What is Balloon Sinuplasty or Balloon Dilation of the Sinuses?
Balloon sinuplasty or balloon dilation of the sinuses is a less invasive way to surgically treat sinus infections. As with traditional endoscopic sinus surgery, procedures are typically reserved for those patients who have failed medical therapy. I believe the main advantage and true benefit of this technology lies in the ability to perform it in the office under local anesthesia with minimal downtime. Numerous medical articles have proven the safety and efficacy of this procedure. In some patients such as those with extensive polyps, it is definitely not a replacement for traditional endoscopic sinus surgery which is performed in an operating room.
What is the theory and science behind Balloon Sinuplasty?
There is actually no cutting or removal of tissue with this procedure which takes advantage of our natural sinus openings. Every sinus has its own opening and drainage pathway into the nose. As long as air can enter through this channel the lining of the sinus remains healthy. Every sinus also has microscopic hairs called cilia that act like a broom and continually sweep the mucous to this natural opening in a pre-programmed fashion. A surgeon can make an opening into a sinus but if this opening is not created at the natural opening, the sweeping mechanism of these hairs will not bring the mucous and debris to this new opening, essentially making it non-functional. Balloon sinuplasty is simply making Mother Nature’s opening larger in a permanent fashion.
How is the in-office procedure performed?
No special pre-operative testing is needed other than a CT scan of the sinuses. Since only topical anesthesia is needed, no blood tests or clearance from a medical physician are necessary. The procedure is done under local anesthesia. Occasionally a patient may want an oral sedative beforehand but then must be accompanied by someone else to drive them. Topical numbing and decongestant medications are first placed into each nasal cavity with cotton and allowed to sit in the nose for at least 15 minutes. Injection with local anesthesia is then performed. A soft flexible wire is placed into the nose to find the natural opening into the sinus to be opened. This wire is so gentle that it cannot even break an eggshell. A light on the end of the cable illuminates through the skin over the cheek or over the eyebrow to confirm that the physician is in the correct location. A soft balloon is then advanced over this guide wire and gently inflated for a few seconds. This inflation may be repeated more than once. A patient may feel/hear a slight cracking but usually with minimal discomfort.
What can I expect afterwards?
There is minimal pain after the procedure and specific pain medications are typically not needed. Severe bleeding requiring any additional intervention is uncommon. A follow up appointment in 4-6 weeks will be scheduled. Most patients return to work and normal activity within 2 days.
Balloon sinuplasty is now a recognized procedure by Medicare and private insurance carriers. Just as with any other surgery, the office will always check with your insurance carrier beforehand to ensure that the procedure is pre-certified and covered.