A stuffy head with pain. Pressure around the face. Sinus congestion. Post-nasal drip. Most everyone has experienced at least one of these sinus problems, all of which are common symptoms of sinusitis.

The sinuses are air-filled cavities inside the bones of the face that drain into the nose and throat. When the sinuses are blocked, the natural drainage does not occur, causing some or all of these uncomfortable symptoms.

Sinus problems can be acute or chronic. While acute sinusitis occurs suddenly, usually after a cold or the flu, recurrent sinusitis is an ongoing problem, resulting from allergies, polyps, airborne pollutants, or even an anatomical obstruction.

“In the past, there were few good options for patients with chronic sinus conditions,” reflects Scott Powell, MD, of Tampa Bay ENT. “With recurrent sinusitis, the treatment was repeated antibiotics, which meant all the side effects that go along with them: upset stomach, resistance to antibiotics, and so on. If a patient’s symptoms became severe enough, we would resort to sinus surgery. In traditional surgery, the patient is admitted into the hospital and has a procedure under general anesthesia. Tissue has to be removed in order to open up the sinuses, and although the recovery is tolerable, it requires multiple office visits.”

Balloon Sinuplasty

Fortunately, now there is a happy medium between taking powerful medications and undergoing invasive surgery.

“Balloon Sinuplasty is a minimally invasive procedure which enables patients to obtain permanent relief from sinus pain and pressure,” explains Miguel Rivera, MD. “The procedure was originally performed in surgical suites like traditional sinus surgery, so patients still had to contend with the same issues: missing work, anesthesia, nausea, etc. It was an easier recovery than the traditional invasive surgery, but not by much.”

“Now, we can offer this procedure in the office, providing patients with the easiest, most cost-effective experience possible. The patient is wide awake and we can have a normal conversation during the procedure. Topical anesthesia is applied, which gets the area numb, and the patient doesn’t feel anything during the procedure.”

Advancing a catheter into the sinus cavity, the surgeon places a small balloon into the area to be treated. When the balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.

“The procedure takes about twenty minutes, after which the patient walks out of the office and goes about their day,” notes adds Dennis Agliano, MD. “They can come in on a lunch break and leave with no limitations whatsoever.”

The technology for Balloon Sinuplasty comes from cardiac catheterization, explains the doctor.

“We don’t leave stents in, and the balloon doesn’t just stretch things,” he clarifies. “There is a thin bone underneath that actually gets micro-fractured, but the patient won’t feel that. Because it’s micro-fractured, the openings are permanent. It’s actually a fixed solution, which makes it more of a long-term benefit.”

He adds that in addition to the convenience of having the procedure performed in the same location as the office, Tampa Bay ENT also has its own scanning equipment, so patients can get all their needs met in one place.

“With our in-house CT scanner, we provide results that can be reviewed immediately,” he explains. “Patients don’t have to travel to multiple locations.”

Fast recovery

Rene Boothby, MD notes that the recovery experience of the Balloon Sinuplasty procedure compares favorably with traditional sinus surgery.

“Endoscopic sinus surgery typically required two weeks of recovery time,” he says. “Patients can’t do heavy lifting or strenuous activity. By contrast, Balloon Sinuplasty patients can go do whatever they want. They can go on a flight, eat whatever they want, and there’s no risk of nausea. The only thing we ask of the patient is that they avoid blowing their nose for the first day.”

Dr. Powell adds that the procedure may be an appropriate treatment for a wide variety of patients.

“The traditional patients for Balloon Sinuplasty were chronic sinusitis patients whom we would otherwise take to the operating room,” he recalls, “but these days we see significant benefits for patients whom we call recurrent, where they go from normal to completely infected anywhere from four to six times a year, requiring multiple rounds of antibiotics.”

“If we intervene with Balloon Sinuplasty for these patients,” adds Jeremy Rogers, MD, “they can go from half a dozen sinus infections per year to the typical one or two most people have. We continue treating their allergies in the office, so that they don’t slide back down that slope. So the recurrent patients are benefiting as much as the chronic ones.

“Another category is that of patients whom we refer to as barotrauma patients because they suffer from barometric sinusitis: when they go scuba diving or fly they experience severe sinus pressure and pain. These patients have sinus openings that are extremely narrow; by dilating them, they receive the same benefit as chronic patients.”

Dr. Powell observes that the long-term results of Balloon Sinuplasty have been well studied and documented.

“The literature shows that the outcomes of these procedures are as good as traditional invasive surgery in the operating room, with none of the downsides,” he reports. “Our patients take the Sino-Nasal Outcome Test, which we use to objectively compare their sinuses before and after the procedure. In doing so, we have completed our own informal research study, and have concluded that it’s a successful treatment.”

FHCN - Michael J. Sahno