Tiny balloon offers huge relief for chronic sinusitis

By Dr. Frederic Pugliano

Greater St. Louis can be a difficult place to live for people with chronic sinusitis — our allergy seasons tend to be lengthy and flu season can be intense, so the pain and pressure of repeated sinus infections can extend throughout the year.

Many of the 29 million Americans who suffer from chronic sinusitis spend years cycling through antibiotics, nasal steroids and decongestants. And if the drugs fail, the usual next option is a painful, bone-cutting endoscopic surgery that requires a general anesthetic and a weeklong recovery.

New medical technology, however, has provided a better choice for many patients than the operating room. Balloon sinus dilation is a minimally invasive office procedure that can painlessly and durably relieve the miserable symptoms of sinusitis in less than an hour. It’s based on the same principle as angioplasty for the heart — widening a blocked or narrowed opening by inflating a balloon.

The procedure is done under local anesthesia and a mild sedative. The physician carefully guides the device into the patient’s blocked sinus passageway aided by a light fiber that illuminates the device tip and a tiny camera that sends a live picture to a monitor.

The balloon is then inflated, and it expands the opening by gently, painlessly fracturing the tiny eggshell bones of the sinus. The patient may hear a faint crackling noise, but it’s not uncomfortable. The actual inflation takes only a couple of minutes, and when the device is removed, those bones stay and heal in that position, permanently improving sinus drainage and air flow. Many patients feel the difference before they even stand up, and recovery requires only a day or two.

Balloon sinus dilation isn’t for every sinusitis patient, but for many people it’s a procedure that can provide permanent relief from the cycle of infection/drugs/recurrence. A study published last year in the American Journal of Rhinology and Allergy found balloon dilation to be 98.1 percent successful in opening impacted sinuses, and it reduced subsequent sinus infections in those patients by more than 75 percent.

Most health insurers cover the procedure, because it’s not only effective but a lot less expensive than traditional sinus surgery in the OR — office-based balloon sinus dilation can save the health care system up to 45 percent.

Chronic sinusitis can have a seriously negative impact on your quality of life — it causes more than 60 million lost workdays in the United States every year — but many people simply put up with the pain because the prospect of surgery is so scary. A procedure performed with a balloon is a lot less frightening — and it can be a real breath of fresh air.