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Rhinology: the Hidden Expertise at Burnaby Hospital


BCBusiness Burnaby Hospital Foundation

The hospital is a hub for endoscopic sinus and skull base surgery

Some see Burnaby Hospital as a small community hospital, but the facility does more than remove tonsils and gallbladders. Many are surprised at the full extent and complexity of services performed there. Burnaby has one of the busiest emergency departments in the entire province, and a full roster of fellowship-trained, surgical sub-specialists using the latest in technology and techniques to perform remarkable and sophisticated surgery. And the hospital is quite the hub for endoscopic sinus and skull base surgery in particular.

Dr. Casey Manarey is one of only four Rhinologists in British Columbia who exclusively perform endoscopic sinus and skull base surgery. Using an advanced image-guided navigation system – one of only two of its kind in western Canada – Manarey treats patients with chronic sinus disease, a condition he compares to congestive heart failure in terms of the amount of suffering an afflicted patient can experience.

The navigation system uses an electromagnetic field to pinpoint the location of surgical instruments and displays the information on a preloaded CT scan, so the surgeon always knows exactly where he is operating. Using an endoscope, images from inside the patient’s nose are displayed on two high definition 4K monitors.

“That’s how we’re operating. Unlike abdominal surgery for example, where you’re making a big incision and you’re looking in, we’re using an endoscope and instruments that allow us to never actually see what we’re cutting, except on the screen,” says Manarey.

Like most equipment in a modern medical setting, the navigation system and monitors do not come cheap, with a price tag of about $300,000. But without question, the benefits of the technology outweigh the cost. 

“It allows us to do a very thorough and detailed surgery. The precision of the equipment helps us to be safely aggressive, so we can effectively get all the disease out and reconstruct the drainage pathways of the sinuses, while minimizing any risk of complications – such as unintentionally breaching the skull base, which can cause a leak of spinal fluid, or breaching the bone separating the eye from the nose, which if not dealt with can lead to blindness.”

The technology at Manarey’s disposal, along with his unique specialized training, allows him to achieve better outcomes than would otherwise be likely in 80 percent of his cases. As a result, patients suffering from a terrible quality of life are coming from all over the province to benefit from the services offered at Burnaby Hospital.

“What we’re doing isn’t just a slight improvement in how a person is feeling; this is a total lifestyle change. We see people come in with chronic sinus disease – they look tired, they look depressed, they have been suffering for years. After we operate, they can breathe better, they’re able to sleep, they regain their sense of smell – they’re almost like a brand-new person and they’re incredibly grateful for what we’re able to do for them. They tell me it has changed their life.”

View exclusive video of Dr. Manarey’s endoscopic surgery at

Created by BCBusiness in partnership with Burnaby Hospital Foundation