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Otolaryngologist (ear, nose, throat)
18 years of experience
Accepting new patients
Video profile


Education ?

Medical School Score Rankings
University of Michigan Medical School (1994)
Top 25%

Awards & Distinctions ?

American Rhinologic Society
American Board of Otolaryngology
American Academy of Otolaryngology: Head and Neck Surgery

Affiliations ?

Dr. Pynnonen is affiliated with 4 hospitals.

Hospital Affiliations



  • University of Michigan Hospitals & Health Centers
    1500 E Medical Center Dr, Ann Arbor, MI 48109
    Top 25%
  • University of Michigan Health System
  • San Juan Regional Medical Center
  • Ann Arbor Veterans Affairs Medical Center
    2215 Fuller Rd, Ann Arbor, MI 48105
  • Publications & Research

    Dr. Pynnonen has contributed to 8 publications.
    Title Progressive Eyelid and Facial Swelling Due to Follicular Lymphoma.
    Date August 2009
    Journal Archives of Ophthalmology
    Title Validation of the Sino-nasal Outcome Test 20 (snot-20) Domains in Nonsurgical Patients.
    Date May 2009
    Journal American Journal of Rhinology & Allergy

    The objectives of this study were, first, to confirm the presence of multiple domains within the Sino-Nasal Outcome Test 20 (SNOT-20) using a medically treated population, and, second, to reanalyze data from this population to reveal incremental information. A prospective, randomized controlled trial was performed.

    Title Probiotics As Adjunctive Treatment for Chronic Rhinosinusitis: a Randomized Controlled Trial.
    Date March 2009
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery

    To determine if oral probiotics as adjunctive treatment are more effective than placebo in improving quality of life in patients with chronic inflammatory rhinosinusitis.

    Title Pathology Quiz Case. Nasal Hamartoma, Fibroglandular Type.
    Date July 2008
    Journal Archives of Otolaryngology--head & Neck Surgery
    Title Nasal Saline for Chronic Sinonasal Symptoms: a Randomized Controlled Trial.
    Date December 2007
    Journal Archives of Otolaryngology--head & Neck Surgery

    OBJECTIVE: To determine if isotonic sodium chloride (hereinafter "saline") nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays at improving quality of life and decreasing medication use. DESIGN: A prospective, randomized controlled trial. SETTING: Community. PARTICIPANTS: A total of 127 adults with chronic nasal and sinus symptoms. INTERVENTIONS: Patients were randomly assigned to irrigation performed with large volume and delivered with low positive pressure (n = 64) or spray (n = 63) for 8 weeks. MAIN OUTCOME MEASURES: Change in symptom severity measured by mean 20-Item Sino-Nasal Outcome Test (SNOT-20) score; change in symptom frequency measured with a global question; and change in medication use. RESULTS: A total of 121 patients were evaluable. The irrigation group achieved lower SNOT-20 scores than the spray group at all 3 time points: 4.4 points lower at 2 weeks (P = .02); 8.2 points lower at 4 weeks (P < .001); and 6.4 points lower at 8 weeks (P = .002). When symptom frequency was analyzed, 40% of subjects in the irrigation group reported symptoms "often or always" at 8 weeks compared with 61% in the spray group (absolute risk reduction, 0.2; 95% confidence interval, 0.02-0.38 (P = .01). No significant differences in sinus medication use were seen between groups. CONCLUSION: Nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays for treatment of chronic nasal and sinus symptoms in a community-based population.

    Title Radiology Quiz Case 1. Labyrinthitis Ossificans (lo)-stage of Fibrosis.
    Date April 2007
    Journal Archives of Otolaryngology--head & Neck Surgery
    Title Conditions That Masquerade As Chronic Rhinosinusitis: a Medical Record Review.
    Date August 2006
    Journal Archives of Otolaryngology--head & Neck Surgery

    OBJECTIVE: To identify conditions that are commonly mistaken for chronic rhinosinusitis (CRS). The hypothesis was that many patients referred to a rhinology clinic with a presumptive diagnosis of CRS do not have CRS. DESIGN: Retrospective, observational design study of adult patients referred for evaluation of CRS-like symptoms. The expert opinion of the rhinologist was the diagnostic standard. SETTING: Tertiary care rhinology clinic. PATIENTS: A consecutive sample of 186 patients referred to the University of Michigan Health Systems' Department of Otolaryngology-Head and Neck Surgery between April 1998 and June 2000 for evaluation of CRS-like symptoms. MAIN OUTCOME MEASURES: For each patient, a history was obtained and a physical examination was performed, including nasal endoscopy and, when indicated, computed tomographic evaluation of the sinuses. Each patient's diagnosis at referral, CRS, was compared with the final diagnosis made by the rhinologist. The final diagnoses were collected and analyzed using descriptive statistics. RESULTS: Of 186 patients, 112 (60%) had CRS and 74 (40%) did not. The most common diagnoses among the patients who did not have CRS were allergic rhinitis (n = 37), laryngitis associated with reflux (n = 21), head or facial pain (n = 18), and nonallergic rhinitis (n = 23). Many patients had more than 1 diagnosis. CONCLUSIONS: Among a tertiary care population, common medical disorders, including rhinitis, laryngitis associated with reflux, and headache disorders, may simulate CRS. Heightened awareness of these conditions may improve diagnostic accuracy in patients with CRS-like symptoms.

    Title Pectoralis Major Myocutaneous Flap Vs Revascularized Free Tissue Transfer: Complications, Gastrostomy Tube Dependence, and Hospitalization.
    Date March 2004
    Journal Archives of Otolaryngology--head & Neck Surgery

    OBJECTIVE: To evaluate the factors related to surgical complications, rate of gastrostomy tube (G-tube) dependence, and hospitalization in patients undergoing reconstruction with a pectoralis myocutaneous flap vs a soft-tissue revascularized flap. DESIGN: Quasi-experimental case series with a historic control group. POPULATION: A total of 179 patients (138 men and 41 women) with a mean (SD) age of 58 (14) years treated between January 1, 1986, and December 31, 1995, with a pectoralis flap (108 patients) or a revascularized free flap (71 patients). METHODS: Inclusion criteria were first or second extirpation, reconstruction with soft-tissue flap, or defect including the upper aerodigestive tract. Exclusion criteria were secondary reconstruction, or reconstruction for salvage of a complication. RESULTS: Although the major complication rate was not significantly different according to reconstructive approach, hypopharyngeal defects had a significantly higher major complication rate of 30% (6/20) compared with 8% (13/159) for other defect sites (P<.003). The minor complication rate was higher in the pectoralis group, at 57% (62/108), than in the revascularized flap group, at 21% (15/71) (P<.001). G-tube dependence was higher in the pectoralis group at 42% (40/96), in contrast to the revascularized flap group at 16% (10/63) (P<.001). G-tube dependence was 25% higher in patients who underwent salvage surgery after radiation (42% [30/72]) than in patients treated with postoperative radiation (17% [12/69]) (P<.004). Revascularized flaps helped ameliorate the effects of radiation before surgery; 56% (23/41) of the patients who received pectoralis flaps were G-tube dependent, while the rate of G-tube dependence in the revascularized flap group was 23% (7/31) (P<.004). Hospitalization was longer in the pectoralis group (14 days) than the revascularized flap group (12 days) (P<.006). CONCLUSION: Patients who undergo reconstruction with a pectoralis flap have significantly higher minor complication rates, a higher rate of G-tube dependence, and longer hospitalization than patients who undergo reconstruction with a soft-tissue revascularized flap.

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