Clear Headed

Balloon procedure eliminates chronic sinus symptoms.

Henry Kuemin

For 40 years, Henry Kuemin, 96, worked in management and steering for Outboard Marine and Ensign Outboard Motors. The Michigan native retired in 1980 and relocated to Florida to bask in the temperate climate. The warmer weather did nothing, however, to temper an uncomfortable sinus condition.
“I’ve had sinus trouble for years,” Henry admits. “I got headaches and couldn’t get rid of them. There was a lot of pressure in my head. It felt like a balloon. My sinuses were all plugged up, and I couldn’t breathe very well.
“All the doctors I went to basically told me to take medication, which didn’t do much of anything. My family doctor finally said I needed to see a specialist. He told me to get in contact with Dr. Berghash, so in February, I made an appointment with him.”
Henry’s doctor referred him to Leslie R. Berghash, MD, a board-certified otolaryngologist at ENT and Allergy Associates of Florida, which has offices in Port St. Lucie, Fort Pierce and Okeechobee.
Dr. Berghash specializes in conditions of the ears, nose and throat.
Henry liked the doctor immediately.
“Dr. Berghash is great,” Henry states. “He is a very nice fellow and a gentleman. I enjoy talking with him. He is very knowledgeable and explained my condition very thoroughly.”
As part of Henry’s initial consultation, Dr. Berghash asked him about his condition and his symptoms. The doctor learned that past treatments Henry tried didn’t give him sustained relief.
“For years, Henry lived with symptoms such as congestion, pressure, fullness, post-nasal drainage, headaches and recurrent sinus infections,” notes Dr. Berghash. “These are all typical symptoms of an ongoing sinus condition. The diagnoses were nasal obstruction, post-nasal drainage and chronic sinusitis.
“Over time, Henry had been on multiple medications, including steroid nasal sprays and various antibiotics, but they didn’t help him long term. I noticed in his medical records that he hadn’t had a CT scan of his sinuses since 2011, so I ordered one.”
The results of the CT showed Henry had inflammation and blockage in all four of his sinuses: the maxillary, ethmoid, frontal and sphenoid. Dr. Berghash recommended a procedure called Balloon Sinuplasty to clear the obstructions, and Henry agreed to it.

Breaking Up Blockages

Blocked sinuses are the result of inflammation of the tissue of the sinus cavities, which obstructs the openings of the sinuses and impedes drainage. Inflammation can be the result of one of two conditions.

Photos by Nerissa Johnson.

Henry breathes much easier since his surgery.

“Fifty percent of the time, it’s related to allergy,” Dr. Berghash observes. “The other fifty percent of the time, it’s a process that starts with a cold or upper respiratory infection that only partially resolves on its own.
“Because the infection only partially resolves, the lining of the sinus cavities can inflame, which then leads to blockage. This, in turn, can cause sinus symptoms and recurrent infections. This is what happened to Henry.”
Balloon Sinuplasty is an in-office procedure using local anesthesia. Patients undergoing the treatment are generally pre-medicated with pain medication and a medication to relax them. Before the procedure, the doctor sprays numbing medication in their nose. When the procedure starts, more numbing medication is added by injection, which patients typically don’t feel.
“Once everything is calibrated, we go in with the balloon and open up the natural openings of the sinuses. This allows normal ventilation of air into the sinuses and healing of the inflamed tissue. We can use this procedure on the maxillary, frontal and sphenoid sinuses.”
During Balloon Sinuplasty, a small, flexible balloon catheter is inserted into the nose to open up blocked passageways in the sinuses, which enables drainage.
“The balloon is on a guidewire, and we use the Fiagon® Sinus Navigation System to get to the precise location of the blockage,” Dr. Berghash describes. “With this system, we can calibrate a CT scan to line up with, and view the patient’s sinuses in three dimensions in real time.”
To open the ethmoid sinuses, Dr. Berghash uses an instrument called a microdebrider. The microdebrider is a tiny instrument that cuts away the blockages. This instrument is used because the ethmoid sinuses cannot be ballooned due to their location in the skull. The microdebrider can also be used to treat certain patients with blocked nasal airways.
“Some patients with deviated septums have spurs, or growths, on their septums,” Dr. Berghash informs. “We can remove those spurs, and we can minimize tissues called inferior turbinates. The job of the turbinates is to increase the surface area of the nose for humidification, filtration and air warming.

“I’m breathing all right since the surgery. Now, I can breathe in and out of my nose and sinuses with no problems.” – Henry

“The majority of patients with chronic sinus and/or allergy problems have inflammation and enlargement of their turbinates. We can use the microdebrider to shrink down the turbinates, which effectively decreases inflammation and post-nasal drainage. In essence, it provides the patients with a healthier airway.”
Dr. Berghash stresses that Balloon Sinuplasty has certain advantages over standard sinus surgery. It decreases surgical risks, and it has a quicker and easier recovery, with patients able to return to work in one to two days. The procedure has been shown to be very effective in qualified candidates. There’s less discomfort as well.
“I had the balloon surgery done on both sides of my nose, and didn’t hurt at all,” verifies Henry, “And it opened my sinuses right up.”

Better Breathing

Another advantage of Balloon Sinuplasty over standard sinus surgery is that less tissue is disturbed, so there’s less bleeding during and after the procedure. This was true in Henry’s case.
Although he occasionally still gets a little congestion, Henry says he has experienced a major turnaround in his condition. His chronic sinus symptoms were completely resolved by the Balloon Sinuplasty.
“I’m breathing all right since the surgery,” Henry confirms. “I can breathe in and out of my nose and sinuses with no problems. Dr. Berghash checked me out and said I’m doing fine after the procedure.”
“Henry is a very healthy ninety-six-year-old,” emphasizes Dr. Berghash. “He’s really done well with this procedure for his age. He’s not reported one sinus symptom since I performed the Balloon Sinuplasty on him in March.”
Henry agrees with Dr. Berghash that the procedure helped significantly. He’s willing to tell his story to others.
“The surgery with the balloon was definitely a success,” enthuses Henry. “I recommend the procedure and Dr. Berghash to anyone with sinus problems.”

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