Balloon Sinuplasty

The balloon sinuplasty procedure is a minimally invasive technique to address chronic sinusitis and recurrent acute sinusitis which was developed in the last 10 years. It involves the use of a small balloon to dilate the openings into blocked sinus cavities. Excellent results have been obtained with this technique and a number of research studies have shown it is equally as effective as older methods of sinus surgery.

Good candidates for balloon sinus procedures are patients with chronic sinusitis or recurrent acute sinusitis involving the maxillary, frontal, or sphenoid sinuses. Patients with chronic sinusitis should have failed maximal medical therapy including at least 3 weeks of antibiotics with a nasal steroid spray and regular sinus saline irrigations. Patients who have had previous sinus surgery can potentially have balloon sinus procedures as well.

Balloon sinus procedures can be done either under general anesthesia in the operating room or in the office with local anesthesia. Most adult and teenage patients prefer to have the procedure in the office. Patients who should go to the operating room include those who require additional surgical procedures such as ethmoid sinus surgery.

Balloon sinus procedures in the office typically take around 1 hour start to finish. There are several rounds of numbing and decongestant medications which are sprayed into the nose to start. After this, cotton gauze soaked in numbing medication is placed into the nose for about 15 minutes. The gauze is removed and then more numbing medication is injected inside the nose around the openings into the sinuses. Once this is done, most patients are able to tolerate the procedure with minimal or tolerable discomfort, similar to a dental procedure.

A recent research study asked patients to rate their level of discomfort on a scale of 1-10 after having a balloon sinus procedure in the office with only local anesthesia (no sedation). The average discomfort score the patients reported was between 2 and 3.

The balloon procedure itself involves careful placement of a thin guidewire through the sinus openings into the sinuses themselves. I use a thin telescope to see where the device is going inside the nose. Once the guidewire has been advanced into the sinus, I am able to advance the balloon over the wire through the sinus opening and then inflate the balloon to widen the sinus entrance. I then repeat the procedure as needed for all diseased sinuses (can be as many as 3 on each side of the nose). There is usually some discomfort (pressure and “snap/crackle/pop” noises more than pain) as the balloon is inflated because I cannot numb the inside of the sinuses. Most patients are easily able to tolerate the procedure though.

The procedure is overall very safe. There is a risk of nosebleed, scarring inside the nose, and recurrence of sinus infections in the future. Large research studies have shown around a 90% success rate 2 years after the procedure. For older forms of sinus surgery, there is a low but present risk of injury to the eye socket and/or leak of cerebrospinal fluid after the procedure. These risks are still theoretically possible with balloon sinus procedures but are much less common. Research studies have shown no major complications in hundreds of balloon procedures.

Post-procedure care is fairly straightforward. Patients should use nasal saline spray 3-4 times per day for the week following the procedure. Expect some bloody oozing or blood mixed in with the nasal drainage for a couple days. I will give a prescription for pain medication though many patients need only tylenol or ibuprofen. The nose usually feels stuffy and congested for about a week after the procedure, then it opens up over the following week.

I will see patients back in the office 1-2 weeks after the procedure. I will look inside the nose at this time and clean any crusting that may have formed. Typically there is less crusting with balloon sinus procedures than older forms of sinus surgery.

Call (512) 550-0321 if you have any questions or to make an appointment! We serve the South Austin Metro Area, including Kyle, San Marcos, and Lockhart.