CINCINNATI—Nearly 40 million hay fever sufferers in the United States experience headache, facial pressure and a stuffy nose when pollen is in the air.
But for 37 million people with chronic sinusitis, relief from these symptoms doesn’t come with a change in the season.
Inflammation of the sinuses (hollow spaces in the bone of the cheeks and forehead) is often due to infection or anatomic abnormalities.
“The sinuses drain through small, bony channels,” says Allen Seiden, MD, professor of otolaryngology. “When the sinuses are blocked and don’t drain, people can have trouble with recurrent infections associated with difficulty breathing, headaches and fatigue.”
Traditionally, sinusitis is first treated with antibiotics and decongestants, as well as by addressing any underlying problems such as allergies. For patients who don’t respond adequately to medications, the next step may be endoscopic sinus surgery.
This involves inserting a thin, fiber-optic tube into the nose, which allows the surgeon to see the sinuses close-up, and then using specially designed instruments to remove small pieces of bone and tissue to open up the drainage passages.
Now a new treatment for the condition is giving sufferers another option that doesn’t involve cutting or removing tissue.
Called balloon sinuplasty, the procedure dilates sinus openings in much the same way as clogged arteries are opened during a balloon angioplasty.
Balloon sinuplasty involves the insertion of a thin wire, which carries the balloon, through the nostrils and into the sinuses. The balloon is then inflated with just enough pressure to dilate the sinus openings.
“This procedure is less invasive than endoscopic sinus surgery because there’s no cutting, which should also result in less scarring,” says Lee Zimmer, assistant professor of otolaryngology.
Seiden and Zimmer point out that the procedure offers a quicker recovery time than traditional sinus surgery because it results in less pain and bleeding. However, it may not be appropriate for all sufferers.
The human skull has a number of different sinuses, including six to 12 small “ethmoid” sinuses on each side of the face between the eyes.
“Unfortunately,” says Seiden, “balloon sinuplasty can’t be used in people with diseased ethmoid sinuses, which tends to be an area that’s a problem for many sufferers.
“That area between the eyes can be very difficult to get into,” he says. “It’s also very hard to open the passages and keep them open.”
Although the procedure cannot be used for ethmoid sinus disease alone, Seiden and Zimmer say, it can be used in a combination approach when other sinuses need treatment.
“It’s fairly common for people to have trouble with more than one of their sinuses,” explains Zimmer. “Traditional sinus surgery can be done on the ethmoid sinuses, and balloon sinuplasty on additional sinuses that may need treatment.”
Balloon sinuplasty is done under general anesthesia and takes 45–60 minutes if multiple areas are being treated. If one area is being treated, the procedure can be as short as 10–15 minutes.
The procedure is fairly new and long-term results are not yet known, but a preliminary study of 125 patients shows the sinus openings become significantly wider, and more than 80 percent stay open.
“Chronic sinusitis affects the quality of life for millions of people,” says Zimmer. “Health care and off-work time cost $8 billion a year. We’re hoping these short-term results prove to be true long term.”
Seiden and Zimmer were trained to perform balloon sinuplasty by the manufacturer, Acclarent Inc. They have no financial interest in the company. For more information on balloon sinuplasty or to reach their office, call (513) 475-8400.