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Balloon Sinuplasty: Advanced Technology in Action
In 2005, the U.S. Food and Drug Administration (FDA) approved of balloon sinuplasty to help those with blocked sinuses. Today, it’s a popular option for surgeons to offer and patients to select. In fact, its effectiveness and unique process earned it the title of the “smart sinus” procedure.
Our office offers balloon sinuplasty in NYC as an option for patients who have conditions like chronic sinusitis. Before you undergo a balloon sinuplasty procedure, you more than likely want to know more about it. Thus, we compiled a list of the most frequently asked questions we hear from our patients.
Balloon Sinuplasty Technology
Balloon Sinuplasty technology contributes to the sinus surgery evolution by offering a surgeon additional tools for endoscopic surgery. The RELIEVA® Balloon Sinuplasty products are catheter-based devices designed to assist Otolaryngologists in further meeting their surgical goals of clearing blocked sinuses, restoring normal sinus drainage and function, and preserving normal anatomy and mucosal tissue.
Utilization Overview: The RELIEVA® Balloon Sinuplasty System
The Balloon Sinuplasty System creates a durable opening and assists Otolaryngologists in achieving the goals of sinus surgery.
The following diagram outlines the Balloon Sinuplasty procedure:
Balloon Sinuplasty Benefits:
- The Balloon Sinuplasty devices are endoscopic tools that may be used with other medical therapies or ESS techniques. Using these devices should not limit future treatment options for patients with progressive disease.
- Balloon Sinuplasty is also available as a procedure conducted in the physician’s office under local anesthesia, allowing some patients to avoid the hassles of surgery in an operating room.
Pediatric Balloon Sinuplasty
Pediatric rhinosinusitis is common but sometimes overlooked. Pediatric patients are often subject to other disease entities which may have a significant overlap with symptoms associated with pediatric Chronic Rhinosinusitis (CRS).
Symptom overlap examples include:
- Allergic rhinitis
- Recurrent viral URI
- Chronic adenoiditis
- ET dysfunction
Currently there is a lack of evidence for antibiotic efficacy in chronic sinusitis. Adenoidectomy failure rate is 40-60% when used as a sole Chronic Rhinosinusitis (CRS) surgical treatment.
The result is a considerable loss of school time and accumulation of medical expenses, affecting children and their parents.
Balloon Sinuplasty, Safe and Effective for Children Suffering from Chronic Sinusitis
Adenoidectomy with Balloon Sinuplasty and lavage of the maxillary sinus may be an appropriate surgical therapy for children deemed to have failed medical treatment.
Multiple studies have demonstrated long-term success of 80-87% with adenoidectomy or after failed adenoidectomy.
In one study, a higher percentage of children’s SN-5 sinonasal symptoms were improved at 12 months, in the Balloon Sinuplasty and adenoidectomy group (80%) compared to the group that underwent adenoidectomy alone (53%).
*Patients were not randomized between the Balloon Sinuplasty and adenoidectomy group and the adenoidectomy alone group. Therefore, the results may be due to different patient characteristics rather than the procedure performed.
Acclarent’s Balloon Sinuplasty Systems (RELIEVA® SPIN, ULTIRRA®, and SOLO PRO™) are indicated for children aged 17 and under and are intended to dilate sinus ostia and spaces associated with the maxillary sinus for diagnostic and therapeutic procedures.
Balloon Sinuplasty is an Effective Option After Failed Adenoidectomy
In a tertiary care, university-affiliated pediatric institution, a side-by-side post-operative comparison of patients who underwent Balloon Sinuplasty with ethmoidectomy or ESS after failed adenoidectomy was conducted. Although the difference was not statistically significant, 62.3% of ESS patients and 80% of Balloon Sinuplasty patients reported improvement in their overall sinus symptoms post-operatively.
**Patients were not randomized between the Balloon Sinuplasty and ESS group. Therefore, the results may be due to different patient characteristics rather than the procedure performed.
Airway Stenosis
Airway stenosis is a congenital or acquired narrowing that obstructs the passage of air to the lungs. Symptoms include stridor, wheezing, hoarseness, shortness of breath and respiratory distress. Patients who have severe airway stenosis are often dependent on a tracheotomy tube to breathe.
The most common cause of acquired airway stenosis is endotracheal intubation, resulting in 90% of cases. Other causes include external trauma, thermal or caustic injuries, chronic inflammatory diseases, infection, and cancer.
Treatment Options
Treatment options range from endoscopic techniques to open surgical procedures. Open surgical procedures involve either increasing the diameter of the stenosed segment with a graft or stent (expansion surgery) or removal of the stenotic area (resection surgery).
Endoscopic techniques may involve the use of instruments to incise and dilate the stenosis. Traditional methods of airway dilation have involved rigid bougies that can impart shear forces and mucosal injury. The recent development of balloon technology for airway dilation enables controlled radial pressure to be applied at the site of stenosis.
INSPIRA AIR® Balloon Dilation System: A minimally invasive solution for airway management.
The INSPIRA AIR® Technology is designed to safely dilate airway strictures such as in the trachea and upper bronchi with minimal mucosal trauma. These devices are endoscopic tools and may be used with other endoscopic techniques or adjuvant therapies.
Unlike traditional rigid dilators, the INSPIRA AIR® Technology applies controlled radial pressure to a stricture through precise inflation and pressure regulation.
The low profile system and soft seeker tip provide atraumatic access.
The following diagram outlines the balloon dilation process:
Balloon Sinuplasty FAQs
What is Balloon Sinuplasty?
Balloon sinuplasty surgery is a procedure an ear, nose, and throat specialist performs to remove sinus blockage. During a balloon sinuplasty, your practitioner uses a catheter to open your sinus passages by increasing the size of the opening. Both the bone and tissue widen as a result of the pressure from the balloon expanding. Additionally, your practitioner will use a saline solution to remove any pus or mucus buildup to further correct your ability to breathe.
Who is Balloon Sinuplasty Right For?
Generally, a specialist recommends balloon sinuplasty technology if you had four or more major sinus infections over the course of a year. A sinus infection categorizes as a serious one if it lasts a month or longer.
In addition, a doctor may advise you to undergo a balloon sinuplasty procedure if you had three significant sinus infections each year for at least two years in a row. Sometimes, you qualify for the procedure if you had a sinus infection that lasted three months or longer. In some cases, our physician will suggest sinuplasty if you experience sinus headaches for other reasons besides an infection.
Your doctor typically won’t encourage sinuplasty if you have a structural issue, such as nasal polyps, deviated septum, or engorged or malformed nasal tissue. The surgery won’t fix these problems. Moreover, the procedure isn’t beneficial if you have severe allergies or immune system disorders that are causing your breathing issues.
Since this surgery is noninvasive, most patients experience little to no complications. Moreover, your doctor may perform it, even if you have other health issues, in most cases.
What are the Benefits of Balloon Sinuplasty?
The results of balloon sinuplasty surgery are comparable to an invasive sinus surgical procedure, but a person can benefit from the minimal risk of problems associated with balloon sinuplasty. For instance, in comparison with other treatment options, balloon sinuplasty surgery has fewer risks. Most patients respond and heal well.
Additionally, your bleeding risk from balloon sinuplasty is less than the alternative. Plus, it’s an outpatient procedure, so you may, more than likely, return home the same day as your surgery. You don’t need as many follow-up appointments after your procedure, either.
Balloon sinuplasty doesn’t involve any cutting of your bone or tissue, so the recovery time is shorter than the alternatives. Your need for general anesthesia and complications from it lessen with this procedure as well. Your risk of scarring and inflammation isn’t as high with balloon sinuplasty, either.
What is the Process of a Balloon Sinuplasty?
The balloon sinuplasty process requires multiple appointments.
Pre-op Appointment
At your first appointment for balloon sinuplasty in NYC, you’ll need to complete a thorough medical background evaluation. Based on your responses, your doctor can determine if a balloon sinuplasty procedure is a safe solution for you.
Next, your doctor will discuss your symptoms and conduct a physical evaluation. In some cases, your specialist may order an endoscopic examination, which is a diagnostic test that uses a narrow, flexible instrument with a light to help your surgeon see inside the internal structure of your nose.
Our surgeon may also recommend a computed tomography (CT) scan to safely capture an image of your paranasal sinus cavity, which is the hollow space surrounding your nasal cavity. It’s a painless way to determine if you require balloon sinuplasty surgery.
After your specialist determines the procedure is safe and may benefit you, you’ll discuss a surgery date that works for you. You and your surgeon will also discuss the appropriate level of anesthesia for you — either a local or general.
During your appointment, you’ll also learn about the steps you should take before your surgery. For example, your surgeon will more than likely recommend you stop food and fluid consumption at midnight the night before your surgery.
In addition, your doctor will ask you to avoid certain medications before your surgery. Your practitioner will discuss your smoking and drinking habits, as well. Both of these habits may interfere with the healing process. Smoking contributes to scar tissue and slows your healing time while drinking may cause swelling and increase your bleeding risk.
Surgery Day
Firstly, your surgeon will position you and administer the necessary anesthetic. Then, your physician will insert a thin, tiny flashlight into your sinus cavity. After, your specialist will insert the catheter. Your surgeon then will inflate the balloon on the catheter to widen your sinus’ opening. Next, the catheter used for balloon sinuplasty surgery will restructure the bones.
Your practitioner will use a saline solution to flush out any mucus or pus build-up from your sinus cavity to complete the process. Finally, your practitioner will deflate and remove the balloon, but your sinus will remain wider.
Once your procedure is complete and the general anesthesia, if you received it, wears off, you may return to your home to recuperate. If you only had a local anesthetic, you may even drive yourself home after the surgery.
What is the Recovery Time for a Balloon Sinuplasty?
Once you return home from your balloon sinuplasty in NYC, you may resume your usual daily activities in 24 to 48 hours. However, you’ll need to avoid strenuous exercise for the first week to keep your heart rate steady. You’ll also need to avoid blowing your nose in the first 24 hours after surgery.
You might experience discharge or bloody drainage from the surgical area, which is normal. Sometimes, swelling or congestion may occur. Sometimes, you’ll experience fatigue after the procedure. Usually, these symptoms subside around five to seven days after the surgery.
At the conclusion of your surgery, you’ll receive a prescription for an antibiotic to prevent infection. You’ll need to complete the entire prescription. You may also receive a prescription for a pain reliever or advice regarding which over-the-counter analgesic you may take. In addition, your surgeon will provide you with at-home remedies to reduce your pain and discomfort. You’ll need to use a saline solution to rinse your nasal passageways for the first three to seven days after your surgery, as well.
Your surgeon will provide you with information regarding signs of potential problems. For example, intracranial complications can arise. Specifically, brain fluid may leak through your nose, although this is a rare occurrence. You should also take notice if you have swelling that doesn’t seem to subside after the first week. You’ll want to look for signs of an infection, too. Your surgeon will explain to you which complications require immediate medical attention.
You’ll have a post-op appointment after your surgery, so the practitioner can examine you for any signs of complications and ensure you’re healing normally.