About the sinuses

The sinuses are cavities within the head, connected by channels. The structure is behind the cheekbones, the lower part of your forehead, between your eyes, and behind the nose. The sinuses are lined with “mucosa,” which produces mucus that clears out bacteria, and drains to the nose. 

What are the most common sinus conditions?

Acute sinusitis:

A short-term infection and inflammation of the sinuses. This condition may resolve in a week or two or persist for several weeks. Those who suffer from allergies and have a deviated septum, or nasal polyps and are more likely to experience bouts of acute sinusitis.

Chronic sinusitis:

Chronic sinusitis is a condition in which the sinuses are inflamed and swollen for a period of three months or more, even with treatment. The usual treatments include nasal irrigation, corticosteroids, or allergy medicines. When these treatments do not resolve the condition, a balloon sinuplasty may be performed.

Allergies (allergic rhinitis):

Hay fever is a common sinus problem, with symptoms including sneezing, congestion, and itchy, watery, red eyes. Allergy medications or shots may be administered to alleviate symptoms.

Polyps:

Nasal polyps are growth that develops in the nasal passages or sinuses. The growths can cause congestion, runny nose, pain, and mucus formation.

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Balloon sinuplasty

A balloon sinuplasty is a minimally invasive endoscopic procedure used to treat chronic sinusitis. Sinusitis is an inflammation of the lining within the paranasal sinuses. Once inflated, the sinus cavities become a fertile ground for viruses, bacteria, and occasionally fungi to grow, resulting in infection. If it becomes chronic there may be a structural problem in the nose or sinuses. In those cases, a balloon sinuplasty may be recommended.
During a balloon sinuplasty, a thin balloon catheter is inserted into the nose. The balloon is gradually inflated to relieve blockages and widen the sinus pathways. The goal of a balloon sinuplasty is to enlarge the opening of the sinuses, reduce blockage and improve sinus drainage.

Balloon Sinuplasty and FESS Animation with Voiceover

What is a balloon sinuplasty?

A balloon sinuplasty could be performed in a hospital, outpatient surgery center or in a doctor’s office. A minimally invasive procedure, it is performed to treat chronic sinusitis. This treatment is indicated for those who have recurring sinus inflammation and infection, but do not have nasal polyps, and is performed with local anesthesia and intravenous sedation, or in some cases, with general anesthesia. 

The ENT performs this surgery by inserting a catheter connected to a wire and a small balloon, through the nostril, near the opening to the sinus cavities. Through the catheter, the sinuses are cleansed with a saline solution, and the balloon inflated to enlarge the cavity for improved drainage. The balloon is then deflated and removed, but the sinus remains open. This procedure gently reconfigures the structure of the bones in the nose, restoring normal sinus drainage, and results in very little post-operative pain or bleeding. When a balloon sinuplasty is complete, the patient is free to return home. 

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Recovery from balloon sinuplasty

Patients may experience a bloody discharge for three to five days after the surgery. They may also experience discomfort and sinus pressure which can be relieved with acetaminophen. Patients should avoid using any type of non-steroidal anti-inflammatory medications (NSAIDs) because they may cause bleeding. Nasal congestion is also common. Nasal passages and breathing should return to normal two to three weeks after surgery.

Benefits of balloon sinuplasty

Unlike traditional sinus surgery, balloon sinuplasty does not require incisions, or any removal of bone or tissue, although, in certain cases, it may be used in conjunction with traditional surgery. Balloon sinuplasty has many advantages over traditional procedures. Benefits may include:

  • Absence of surgical incisions
  • No damage to surrounding tissue
  • Lack of serious complications
  • Shorter recovery time
  • Reduced bleeding

Although balloon sinuplasty is an effective treatment for relieving many sinus problems, and has no reported serious complications, it is not appropriate for everyone. Balloon sinuplasty cannot be performed on patients with extensive scarring of the sinuses, ethmoid sinusitis, or nasal polyps.

Risks of balloon sinuplasty

Since balloon sinuplasty is a minimally invasive procedure, risks are minimal but could include bleeding, infection or swelling. The great majority of patients experience relief from the symptoms of sinusitis, soon after a balloon sinuplasty procedure. Studies indicate that most patients experience continued sinus health for up to two years after the procedure.

What is the recovery time?

This treatment is performed on an outpatient basis and does have a long recovery time. You may need to administer a nasal spray or rinse the area with saline to promote faster healing. You may have excessive nasal drainage for a few days or longer, with a full recovery, for most patients, in about two weeks.

What is the treatment for sinusitis in patients with nasal polyps? 

If you have nasal polyps and suffer from chronic sinusitis, the treatment may involve injecting a medication to shrink the polyps as one aspect of your treatment. If sinusitis persists after this approach, an endoscopic surgical procedure can be performed to remove the polyps or other nasal obstructions causing the blockage in the drainage system. Some patients may achieve relief with biologic therapy to reduce polyps, irritation, and swelling.

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Septoplasty – deviated septum surgery

The inner nose structure may be crooked or uneven, affecting breathing function. The “septum” is the cartilage dividing the nostrils. A deviated septum is a condition in which the cartilage is crooked, bent, or uneven, which can occur due to trauma, or be present at birth. A septoplasty is the only way to correct this condition.

It is performed on an outpatient basis, under general anesthesia or local anesthesia and intravenous sedation. During a septoplasty, the bone and cartilage are reshaped and repositioned. A septoplasty will restore breathing function and is often a successful treatment for snoring or sleep apnea. Once the structure is corrected, healthy breathing from both nostrils is restored.

What is the recovery?

After a septoplasty, it is normal to expect some tenderness, a stuffy nose, and nasal drainage of mucus and bloody discharge, which can last a few days. The discomfort is typically easily managed with over-the-counter painkillers. You may need to irrigate or spray the sinuses to clear any congestion. The nose may be protected with a packing material, restricting the patient to breathing through the mouth until it is removed. The optimal result in improved breathing may take a few months.

Nasal turbinate reduction – what is it?

The turbinates are inner nose structures that humidify and cleanse the air before it enters the lungs. This structure is composed of bone, blood vessels, and mucus membranes. The turbinates could become inflamed due to allergies, irritation, or infection, resulting in excessive mucus production and congestion.

Nasal turbinate reduction reduces the size of the turbinates to improve airflow and breathing. The procedure takes only about ten minutes to perform, under local anesthesia. Radiofrequency energy is applied to the tissues to achieve a precise reduction in the size of the structure.

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Recovery from turbinate reduction

The recovery time is generally painless but may include a few weeks of crusting. The patient may be asked to perform saline irrigation and apply antibiotic ointment during healing. The recovery involves a day of rest and two days of avoiding any vigorous physical activity.

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