March 1, 2023

Balloon Sinuplasty

Chronic sinusitis can make you utterly miserable. In addition to a stuffy nose, you may have pain and swelling around your eyes, cheeks, nose, or forehead. And unfortunately, those aren’t the only unpleasant symptoms associated with it.

It used to be that you had only two choices to treat this debilitating condition:

• Medication – such as topical steroids or antibiotics which may or may not be effective.
• Extensive surgery – which often required a lengthy hospital stay.

Decades ago, the surgery usually included invasive surgery on all the affected sinuses. Endoscopic or minimally invasive sinus surgery changed all of that. This revolutionary procedure was first performed in the United States in 1985 by David Kennedy, M.D., a professor at Johns Hopkins University Hospital.

Doctors usually perform minimally invasive functional endoscopic sinus surgery (FESS) in hospitals.

Here are some of the benefits of the procedure:

• Instead of removing the diseased sinus mucosa, physicians can simply relieve the obstruction.
• It’s performed with less general anesthesia time.
• There is less post-surgical bleeding.
• You will recover more quickly than with traditional sinus surgery, and most patients return to regular activities within a week or two.
• You won’t have any external scars on your nose.
• Surgical complications are rare.
• Your doctor won’t have to remove as much tissue.

If medication hasn't fixed your sinus symptoms and you're curious about minimally invasive options, chat with us to find a sinus specialist near you who can tell you whether Acclarent is a fit for your anatomy.

Living with Chronic Sinusitis

Your sinuses are interconnected, hollow spaces in your skull. They are located behind your cheekbones, forehead, and nose. As air flows through your sinuses, mucus traps harmful substances like dust and bacteria. As the mucous drains the sinuses are kept healthy by clearing these harmful substances from the nasal cavities.

Sinusitis occurs if your sinuses get swollen, blocked, or filled with fluid due to a cold, allergy, infection, or growth in your sinuses. Every year, this miserable condition affects about 14% of the adult U.S. population, including 17% of women and 10% of men. Sinusitis results in $8 billion per year in direct expenses. It also restricts people’s activities by more than 73 million days yearly!

Sinusitis can be categorized in four ways: acute, subacute, chronic, and recurrent. Acute sinusitis usually lasts a few days. It can last up to four weeks, but it typically goes away with little or even no treatment. Recurrent sinusitis means that you have 4 or more episodes a year but you do have stretches in between with no symptoms. Sinusitis becomes chronic sinusitis when your symptoms persist for three or more months with no relief. It is the 5th most common condition treated with antibiotics and accounts for a whopping 18-22 million physician visits yearly, costing the healthcare system between $3.4 and 5 billion annually.

Chronic sinusitis can be caused by several factors including:

• Blocked airways caused by allergies, asthma, or chronic conditions such as cystic fibrosis.
• Fungal, viral, or bacterial infections.
• Growths or polyps.
• Abnormalities in the nasal structure such as a deviated septum.
• A weakened immune system.

If you suffer from sinusitis, you understand its negative impact on your life. It is painful and makes it difficult to breathe. Symptoms may include:

• Congestion – Chronic sinusitis impedes mucus drainage, causing a stuffy nose or congestion.
• Facial pain and pressure – Your sinuses are above and below your eyes and behind your nose. Inflammation and swelling can cause pressure in your sinuses, which results in pain in your face.
• Teeth or jaw aches – A sinus infection or inflammation can cause your jaw to ache or pain in your teeth, mainly your upper and rear teeth, which are very close to your sinuses.
• Headache – When the sinus passages behind your eyes, nose, cheeks, and forehead are blocked, it can cause pain and pressure resulting in a headache.
• Scratchy, sore throat – When your sinuses are blocked, fluid may build up in the back of your throat, making it feel raw, painful, or itchy.

Living with sinusitis can be difficult, but there are things you can do to temporarily relieve your symptoms, including:

• Drape a towel over your head and breathe in the steam from your sink or a bowl filled with hot water to moisturize your sinuses and loosen the mucus.
• To irrigate your sinuses, purchase a Neti pot from a pharmacy, fill it with warm sterile water (never tap water), dissolved salt, and baking soda, or a prepackaged mix, then use it according to the directions.
• Place warm and cold compresses over your nose and cheeks to relieve pain.
• Clear your sinuses with a bulb syringe.
• Run a humidifier filled with distilled water in your bedroom at night.
• Drink lots of water to help keep mucus thin and loose.
• Avoid allergens.
• Your doctor may prescribe antibiotics, oral, nasal, or injected steroids for a bacterial infection, an antifungal for fungal infections, or immunotherapy if it’s associated with allergies.

If chronic sinusitis goes untreated, it can cause long-term complications, including difficulty breathing, frequent wheezing, chronic pneumonia, or even permanent damage to your vision or sense of smell. Even more frightening, it can cause an infection in your bones, spinal fluid, or brain. Ultimately, this could cause meningitis and brain abscesses, which are life-threatening and require immediate emergency surgery.

How Does Sinuplasty Work?

Balloon sinuplasty is newer than functional endoscopic sinus surgery. Approved by the FDA in 2005, it preserves normal anatomy without surgical incision and it allows more patients to get relief because it was less invasive, less expensive, and safer than FESS. There was a 59% annual increase to patient access to these procedures in the U.S. between 2011 and 2014, according to a 2017 study.

A physician performs a balloon sinuplasty in an outpatient clinic or office. First, you will be under general anesthesia or treated with a topical numbing medication, similar to the experience of having a dental procedure. After the medicine takes effect, the doctor will insert a small, flexible sinus balloon catheter. Once inflated, the balloon gently restructures and widens the nasal passage while maintaining the integrity of the sinus tissue. Also while inflated, the doctor may flush your sinuses with a saline rinse to remove debris, excess mucus, or infection.

Benefits of Balloon Sinuplasty

Balloon sinuplasty has many benefits. The procedure takes about an hour if done in the operating room and less than 30 minutes if done in the office. It doesn’t involve any bone cutting or tissue removal. Therefore, it has a shorter recovery time than FESS, with most patients returning to normal functioning within 24 to 48 hours. In addition, balloon sinuplasty is incredibly effective. A study of 1,036 patients found that the procedure’s success rate is around 95%. After one year, 90% of patients still have open sinuses. After two years, 85% of patients still showed symptom improvement after the procedure.

Other benefits include:

• Less discomfort – Because it doesn’t include incisions, balloon sinuplasty is much easier to tolerate. Your doctor won’t have to pack your sinuses with gauze to slow bleeding, instead requiring only saline rinse to help you heal.
• Less bleeding – Because no tissue or bone is removed using this technology, you should bleed less.
• More economical – It is less expensive than in-patient procedures.
• Increased comfort – Balloon sinuplasty helps you breathe and relieves painful headaches and facial pressure from blocked sinuses.

Relieva SpinPlus and Acclarent Pivot

Two commonly used systems for balloon sinuplasty procedures are the Relieva SpinPlus and the Acclarent Pivot. The Acclarent Relieva SpinPlus includes a fine wire called the Acclarent nav wire, with a balloon at the end and irrigation jets in the tip of the catheter so your doctor can reduce bacteria while opening your sinuses.

The Acclarent Pivot opens your eustachian tubes as well as dilates your sinuses. The eustachian tubes connect your middle ears to the back of your throat. When they drain properly, they equalize air pressure inside your ears. This is useful because sinusitis can inflame and allow mucus or fluid to build up in eustachian tubes, which may cause popping, ringing, or a feeling of fullness or pressure in your ears.

Sinuplasty Side Effects

Sinuplasty is very safe, but as with any medical procedure, there can be side effects, such as:

• Most patients feel numbness or sinus pressure during the procedure, but minimal pain.
• Sinuplasty may cause you to feel groggy, sore, or tired for about a week after the procedure.
• Patients may experience light bleeding or discharge
• In very rare cases, there can be damage to the structures that separate the sinuses from the brain.
• Also rarely, some patients have a change in their sense of smell or the appearance of their nose.
• Your face or sinus cavities and nasal passages might be swollen following the procedure for a couple of days.
• Some patients have reactions to the anesthesia.

To minimize the side effects of a balloon sinuplasty, after the procedure, you should:

• Avoid blowing your nose.
• Rinse out your nasal passage for three to seven days after the procedure with a doctor-recommended saline rinse.
• Avoid strenuous activity for one to seven days depending on your doctor's recommendation.
• During the 24 to 48 hours immediately after your procedure, allow ample time to rest and recover.

Helping You Breathe Easier

Treatment for sinusitis has come a long way. A minimally invasive balloon sinuplasty may be a great option if you suffer from sinusitis. Check with your doctor to determine if this procedure is the right choice for you.