19 June 2018
Badly blocked sinuses and the pain they bring can have a big impact on your enjoyment of everyday life.
But there is a procedure that can put an end to the pressure headaches, severe face pain, lethargy and even the loss of the sense of smell and taste that blocked sinuses can cause.
Balloon sinuplasty is an innovative, minimally invasive procedure that involves unblocking the sinus with a tiny balloon on the end of a thin flexible wire, allowing the sinus to drain and relieving the sinus pressure without damaging delicate membranes.
Consultant ENT (Ear, Nose and Throat) Surgeon Mr Rohit Pratap carries out balloon sinuplasty operations at Spire Bushey Hospital. Here he answers questions on what the procedure entails and the benefits it can bring to people suffering with sinus problems.
What are the usual causes of sinus problems?
Sinus problems are caused by nasal inflammation, allergies, infections and structural issues inside the nose.
Is there anything sufferers can do before turning to surgery?
There are several medical treatment options. Depending on the cause, patients can be recommended to undertake allergy avoidance, decongestants, nasal saline irrigation, nasal steroids, oral steroids, and various antibiotic regimes. In acute sinus issues, these are usually totally curative. In chronic sinus issues, medications can permanently or temporarily help up to two third of patients.
Is the problem more prevalent in men or women?
It occurs equally in men and women.
Can it be a seasonal thing – people suffering more if the pollen count is high?
Yes, seasonal allergies can cause nasal and sinus issues.
What about age groups – is there a certain age that is more susceptible to sinus problems?
As we age, the mucous membranes inside our nose can thin, and lead to more sinus issues. Chronic sinus issues are very uncommon in children.
Before balloon sinuplasty what was the most common form of treatment?
Endoscopic sinus surgery has been a treatment of choice for a couple of decades. It uses an endoscope (tube-like instrument) inside the nose and metal dissecting instruments to remove bony and mucosal tissue inside the nose. This widens the narrowed pathways of the natural sinus openings in the side wall of the nose.
Why, in your opinion, is balloon sinuplasty more effective?
Balloon sinuplasty is more effective in selected cases. Where extensive sinusitis or nasal polyps are present, more extensive surgery is still required. However, with limited sinus obstruction and particularly with the more difficult sinuses to reach the balloon dilatation procedure results in safe, effective and faster recovery procedure with good symptom relief. It does not remove bone or mucosa, but ‘stretch’ open the natural openings, akin to angioplasty of blocked arteries in the heart, hence healing is much faster, with faster return to work and normal activity. As it does not remove the nasal lining, it also results in the opened pathway remaining open for years, without the risk of post-operative scarring closing down the surgically opened drainage pathway.
What does surgery entail?
Surgery is usually undertaken under general anaesthesia but can be done under local anaesthesia. A delicate, fine guide wire with a bright light is inserted into the complex bony labyrinth of the sinuses and passed into the sinus cavity. The natural drainage pathway of that sinus is then gently stretched open by inflating a tiny balloon and thereby ‘stretching’ open the pathway. An irrigation catheter is then inserted into the sinus and a washout performed which is like your sinuses going into an automated car wash!
How long will it take?
The procedure takes 30-60mins depending on how many sinuses are involved.
What changes can a patient expect to experience and over what sort of timescale?
Some patients report an immediate resolution of the pressure in their head while waking up in recovery! More often however, symptom resolution (nasal blockage, pressure headaches, thick nasal discharge and poor smell and taste) takes four to six weeks to resolve.
What sort of patient feedback have you received so far?
Patient feedback for this procedure has been excellent. Patients particularly like the fact that there is not much nasal bleeding, crusting and pain in the post-operative period, meaning a faster return to normal activity.
Mr Rohit Pratap is a Consultant ENT Surgeon at Spire Bushey Hospital.