Sinus infections bring pain and misery to millions of Americans. When the condition is chronic or recurs frequently, and medications do little to provide relief, then sinus surgery is often recommended. There are multiple procedures available, each with the same goal in mind: to remove any obstructions and enlarge the sinus openings, improving both airflow into the sinuses and drainage of fluids out of the sinuses.
Sinus surgery is far more commonplace now than in the past. Advances in medicine have led to procedures that are minimally invasive with little risk for complications.
Who Is A Candidate for Sinus Surgery?
To determine if you are a candidate for sinus surgery, your ENT doctor will thoroughly examine your ears, nose and throat, looking for obstructions and other abnormalities such as nasal polyps. This usually involves nasal endoscopy and a CT scan of the sinuses. Allergy testing is often part of the diagnosis as well. If medicines fail to provide long-lasting relief and allergy testing does not provide a treatment strategy, surgery will be considered.
In some cases, sinusitis leads to other very serious health problems like pneumonia, worsening asthma, eye infections or even meningitis. In those cases, rather than relying on medication, surgery may be the best first step to help control or prevent these serious problems from happening again.
What Sinus Surgery Options Are Available?
Depending on your condition, insurance, lifestyle and symptoms, your ENT physician may recommend one or more surgical treatment options.
Functional Endoscopic Sinus Surgery (FESS)
This technique uses a nasal endoscope to visualize the natural drainage pathways of the sinuses. Specialized instruments are then used to remove tissue to widen those pathways. It is usually done in the operating room.
Propel Sinus Implants
This is a technology that significantly improves the results of Functional Endoscopic Sinus Surgery. This dissolvable implant is inserted into the surgically widened sinus openings. While the implant dissolves over the next four to six weeks, it delivers a measured dose of mometasone furoate, an anti-inflammatory steroid, directly onto the lining of the sinus openings; this keeps the openings wide open during the healing process.
These steroid implants are especially effective at preventing the regrowth of nasal polyps. Sinuva, one variation of this implant, can be inserted in the office in patients who have had sinus surgery in the past. This procedure can be an effective way to treat polyps, which have regrown.
Balloon sinuplasty revolutionized sinusitis treatment. It does not require any tissue to be removed and can be done right in the office. Your surgeon inserts a balloon catheter into the sinus passages with an endoscope and gently inflates it. The goal is to permanently expand the sinus openings, allowing for better drainage and airflow. The balloon gets removed after it deflates. This operation is minimally-invasive, usually takes less than 30 minutes to perform, does not require nasal packing and has an average recovery time of less than a day. It is just as effective as traditional Functional Endoscopic Sinus Surgery and results in a faster recovery.
Image-Guided Sinus Surgery
This technology coordinates a 3D CT scan mapping system with computer chips embedded in your surgeon’s instruments using infrared signals. This allows the surgeon to accurately link your anatomy with the scan to guide those instruments safely and accurately through complex sinus passages.
If you suffer from chronic sinusitis and have run out of options, you may be a candidate for balloon sinuplasty. This minimally invasive surgery is a safe and effective method of enlarging your sinus passages for easier breathing and a drastic reduction in sinusitis symptoms.
What Is Sinusitis?
Recurrent acute sinusitis and chronic sinusitis affects around 30 million Americans each year. These infections occur when the sinus opening becomes blocked, decreasing airflow and preventing mucus from draining properly. They cause cold-like symptoms that include congestion, runny nose, sore throat, facial pain and swelling, pain in the upper teeth, loss of smell or taste, bad breath, fatigue and headache.
Viral infections most often cause these conditions, though they can also occur due to nasal polyps, a deviated septum or head trauma. Medical treatment and allergy shots work for some, but others continue to suffer despite numerous attempts using various treatments. Balloon sinuplasty may be the answer.
What’s Different About Balloon Sinuplasty?
Conventional sinus surgical procedures involve cutting and excision of bone and tissue. Dissolvable packing often helps control bleeding. The average recovery period is about five days long. Balloon sinuplasty dilates (widens) the openings of your natural sinus openings without removing tissue. For that reason, it causes less pain and has a much shorter average recovery period of only about a day and a half. It rarely requires packing.
Balloon sinuplasty can be performed in the office quickly (the actual operating time is often under 30 minutes) and has a lower risk of complications or side effects. It is FDA-approved and considered a safe alternative to endoscopic sinus surgery.
How Is Balloon Sinuplasty Performed?
Balloon sinuplasty is typically performed in an outpatient setting. You’ll usually be given an oral sedative and a local anesthetic to help keep you comfortable while your ENT surgeon uses an endoscope to help guide the balloon catheter into your sinuses. The balloon is then inflated to enlarge the sinus opening and widen the walls of the nasal passages. The goal is to enlarge your sinus opening to improve drainage and airflow permanently.
During the surgery, a saline solution is often sprayed into the sinuses to flush out mucus and other debris; the catheter is then removed. Up to 95% of patients report a significant improvement in sinus symptoms following this procedure.
Propel Sinus Implant
Chronic sinusitis is a common affliction that affects an estimated 30 million Americans each year. The condition involves inflammation of the sinuses that block the nasal passages and cause chronic infections. Symptoms include nasal congestion, sinus pain and pressure, loss of smell and taste, nasal discharge, headache, pain in the upper teeth, fatigue and depression.
Medications may provide temporary relief, but their effectiveness over the long term is not very impressive, prompting many patients to turn to surgery that involves enlarging the sinus cavities responsible for drainage. Sinus surgery effectively relieves symptoms because it opens the natural sinus openings to improve drainage and increase airflow. Your sinus surgeon welcomes any technique that can help sinus surgery lead to this goal. That’s where Propel comes in.
How Does Propel Work?
Propel is a dissolvable, steroid-releasing implant that decreases inflammation during the healing process that follows sinus surgery. It helps assure that the sinuses remain open.
The implant, inserted during an endoscopic sinus procedure, resembles a spring and delivers a measured dose of mometasone furoate, an anti-inflammatory steroid that gradually dissolves over four to six weeks.
Approved by the FDA in 2013, Propel is safe and effective and decreases the risks of post-surgical scarring that can impair sinus drainage and airflow. Patients typically have a smaller chance of requiring follow-up surgery.
If you are bothered by sinusitis and are looking for a long-term solution, schedule an appointment to learn if Propel is a viable option for you.
Many problems that occur in the nose are temporary and easily treated with medication. Sometimes, however, surgery is needed. Some examples of symptoms and conditions that may require nasal surgery include:
- Nasal blockage
- Chronic sinusitis
- Deviated septum
- Sinus or nasal trauma
- Nose bleeds
- Nasal polyps
- Enlarged turbinates
- Chronic stuffiness
- Chronic breathing issues
What Nasal Surgery Options Are Available?
Depending on your condition, insurance, lifestyle and symptoms, your ENT physician may recommend one or more surgical treatment options. Some of the most common procedures we perform in-house or at our outpatient surgery center include:
These procedures reshape, reduce or reposition portions of the septum’s bone or cartilage to open up the nasal passageway and improve drainage and breathing.
Turbinate surgery reduces airway obstruction and breathing difficulties that result from enlarged or swollen turbinates. Turbinates are long ridges on the inside wall of your nose that clean and humidify air as it passes through.
There are multiple types of turbinate surgery—most reduce the size of the turbinate to improve airflow. The most commonly performed turbinate surgeries are turbinate reduction and turbinate outfracture.
Turbinate Reduction: In this procedure, the surgeon uses an instrument to penetrate the turbinate lining to remove some of the underlying soft tissue and bone. This decreases the size of the turbinate.
Turbinate Outfracture: This surgery pushes the turbinate bone further to the side so that air has more space to flow through the nose.