Balloon Dilation Sinus Surgery
Almost everyone has experienced a sinus infection in their lifetime. The sinuses are outpouchings from the nose. Most people have develop sinuses in the forehead are, cheeks, and between the eyes, although there is some variability amongst individuals. The sinuses are connected to the nose by small tubes. Your nose and sinuses make about 1 liter of mucous a day! This normal mucous drains from our sinuses to our nose, and then down the back of the throat where we swallow it. This mucous is normal and important for the natural cleaning process of the nose and sinuses. If the mucous is more than typical, or thicker, we may feel it as post-nasal drainage.
“Sinusitis” is a term frequently applied to a variety of nasal symptoms, but specifically refers to inflammation or infection of the sinus lining. Symptoms of sinusitis may include nasal congestion, runny nose, post-nasal drainage, cough, facial pressure, and fatigue. Acute viral sinusitis (“the common cold”) is caused by viruses where acute bacterial sinusitis is caused by bacteria. They are really identical in symptoms, but differ in their length of symptoms. If the nasal symptoms do not improve after 7-10 days, or worsen after 5, you should consider seeing your doctor to discuss antibiotic use. Antibiotics are not helpful, and may be harmful if used inappropriately for viral illnesses.
It is estimated by the CDC that 32 million people suffer with chronic sinusitis. Chronic sinusitis is sinus problems lasting more that 3 months, which have not been cured with antibiotics, nasal steroid sprays, and other medical therapies. It is in these cases not cured by medical therapy where surgery may be recommended. Sinus surgery evolved during the 1980’s from a procedure involving incisions on the face and in the mouth to treat the sinuses, to surgeries that can be accomplished through the nostril, with no visible incisions. 200,000 to 350,000 people undergo sinus procedures every year. Many of these patients will have significant improvement in their daily symptoms and quality of life. While not a cure for all sinus problems, the surgery may be very helpful for these patients. The surgery involved removing tissue (lining and bone) from around the openings of the sinuses, where they connect to the nose. By enlarging these opening, the drainage of the sinuses necessary for good health can be improved.
Johnathan McGinn, MD, Assistant Professor of Otolaryngology – Head & Neck Surgery, has been performing traditional sinus surgery for many years, but has incorporated a new technique, Balloon Sinuplasty, into his sinus practice.
Q: What is balloon dilation sinus surgery, or Balloon Sinuplasty?
A: Traditional functional endoscopic sinus surgery (FESS) involves the removal of tissues around the sinus openings using instruments and cameras through the nostril. This tissue removal assists in sinus drainage, but yields raw areas which must then heal. The balloon dilation technique instead moves the bone and lining within the nose to open the sinuses, but does not remove tissue. Healing times and bleeding are thus reduced.
Q: How is the balloon sinus surgery done?
A: Sinus surgery is typically done as a same day surgery (no overnight stay in the hospital), but patients are under general anesthesia. A balloon catheter, similar to those used in blood vessel procedures like cardiac catheterizations, is inserted through the sinus openings. By inflating this balloon, the bone and tissues around the opening are moved to open the sinus drainage pathway.
Q: Does this balloon technique for sinus surgery work for everyone?
A: No. Consultation with an otolaryngologist with a sinus CT scan will be necessary to decide what surgical options may be available. The balloon technique can be used in many of the sinuses, but not all. Often the balloon dilation technique is used in combination with traditional surgery to yield the best results.
Q: What are the success rates with this surgery?
A: Sinus surgery as a whole is successful in reducing the severity and frequency of nasal symptoms of chronic sinusitis in most patients. The balloon technique has been shown to be safe and effective when compared with traditional FESS techniques. A study from 2008 showed that 95% of patients had improved symptoms, and 74% were freed of sinus infection at an 8-month follow-up.
Q: How long does surgery take?
A: Surgery usually lasts one to two hours, depending on how many of the sinuses must be addressed, and if both sides are involved.
Q: What is recovery like?
A: With sinus surgery, there is some expected discomfort, nasal bleeding, and drainage. When the balloon dilation technique is used, similar or reduced post-operative symptoms should be seen. Patients go home the same day, usually within hours.
Q: Are there any risks involved with this procedure?
A: As with any surgical procedure, risks exist. Traditional sinus surgery techniques carry a very small risk to surrounding tissues of the eye or brain. (less than 1 %), Balloon Sinuplasty has similar or smaller risks.
If you are a referring physician with questions about Balloon Sinuplasty or other sinus problems, please call (717) 531-8945, or our 24-hour MD Network 1 (800) 233-4082.
If you are a patient diagnosed with chronic sinusitis and would like to schedule an appointment, you will need to have a recent CT scan ordered by your medical doctor.