In the past, sinus surgery required incisions to be made on the face and in the mouth. Extensive nasal packing was required to promote healing, and patients experienced a great deal of pain and discomfort on the long road to recovery.
Thanks to modern advances, such as the nasal endoscope, sinus surgery can now be performed entirely through the nose. In addition, less nasal packing is required and recovery times are significantly shorter. Dr. Hall finds that he rarely needs to use any non-absorbable nasal packing for any of his nasal or sinus surgeries.
An Incredible Tool
A nasal endoscope is a small telescope that is placed directly into the nostril. A small light and special camera are attached to the end of this metal device. For those suffering from chronic sinusitis, which is inflammation of the nose and sinuses, endoscopic sinus surgery is often the answer, especially when all other treatment options have proven unsuccessful.
Chronic sinusitis can be caused by a number of factors, including nasal polyps, allergies, or other environmental irritants. Recurring infections or chronic sinus infections may warrant endoscopic surgery. Other indications are an impaired sense of smell, nasal tumors, and tear duct blockage.
The nasal endoscope is by far not the only successful means of performing sinus surgery. In fact, the field of rhinology has greatly benefited from a tool originally designed for cardiac surgeries. The balloon dilating catheter was released to treat sinus issues in 2005. Dr. Hall finds that balloon sinuplasty is a very effective tool that he uses in selective cases, however, it is not always the best procedure for an individual patient. The use of the balloon technique has exploded in popularity in recent years due to reimbursement changes and aggressive marketing practices. Dr. Hall focuses on surgery that is tailored to the individual patient, and only uses the balloon technique when that is the most appropriate and effective technique for the surgery.
The process is quite simple. A lighted guidewire passes from the nasal cavity into the particular sinus cavity in need of treatment. Next, the balloon dilating catheter passes over the wire into the narrowest part of the sinus drainage pathway. The high-pressure balloon is then inflated briefly, which widens the outflow tract of the sinus by fracturing the bone and pushing it outwards. The end result is a widened outflow tract, accomplished without actually removing any tissue.
The balloon dilating catheter can actually be used in two different ways. As with any other instrument, it can be used as an adjunct to standard minimally invasive sinus surgery where nasal tissue is removed. However, it can also be used as a stand-alone procedure, meaning that only the balloon is used.
In the later method, the sinus cavity is opened without removing any tissue. This technique may result in less postoperative pain and thus a shorter recovery. Less pain medication may be needed as well. The balloon dilating catheter is not always the best tool for all situations. It is merely one of the many tools available that a surgeon may choose from depending on the situation and individual sinus issues. Even when not using the balloon technique, Dr. Hall’s focus is on minimally invasive, safe and effective surgery, or functional sinus surgery, which often has a similar post-op recovery as the balloon technique.
Growing in Popularity
Boasting FDA approval, the balloon dilating catheter is held in favor by both the American Rhinologic Society and the American Academy of Otolaryngology-Head and Neck Surgery. This procedure has proven successful for tens of thousands of patients, however, as mentioned above it is used by Dr. Hall in carefully selected patients.
Indications and Results
The indications and results of a sinuplasty performed with a balloon dilating catheter are much the same as those of an endoscope. The benefits and risks are generally the same as well.
When All Else Fails
Sinus surgery is a viable option for those suffering from chronic sinusitis that has not improved with medical management that includes long durations of antibiotics as well as over-the-counter medications.
For acute sinusitis, treatment measures include saline rinses and nasal sprays as well as antibiotics. Nasal and oral steroids are common treatments for reducing inflammation. However, these are short-term solutions that should not be relied upon for extended periods of time.
Long-term usage can cause dependence as well as other complications. Those with heart issues, such as irregular heart beat, high blood pressure, or other heart diseases, and people who have been diagnosed with glaucoma or urinary retention should consult their physician prior to using any nasal decongestants.
When sinus infections or inflammation consistently lasts more than four weeks, it becomes chronic. It is now time to explore sinus surgery, but only after consultation with Dr. Hall and an intensive medical regimen which tries to clear the infection. The goal is to widen the drainage pathways of the sinuses. Patients with obstructions or other blockages benefit greatly from sinus surgery.
It is best to discuss all options with a doctor to determine the right course of action for each individual case.