Balloon sinuplasty

Overview

Balloon sinuplasty is a recommended treatment option for individuals who suffer from chronic rhinosinusitis (CRS) symptoms that continue for more than 12 weeks without showing improvement with standard medical treatments. Instead of opting for the more invasive endoscopic sinus surgery (ESS), some patients with ongoing sinus issues may find relief through this less invasive procedure.

Reasons for undergoing the procedure

Chronic rhinosinusitis, also known as CRS, encompass a range of symptoms such as a stuffy nose, congestion, facial pressure, runny nose, and loss of sense of smell.

CRS is commonly treated with antibiotics among other medical therapies. However, if the symptoms persist for longer than 12 weeks, balloon sinuplasty or endoscopic sinus surgery may be suggested. 

Risk

Balloon sinuplasty is generally associated with minimal risks. There is also a chance that symptoms may reoccur, prompting the need for further interventions, such as undergoing another balloon sinuplasty procedure or opting for an alternative treatment like endoscopic sinus surgery.

Potential complication include:

• Excessive nosebleed
• Bacterial sinusitis

Before the procedure

Computed tomography (CT) scan is frequently performed prior to undergoing balloon sinuplasty to verify the suitability of the procedure for addressing one’s condition.

During the procedure

Balloon sinuplasty is not commonly painful. Individuals undergoing this procedure describe experiencing a sensation of pressure in their nose rather than pain. The treatment can be performed either in a medical office or a hospital operating room.

Balloon sinuplasty performed in a medical office begins with administering a topical decongestant to the nose. It proceeds as follows:

• An anesthetic spray will be applied, followed by additional anesthetic on cotton pads inserted into the nose. The pads will be removed, and a local anesthetic will be injected into the nasal tissue.
• Using an endoscope, the catheter will be guided into the nose. Through the catheter, a small balloon will be directed into the sinuses, gradually inflated to gently alleviate blockages.
• The healthcare provider may repeat the process as needed before deflating and removing the balloon.

In the operating room setting, the procedure involves receiving general anesthesia or conscious sedation to block pain while remaining awake during the process. Then: 

• To control potential bleeding, a topical decongestant is applied, followed by the injection of a local anesthetic into the nasal tissue. 
• A thin tube with a light, known as an endoscope, is used to guide a catheter into the nostril. A small balloon is then inserted through the catheter and slowly inflated to gently alleviate sinus blockages.
• The healthcare provider may repeat the process as needed before deflating and removing the balloon.

After the procedure

After balloon sinuplasty, it is also advisable to remain at the hospital or medical office until one feel at ease leaving after the procedure. 

Post–procedure follow–up appointments and tests may be necessary to ensure ongoing monitoring and evaluation of the sinus health. The schedule may include a follow–up appointment and nasal endoscopy one week after the procedure, and another follow–up appointment with nasal endoscopy three months later. 

A comprehensive assessment of the nasal health, including another nasal endoscopy is necessary one year after the procedure.

Outcome

Following the procedure, individuals may need to rest at home for 24 to 48 hours. It’s common for individuals to notice some bloody drainage from their noses, which is completely normal. However, if someone experiences severe and unmanageable nosebleeds, it is recommended to reach out to their healthcare provider for assistance.

Balloon sinuplasty is a secure and minimally invasive method for chronic rhinosinusitis (CRS) treatment, with studies indicating minimal reports of side effects or complications. For a smoother recovery process, one may need to:

• Avoid strenuous activities during the initial week post–surgery
• Refrain from blowing the nose for 24 to 48 hours.
• Use nasal spray for nostril rinsing
• Elevate the head while sleeping if congestion is felt