Dr. Victoria Lim holding the balloon catheter.

Otolaryngologist

Victoria Lim’s commitment to a career in medicine—and her fascination with her  specialty, otolaryngology—both began early. Her mother was a nurse who encouraged her aspirations, and her maternal uncle, who fills the otolaryngology chair at the University of Arkansas for Medical Sciences, served as an admired role model.

“I love the anatomy,” Lim explained. “There are a lot of major structures in the head and neck that are very important, and it’s such a diverse field, even within the specialty.”

After a childhood spent in Little Rock, Lim attended Washington University in St. Louis, but returned to Arkansas to complete her studies at UAMS. She met her husband, Memphis radiologist  Phillip Zeni, MD, during their first year in medical school and, although she admits it can be tough to raise their 4-year-old daughter and 8-year-old son with two doctors in the house, fortunately her mother lives in the area and Lim has a “phenomenal” childsitter, as well!

She has seen a number of changes in medicine since she entered the field 14 years ago. “It’s a much kinder, gentler medicine now. Physicians are much more attuned to people’s feelings when they are treating them, and that’s a very good thing,” she reflected. “I think people are much more educated about their own health, and they’re making more informed decisions about their healthcare. They realize that doctors are people, too, and unfortunately, we don’t know everything. We’d like to, but we just don’t.”

Lim characterized herself as old-fashioned in her adherence to the ideals that led her into medicine. “Helping people has always been my goal. My family is my life, but this is my passion. I truly feel that it’s a privilege to serve; for someone to trust you with their health or their child’s health is a huge compliment.  My feeling is that I’d better be worthy of it. ”

A healthy blend of humility and competence is needed to be a good doctor, she believes. “Realize you’re human. Know your limitations. Know when to ask for help.  And please don’t think you’re infallible! Just do the very best you can, treat everybody with respect—as you want to be treated. In that way, you can’t go wrong.”

Her proudest accomplishment is seeing her patients do well. “That is what motivates me.”

And in pursuit of better methods to serve those patients, Lim keeps up with the latest technology — notably, a new endoscopic, catheter-based sinuplasty procedure that offers myriad benefits: Lim has pioneered the Balloon Sinuplasty™ system in the Memphis area, effectively and successfully performing more than 200 of the procedures, thus earning the title of “Champion” awarded by Johnson & Johnson, manufacturers of the balloon sinuplasty surgical devices and promoters of the widely accredited technique.

Where traditional sinus surgery involves the removal of tissue and bone in order to open blocked sinus passageways and restore normal drainage and relieve pressure—which may lead to pain, scarring and bleeding—the balloon sinuplasty technique is a true example of the “kinder, gentler medicine” Lim applauds and advocates.

Developed in 2004 by cardiologist Josh Makower, MD, the balloon sinuplasty is a spinoff of the balloon angioplasty that has offered so many cardiac patients a less-invasive alternative to open heart surgery. The method originally designed to open blood vessels works just as well to open up sinuses, as Makower proved in 2007 by having his own sinuses dilated using the technique.

He was astonished to experience the unexpected bonus of minimal downtime, minimal discomfort afterwards, and a quick return to work.

The new technique, which Lim predicts will soon become the gold standard for sinus surgery, is minimally invasive, and thus “it eliminates the vast majority of bleeding and post-operative discomfort during debridement, where we clean the sinuses out because traditional methods cause a lot of crusting,” explained Lim. 

“It’s also much safer. The major complications that can occur with sinus surgery are damage to the eyes, blindness, and also skull base injuries including meningitis, intracranial injury, and damage to the brain. It’s not that surgeons aren’t careful; the bone that separates the sinuses from those areas is just very thin. In fact, the bone between the eye and the sinuses is called the lamina papyracea, which means ‘paper wall.’ That’s why there is increased risk in those areas when you are doing sinus surgery. Sinuplasty largely eliminates that risk.”

When the instrument is inserted, a guide wire leads the way, letting the surgeon know they are in the right place when placing the balloon catheter into the sinus opening; the wire also stabilizes the balloon as the surgeon gently dilates it open.

The inflated balloon contains seven times the amount of pressure of a normal vehicle tire—and is firm enough to micro-fracture the bone surrounding it.  This micro-fracturing process remodels the opening to the sinus, which retains its freshly remodeled position after the balloon is collapsed and the instrument removed.

Studies have shown, said Lim, that after a year’s time, the sinuses of more than 91 percent of patients who experienced the balloon sinuplasty procedure are still completely open.

“That’s actually statistically better than the traditional endoscopic surgery techniques,” she claimed. “This is the most-studied technique or instrumentation since the endoscope; and after 34 peer reviewed papers on using balloon sinuplasty, nine clinical studies following patients up to two years, and over 500,000 sinuses treated to date, there have been zero adverse events reported. Zero. That’s really impressive,” Lim stressed.

Its track record makes the sinuplasty a great choice for children, too, she pointed out. “Traditionally we’ve treated sinusitis in children with sinus ‘windows’—a pediatric method that required us to punch a hole through the bone to drain the sinus. With the sinuplasty, however, you’re actually going through the natural opening of the sinus instead, and dilating it with a balloon.”

“Statistics show that with an adenoidectomy and traditional ‘windows’, only about 50 percent of children got better. With an adenoidectomy and sinuplasty, over 90 percent of children get better. I think that’s pretty incredible,” she marveled.

Worldwide, approximately 6,700 otolaryngologists have been certified to perform balloon sinuplasty — 5,000 of them in the United States —and nearly 3,000 hospitals and surgery centers use the technique. Few of them, however, have merited the Sinus Center of Excellence designation recently conferred on Baptist – Desoto. 

Johnson and Johnson and Acclarent™ have partnered with “Champion” surgeons to help develop several sinus centers of excellence across the U.S., and they consulted Lim concerning an appropriate site to similarly serve the Mid-South. Lim was proud to recommend Baptist – Desoto. “It’s a phenomenal hospital, very state of the art, with the latest technology—and the Sinus Center of Excellence has been really needed in this region where so many people suffer from sinusitis.”

There are more than 100,000 such sufferers in the greater Memphis area, Lim estimated. “It is essential that we raise both public awareness and physician awareness of new treatment solutions like the balloon sinuplasty.”

More than 85 percent of Lim’s patients who have sinus disease are candidates for the balloon sinuplasty and its benefits. “But I always look at surgery as the last option,” she noted. “If I can isolate what’s causing their infections and treat it appropriately, often they can avoid surgery altogether.”

Outside the OR and office, look for Lim at the bead shows: In her free time, she enjoys designing and making jewelry—delicate work that utilizes her professional hand skills. Silver, beaded jewelry, and wire work provide a creative outlet, as well as uniquely beautiful custom-crafted gifts treasured by her friends and family. “You put effort into it, you put imagination into it, and people appreciate something that’s handmade a bit more than something purchased.”       

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