Health

What's New in Health Care: Breathing Easy

by Walter Pierce

New in-office solution gives chronic sinus sufferers an intermediate (and 98 percent effective) option to full-blown surgery.

New in-office solution gives chronic sinus sufferers an intermediate (and 98 percent effective) option to full-blown surgery. By Amanda Bedgood

Tuesday, July 1, 2014

More than 28 million adults face chronic sinusitis every year, according to the CDC, and a new balloon may mean the difference between breathing easy and months of misery.

From pain and congestion to the telltale vibrant nasal discharge, a sinus infection is a well-known malady for many adults and one that, until recent years, meant either sinus surgery or simple medication. Enter the new Balloon Sinuplasty procedure, also called balloon sinus dilation.

"It's a lot less pain because you're moving tissue - not removing tissue," says otolaryngologist (commonly called an ENT) Dr. John Alldredge, who specializes in sinus problems.

Photo by Robin May

Dr. Jason Durel says baloon sinus dilation is an intermediate between
traditional sinus surgery and medical treatment.

The balloon creates a better passageway for drainage and offers a solution for many patients with chronic sinus problems who may not respond to medication but don't necessarily need the more invasive traditional sinus surgery. The traditional route is still necessary for some patients, and Alldredge is quick to say the balloon will not replace the traditional surgery but provide just another tool in the box of sinus treatment. However, in the cases in which a balloon is used, a new study published in the American Journal of Rhinology and Allergy reports that the procedure was 98 percent effective and reduced sinus infections by more than three-quarters.

Dr. Jason Durel, an otolaryngologist and facial plastic surgeon who practices at Lafayette General Medical Center and Our Lady of Lourdes, also stresses that the method's use is determined patient by patient and begins with an evaluation that includes a CT scan. Candidates for the procedure are treated in the office with very little down time. In fact, most people are back to work in a day or two.

"What I think is the beauty of this - it gives us an intermediate procedure between traditional sinus surgery and medical treatment," Durel says. "Why kill a fly with a sledge hammer if a fly swat will work?"

Traditional sinus surgery means the operating room, general anesthesia and about two weeks of recovery time because the procedure removes bits of bone and some tissue. Some patients will most certainly still require the traditional surgery, but the balloon offers that intermediate patient the chance to try a less invasive option. And, if it doesn't work, they can still have traditional surgery later.

"With the balloon you are using a balloon catheter to access the natural drainage pathways and dilating these narrow passageways and it restores function and promotes better natural drainage of sinuses and you avoid recurrent infections," says Alldredge, who primarily practices at LGMC, Lourdes and Lafayette Surgical Specialty Hospital.

For patients with fungal issues and polyps, the balloon is not an option. Alldredge says there are typically two patients they evaluate for the balloon procedure.

"Patients with chronic symptoms - headaches, facial pain and facial pressure and colored nasal drainage and decreased sense of smell and malaise," Alldredge says.

The first patient is one that experiences these symptoms for three months or greater and the second is a patient who has recurrent sinus infections that may improve with medication but return again and again - typically four or more in a year.

"I think it's very effective - as with anything else it's all about patient selection, to understand who the right patient is to do the balloon versus traditional sinus surgery comes down to patient symptoms and their CAT scan," Durel says.

For a video of the balloon method head to theind.com.

An Ounce of Prevention

Dr. John Alldredge says there are a few lifestyle changes that can aid patients facing sinus problems.

WASH IT UP

Most sinus infections start with viruses that lead to bacterial infections. General hygiene like hand washing can help prevent infection.

WASH IT OUT

Nasal irrigation can help prevent infections if done when patients have a cold or other signs pre-infection. Try a neti pot or saline-type irrigation to flush mucus before it causes infection. Alldredge says a squeeze bottle with high volume and low pressure is best and reminds patients to use distilled water (always) with some kind of saline solution.