any nasal packing. Dr Khetarpal is a perfectionist, whether he is doing sinus surgery, ear surgery or rhinoplasty. Dr. Khetarpal’s Trademarked PIVA Office Balloon Sinuplasty Procedure is performed in-office.


He is currently involved in research projects trying to identify causes of chronic sinusitis and devising newer treatments. He has a Western Institutional Review Board approval for performing research on chronic sinusitis, allergic fungal sinusitis, nasal polyps, and allergic rhinitis as well as on data collection and clinical research on these patients. He is also conducting research on the impact of endoscopic sinus surgery or balloon sinuplasty on sinus headaches. Dr Khetarpal did his residency training in Syracuse, New York and has extensive clinical and research experience at Massachusetts Eye and Ear Infirmary, Brigham and Women’s Hospital and Harvard Medical School in Boston. In addition to his interest in sinus disease and allergies, Dr Khetarpal is Board certified in Sleep Medicine and also has a tremendous interest in rhinoplasty and facial plastic surgery. He brings his ear surgery and facial plastic surgery expertise into sinus surgery as well.

Dr Khetarpal spent many years in the Rio Grande Valley treating the underprivileged, uninsured and indigent patients with severe sinus conditions and significant Ear, Nose and Head and Neck and thyroid disease. He is in the process of publishing his experience with allergic rhinitis in chronic sinus disease as well as his experience with fungal sinus disease. His multimedia presentations on Chronic Sinusitis, Allergic Fungal Sinus disease and balloon sinuplasty have received praise from fellow physicians.