Some people live with sinus pain and pressure for years: congestion that never fully clears, headaches, and infection after infection. When medicines and home care don’t help enough, an ear, nose and throat (ENT) specialist may talk with you about procedures that open up the sinuses. One of them is balloon sinuplasty.
In the video above, ENT specialist Dr. Timothy Ragsdale explains who he usually recommends the procedure for and walks through how it’s done, and one of his patients describes life before and after.
Chronic sinusitis in brief
The sinuses are air-filled spaces in the skull, behind the forehead, nasal bones, cheeks and eyes. Normally, mucus drains out of them and air flows through. Sinusitis means the tissue lining the sinuses is swollen or inflamed. According to the National Library of Medicine’s MedlinePlus, when the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
MedlinePlus describes acute sinusitis as symptoms that last 4 weeks or less, and chronic sinusitis as symptoms and swelling of the sinuses that last longer than 3 months. Symptoms include a stuffy nose and nasal discharge, pressure-like pain or tenderness in the face, headache, cough, tiredness, sore throat and postnasal drip, and bad breath or loss of smell. In chronic sinusitis, the symptoms tend to be milder but last longer.
Treatment usually starts without surgery. Mayo Clinic lists nasal corticosteroid sprays, saline nasal rinses, allergy medicines and, when a bacterial infection is likely, antibiotics. For chronic sinusitis that doesn’t clear up with treatment, surgery to open the sinuses may be an option.
What balloon sinuplasty is
Balloon sinuplasty, also called balloon sinus dilation, uses a small balloon to widen the natural drainage openings of the sinuses. The American Academy of Otolaryngology–Head and Neck Surgery describes it as the endoscopic use of a balloon device to enlarge or open the outflow tracts of the maxillary, frontal or sphenoid sinuses. It can be done on its own or together with traditional endoscopic sinus surgery.
Who it may help
In the video, Dr. Ragsdale says the patients he usually recommends the procedure for are those who have several sinus infections a year, or who have chronic sinus problems with constant pain and pressure.
Specialty societies have set out who is, and isn’t, a good fit:
- The American Rhinologic Society supports balloon dilation as an option for selected patients with chronic sinusitis or recurrent acute sinusitis who have not improved with appropriate medical treatment, with the diagnosis supported by objective findings, such as nasal endoscopy or a CT scan.
- An expert panel convened by the American Academy of Otolaryngology–Head and Neck Surgery agreed that a CT scan of the sinuses is necessary before the procedure.
- The same panel agreed that balloon dilation should not be done for people without sinus symptoms and CT findings, or for people whose only symptoms are headache or sleep apnea without signs of sinusitis.
In other words, the first step is an accurate diagnosis. Sinus pain and headaches have many possible causes.
What happens during the procedure
Dr. Ragsdale describes the steps in the video:
- A camera guides the work. The procedure is done using a scope placed in the nose, with the view shown on a large monitor.
- A lighted guide wire finds the sinus. A guide steers a thin, lighted wire into the sinus. When the light is inside the sinus, it glows, which confirms the wire is in the right place.
- The balloon widens the opening. The balloon is advanced into position and inflated for a few seconds to dilate the sinus opening. Dr. Ragsdale says this creates a long-lasting opening, because the bones around the opening are actually expanded, rather than only the swollen tissue being stretched.
- The sinus is rinsed. After the dilation, the sinuses are flushed with saline. The balloon is removed, and the next sinus is treated the same way.
One patient’s experience
The patient in the video had lived with constant sinus pain and frequent bronchitis for many years, describing bouts of bronchitis about four times a year. Antibiotics, Claritin and other over-the-counter medicines didn’t bring lasting improvement, so the patient’s primary care physician suggested a visit to Dr. Ragsdale.
Since the procedure, the patient reports no bronchitis and no sinus headaches, no longer needing Sudafed several times a day, and being able to play golf without planning around pollen. His story is one person’s experience; results vary from patient to patient.
Recovery and risks
The video doesn’t cover recovery time or possible complications, and both depend on your situation, including which sinuses are treated, whether the procedure is done in an office or an operating room, and whether it’s combined with other sinus surgery. Ask your surgeon to walk you through what recovery will look like for you and which complications are possible, and how they’re handled.
Questions to ask your doctor
- Do my symptoms and my CT scan show chronic or recurrent sinusitis?
- Which medical treatments should I try first, and for how long?
- Which of my sinuses would be treated, and would balloon dilation be done alone or with other sinus surgery?
- Will the procedure be done in the office or in an operating room, and what kind of anesthesia is used?
- What recovery should I expect, and when can I return to work and exercise?
- What are the possible complications, and how often do you see them?
- How many of these procedures have you done?
- What results can I realistically expect, and what happens if my symptoms come back?
Dr. Ragsdale is an ENT specialist in the Dallas-Fort Worth area. See Dr. Ragsdale’s Best Docs Network profile for more about the practice.
This article is for general information only and is not medical advice. Talk with a qualified health professional about your own situation. If you think you may have a medical emergency, call 911.
