Today’s blog is a continuation of my previous communication describing how I became the first Ear, Nose and Throat Physician to perform the Balloon Sinuplasty in The State of Pennsylvania in May 2006. Here I’d like to describe the evolution of this conservative surgical technology in ways that no one initially felt would ever be possible.
Balloon Sinuplasty has been described as the “Angioplasty of the Sinuses” in that the same disruptive technology was first introduced to the Cardiothoracic physicians as another alternative option to help patients with narrowing of the blood vessels that provide oxygen and nutrition to the muscle of the heart. Now instead of only open heart surgeries, healthcare providers can now offer a more conservative alternative of treatment with less potential for side effects, faster recovery with less discomfort and potentially the same outcomes.
The Balloon Sinuplasty offers exactly the same disruptive technology for sinus care as the balloon offered to heart surgeons. Traditionally, sinus surgery was performed in the operating room with the patient under general endotracheal anesthesia. X rays would also need to be taken during the procedure which places not only the patient but all other support staff at risk for radiation exposure. Sinus membranes were scraped and removed even if healthy. This would add scar formation, delayed healing, added pain and potential severe bleeding since the approach to fixing the sinus problem involves a more complicated procedure.
Enter present day Balloon Sinuplasty. This technique is now performed in our office setting. Yes, without general endotracheal anesthesia, without intraoperative X ray radiation exposure, quicker often pain free recovery all with the same successful outcomes of improved nasal breathing, reduced if not eliminated facial and head pain associated with sinus inflammation, less frequent sinus infections and that constant thick drainage causing sore throats and cough is often a thing of the past.
The process of anesthesia begins prior to the patient arriving at our door. The patients will take a low dose of a pain and nerve pill which helps to reduce anxiety and mild discomfort for my manipulation inside the nose. Afrin nasal spray is also recommended to reduce congestion. Once the patient arrives and is registered, they are brought back to the procedure room and some thin, small intranasal gauze strips are gently placed into the nose to start the numbing. The scope is brought into the field and a topical gel which contains a decongestant and numbing lidocaine based medication is carefully and accurately placed onto the surfaces of the nose where the pain nerves concentrate.
This is the same approach a Dentist would use to numb the mouth and gums prior to their numbing injection. In fact most of these anesthesia techniques have been borrowed from our Dental Colleagues and adapted to use inside the nose and sinuses. After the medication is left inside the nose for ~ 10 minutes, the thin gauze strips are removed and the procedure can then proceed. 2 small injections are placed inside the nasal membranes and patients often state that they never even felt the injections.
The entire procedure from walking into our office to walking out the door after the procedure is completed averages 63 minutes. Pain following the Balloon Sinuplasty is controlled with Tylenol/Motrin as needed, a saline mist is recommended for a few days after the procedure to help keep the nose and sinuses from creating too much crusting and scabbing. An antibiotic and steroid medication is often used to help speed recovery and minimize the inflammation that initially brought our patients into the office.
To date, conservatively, I have personally performed over 2000 in office balloon sinuplasties. If you also figure that in any given case, I could treat anywhere from 1 to 6 sinuses per case, that number increases dramatically. Our overall success rate is in the 70%+ overall improvement. These improvements continue to this very day.
Technology enhances each of our everyday lives. With every new discovery or advancement, options are created allowing patients and healthcare provider choices for treatment of varying degrees of problems. Hopefully these last few blogs as well as future communications will allow the reader my observations of this technology and with the continued modifications, we can successfully treat complicated sinus infections helping our patients return to their normal activities in a quick, pain free recovery leaving all those bothersome sinus complaints in the “rear-view mirror”.
We take pride in offering quality, state-of-the-art treatment solutions for sinus and nasal problems, allergy testing and treatment, ear infections, snoring, and sleep apnea, and are staffed by qualified ENT doctors.