Ear, Nose and Throat

What you should know about balloon sinuplasty

Balloon sinuplasty is a type of endoscopic nasal surgery. It uses small balloon catheters that inflate to drain the large nasal sinuses.

Balloon sinuplasty is typically used to treat cases of severe rhinosinusitis or sinus inflammation and blockage in the nose.

The procedure was adapted from angioplasty, where balloon catheters are used to dilate damaged or congested blood vessels near the heart.

Fast facts on balloon sinuplasty:

  • The surgery is fairly new, approved by the United States Food and Drug Administration (FDA) in 2005.
  • Balloon sinuplasty, as with all sinuplasty surgeries, is considered extremely effective in reducing symptoms of rhinosinusitis.
  • Increasingly, balloon sinuplasty is being recognized and fully covered by medical insurance companies.

What is a balloon sinuplasty?

Doctor holding a model of the side view of interior respiratory system in nose and and throat to explain balloon sinuplasty.
A balloon sinuplasty is a procedure used to treat conditions causing blocked or inflamed sinuses.

The procedure is minimally invasive, involves no cutting or loss of nasal tissues or bone, and has a short recovery time.

As a result, balloon sinuplasty is quickly becoming the surgery of choice for chronic or severe sinusitis that does not respond to other medical therapies, such as nasal decongestant medications and rinses, antibiotics, and nasal and oral corticosteroids.

A 2017 study found that the number of balloon sinus procedures performed in the U.S. increased 59 percent annually from 2011 to 2014.


How does it work?

Balloon sinuplasty works by dilating the openings of some or all three of the major nasal sinuses. This enables them to be cleared and drained.

Most people who need the surgery have a condition that leads to the sinus membranes becoming inflamed, preventing drainage of mucus, pus, and discharge, and causing congestion.

Over time, blocked and inflamed nasal passages can interfere with breathing, and lead to symptoms, such as a headache, jaw ache, and insomnia.

Balloon sinuplasty allows doctors to forcibly widen blocked nasal passages and flush out or remove congestion, often using a saline solution.


Does it help?

Man blowing his nose into tissue because of cold infection or sinusitis.
A balloon sinuplasty procedure may help to ease the symptoms of chronic sinusitis.

A 2016 study found that out of 15 adults who received balloon sinuplasty, all reported improved symptoms 3 and 6 months after surgery, without any unanticipated side effects.

The same study concluded that those who underwent balloon sinuplasty had more open, clear nasal passages after the surgery than before.

Furthermore, the procedure helped preserve healthy nasal tissues, mucous membranes, and structure.

A 2017 study found that balloon sinuplasty was successful in treating 94 percent of chronic sinusitis cases in 30 children who underwent the procedure. The positive effects persisted for up to 1 year following surgery.

A 2013 study found that out of 20 individuals who received balloon sinuplasty, all reported dramatically improved symptoms within 1 week of surgery. These participants were also symptom-free during follow-ups in the year after their surgery.

Another 2013 study, found that when performed in a doctor’s office under local anesthesia, people who had balloon sinuplasty reported an overall improved the quality of life. They also had more open sinuses in radiographic images 24 weeks after surgery.

The same researchers reconfirmed the improvements in 2015, a further year after their original operations.


Is it safe?

Balloon sinuplasty is considered a very safe, effective, procedure when performed by a doctor.

Since its introduction in the mid-2000s, balloon sinuplasty has become one of the most commonly performed types of sinus surgeries. This popularity is because it is associated with such high rates of success and low risks of complications.

Benefits of balloon sinuplasty over traditional endoscopic sinus surgeries include:

  • lower risk of bleeding
  • shorter office, clinic, or hospital stay and much faster recovery time
  • no intended damage or removal of sinus tissues, structures, mucous membranes, nasal bones or sinus cartilage
  • fewer required post-operative appointments or need to inspect stitches or sutures
  • reduced need for the use of operative and post-operative pain medications
  • reduced need for general anesthesia and lowered risk of adverse reaction to it
  • reduced risk of post-operative infection
  • reduced risk of unintentional tissue or structure damage
  • reduced risk of scarring and continued inflammation

As with all surgical procedures, balloon sinuplasty is known to cause some minor symptoms, but this resolves shortly after surgery.

Side effects

Common minor side effects associated with balloon sinuplasty include:

  • bleeding or bloody drainage for a few days
  • nasal, cheek, or forehead tenderness
  • minor swelling in nasal cavities and passages and surrounding facial area
  • congestion
  • infection, usually from a failure to properly cleanse the sinuses after surgery

In rare cases, sinuplasty has been reported to cause more severe symptoms, most notably damage to the structures that separate the brain from the sinuses.

Though also considered a rare complication, sinuplasty has been known to occasionally interfere with an individual’s sense of smell, and the appearance of their nose.

Anytime a person is exposed to a form of anesthesia there is always a risk of severe adverse reactions, such as breathing difficulties and heart failure.

What is the procedure like and does it hurt?

ENT doctor in consultation with patient before procedure.
Balloon sinuplasty is a low-risk procedure that has positive results for almost all patients.

Depending on individual factors and preferences, balloon sinuplasties are done by an ear, nose, and throat or ENT doctor in their office, an outpatient clinic, or a hospital.

The procedure may be done using general or local anesthesia.

After administering either form of anesthesia, a doctor inserts an endoscope, a thin, flexible, plastic tube with a camera and light on the end, into the nasal passages.

Once the entrance to the cavity is reached, the doctor will slowly advance a small balloon catheter over the guiding endoscope wire.

When the balloon catheter is correctly positioned inside the nasal passage and cavity, it will be slowly inflated and pressed against the sinus walls, to fracture the bone slightly and force an opening.

Once the balloon is fully inflated, a doctor will flush out the passageways and cavities with a saline rinse to further remove debris. Finally, the balloon is removed and the sinus is left to continue to drain naturally.

Most people who undergo balloon sinuplasty report feelings of sinus pressure or numbness only during the surgery, not noticeable pain. Most procedures take around 1 hour to perform.


Costs and insurance

A few medical insurance policies still consider the surgery to be an elective procedure, meaning it is not eligible for coverage.

A 2014 statement by the American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS), called for all insurance payers to consider balloon sinuplasty as a standard cover service.

The out-of-pocket costs and medical approval process associated with each sinuplasty depends on an individual’s plan and case, the severity of symptoms, and whether or not their condition improved with other, less invasive medical therapies.

Overall, the costs associated with balloon sinuplasty range from $2,000 to $7,000. Without insurance, endoscopic sinuplasties typically cost around $20,000 dollars. Generally, surgeries performed in a doctor’s office or clinical setting under local anesthesia cost a fraction of those done in hospitals.

How long does it take to recover?

Most people can go home a few hours after balloon sinuplasty surgeries and return to most regular activities after 24 to 48 hours.

Usually, sinuplasty tends to cause grogginess, tiredness, tenderness, congestion, and bloody drainage in the week following surgery.

A doctor may advise against nose-blowing for 1 to 2 days immediately after the surgery. Usually, it is advisable for an individual to avoid strenuous activities for at least a week after sinuplasty.

Many people find it helpful to sleep or rest with their head and neck in an elevated position to promote drainage. And over-the-counter anti-inflammatories can help manage irritating or uncomfortable symptoms afterward.

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