The balloon sinuplasty surgery is one of the latest tools to open sinuses along with the FESS or functional endoscopic sinus surgery. This is a relatively minimally invasive procedure that can be performed in the office or the operating room. The technique may shorten recovery time in a very select group of patients, and provide those suffering from recurrent acute sinusitis or chronic sinusitis episodes with improvement in sinus drainage.
Balloon sinus surgery is similar to FESS in that both procedures involve the use of an endoscopic surgical instrument that is used to eliminate blockages in the paranasal sinuses. The types of symptoms that normally qualify a patient to receive a balloon sinuplasty are identical to those required for a FESS procedure. These symptoms include a diagnosis of recurrent acute sinusitis or chronic sinusitis, in addition to a poor response to traditional antibiotics and other medications used to treat the condition.
The U.S. Food and Drug Administration has approved balloon sinus surgery as an optional treatment for sinusitis. Balloon sinuplasty is described as an endoscopic, catheter-based procedure, involving the placement of a balloon on a wire catheter used to dilate blockages in the sinus passageways. When the balloon is inflated, it widens the walls of the sinus passageway, with the goal of restoring normal drainage with preservation of the sinus lining. The tissue is not removed by the balloon but a functional endoscopic sinus surgery, FESS, may be performed at the same time, to remove additionally inflamed or infected tissue.
The Procedure
Balloon Sinus Surgery allows for flexibility because it can be performed in either a hospital or surgery center. Alternatively, the surgery may also be performed as an outpatient procedure at a doctor’s office. The procedure can be performed with either general or local anesthesia.
When beginning the procedure, your surgeon will insert a guide wire into your nostril and through the sinus opening via the aid of lighted fiber optics or image-guidance. An endoscope is used to visualize the insertion inside the nose. A balloon is threaded over the wire into the opening of the sinus. The sinus balloon is slowly inflated to open the blockage at the obstructed sinus opening. The balloon will then be deflated and the balloon and guidewire removed from the sinus. The surgeon will inspect the sinus opening to make sure that your sinus has been opened.
If the procedure is performed in the office, you will likely feel healthy enough to return to work and your daily routine in approximately two days.
Possible Risks and Complications
Balloon Sinus Surgery is relatively safe. As with any procedure, there are risks that you should be aware of. These include:
- Extensive bleeding following surgery, requiring nasal packing or more extensive bleeding control
- Problems during surgery involving the visualization and instrumentation or patient discomfort
- Persistent or early return of infection
- Later need for more extensive surgery
Limitations
Since balloon sinuplasty is concerned chiefly with the dilation of the blockage of the sinus opening, only patients with obstruction of three of the four paranasal sinuses (frontal, sphenoid, and maxillary) are candidates for the procedure.
Patients who suffer from pansinusitis which includes all of the sinuses may have limited benefit from using balloon sinuplasty exclusively. This group of patients requires a more extensive procedure in order to properly treat their condition. Thus, Balloon Sinus Surgery may be appropriate for those characterized as having “mild to moderate” cases of chronic sinusitis.
Balloon Sinus Surgery is not appropriate as an isolated procedure for patients where there are nasal polyps or tissue needs to be removed. A FESS procedure or combined procedure may be a better choice.
Balloon Sinus Surgery Final Thoughts
Balloon sinuplasty is a tool that can be used in specific cases to open blocked sinuses. The goal is to do this with preservation of as much of the delicate tissues of the sinuses and nasal cavity as possible. Comparisons have been made between this new form of sinus surgery and angioplasty, in that just as an angioplasty avoids the more invasive bypass graft surgery through ballooning open the coronary arteries, Balloon Sinuplasty avoids a more extensive FESS procedure by opening up the sinus passages with limited damage to the nasal tissues. A failed balloon procedure will likely require an additional FESS procedure.
Balloon sinus surgery is a procedure that is not without its own separate set of risks and complications. In choosing whether Balloon Sinuplasty is an option, patients must be cognizant of their symptoms and which paranasal sinuses are affected, in order to make the most well-informed decision.
