Posts for tag: Balloon Sinuplasty
What is Chronic Sinusitis?
It all starts with a congested nose due to a viral cold or allergy. Not much to do about the virus, it should resolve within 10 to 14 days. Chicken soup is a good idea for a cold. Antihistamines, decongestants, and nasal steroid sprays for allergy control don’t even seem to be enough. But, you just don’t seem to improve even after a couple of weeks.
Facial pressure and pain (particularly when you bend over to tie your shoes), fatigue, persistent discolored nasal mucous, cough, and even wheezing are signs that the congestion has progressed to something more: sinusitis. Now we call in the big guns – antibiotics and even oral steroids like prednisone. Most of the time that infection gets better. But, sometimes all the medicines you have taken can’t get you better.
You may end up in your friendly neighborhood ENT office. But not to worry, there is a way out. Your Otolaryngologist (medicalese for ENT) will likely take a look around, even to the point of putting a scope in your nose to see where the problem resides. And if you are both convinced that you have run out of rational medical options you have to begin to consider surgery. Yes, it comes to that sometimes.
Before you can have any type of procedure the precise nature and location of your infection needs to be found. CT scans are our best bet for this. It is an X-ray, which means radiation exposure. We know and take that into account. But don’t worry, a screening CT is fast, painless (no needles I promise), and has minimal X-rays involved. Without this critical piece of information, a sinus surgeon would just be operating blind – and you don’t want that I promise.
So, now know you know what is going on and you can make decisions based on information. Sinus surgery is surgery (duh) but it is usually VERY effective at relieving those unremitting, chronic sinus infections.
The prevalence of concha bullosa and nasal septal deviation and
their relationship to maxillary sinusitis by volumetric tomography.
Smith KD, Edwards PC, Saini TS, Norton NS - Int J Dent (2010)
Mark T. Brown, MD, FACS
Every now and then in medicine a new technique comes along that revolutionizes the field. Imagine a world without cardiac catheterization and repair of coronary disease. How about living in a time without penicillin? These are two of the myriad medical advances that have improved the lives of people worldwide since the 1940s. Balloon sinuplasty is NOT one of those advances despite the advertising.
Sinus surgery has evolved over the years to the remarkably effective procedure we have today. The introduction of endoscopes brought a level of safety not seen before. Operating in the nose where the sinuses drain to improve the natural function of the nose has resulted in great success for patients. As with any operation there are risks, and some of them are pretty scary. However, in experienced hands those risks are minimized and patient outcomes are excellent.
Enter the new technique. The balloon has evolved for use in the nose from the aforementioned cardiac catheterization. The idea is that we dilate the sinus opening (instead of physically removing tissue to enlarge it), drainage improves, and chronic infection resolves. Unfortunately, there is no data to show that this is a safer or more effective technique than standard approaches. Is it bad? Probably not. Is it safer? Probably not. Is it marketable? Very much so!
The marketing strategy has been direct to consumers – “ask your doctor about…” – and to primary care doctors – “send your patients for balloon sinuplasty.” To me that is, at best, medically meddlesome. At worst it may be unethical.
Balloon sinuplasty is not evil. It is a tool that, when applied correctly, has applicability to modern sinus care. It is not proven to be safer or more effective. Nor has it proven to be unsafe or less effective. It is what it is, a tool. Don’t be taken in by the advertising. Go to a doctor who focuses on patient care, not the marketing of a technique.
Oh by the way, there is one thing balloon sinuplasty excels at - increasing the price of a procedure.
Mark T. Brown, MD, FACS
Dr. Mark Brown is an Otolaryngologist (Ear, Nose and Throat) specialist at Great Hills ENT in Austin, TX. Dr. Brown is Board Certified in both Otolaryngology, Head and Neck Surgery as well as Sleep Medicine. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, dizziness/vertigo and sleep disorders.
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