Balloon Sinuplasty

Dr Rajeev Nerurkar

A MicroInvasive Technique for Chronic Sinusitis

Since January 2009 at Bombay Hospital we are offering a less invasive procedure for patients with chronic sinusitis.

Using a balloon sinus device, we are treating patients with chronic sinus infections using a more minimal approach than traditional surgery and even Endoscopic Sinus Surgery. The device is a disposable catheter attached to a rod that is inserted into certain sinuses through the nasal cavity, where it then is inflated to expand and remodel the sinus opening.

The new procedure is less invasive because it does not involve cutting through bone and tissue to get to the blocked sinuses.

The goal of any sinus surgery is to expand to drainage pathways in the sinuses.Traditionally bone and tissue are removed to achieve this goal.This is performed with the use of a powered instrument called the Microdebrider.

I have used the device on many patients with chronic sinusitis & Polyps.

The balloon sinus device costs from Rs 15000/ to Rs 70,000/- per procedure, but the additional cost may be offset by the reduction of operating time, hospital stay & recovery period.The patients who undergo this procedure may be able to attend work as early as the next day.

With traditional surgery, recovery time is about a week. It is usually a week before a patient is ready to resume his or her normal routine, and it takes several weeks for the inside of the nose to completely heal because of broken bone and tissue during surgery.

The new technique allows for faster patient recovery because it involves less disruption to surrounding tissues.

The technology was first introduced to the market in September 2005 through Acclarent, in the US.

Josh Makower, inventor of the balloon sinuplasty technology and a former chronic sinusitis sufferer, said the device makes it easier to access certain sinuses, Frontal,Maxillary and Sphenoid in the cheek and below the skull. With traditional surgery whether endoscopic or otherwise, accessing frontal sinuses can be dangerous because of complicated anatomy and the close relationship of the frontal sinus to the brain.

The balloon sinuplasty technology can be guided through passageways in sinuses without having to remove bone and tissue. Bleeding associated with traditional surgery for chronic sinusitis, before during and after the procedure, is negligible.

Chronic sinusitis is an inflammation of the sinuses, which are located behind the eyes, forehead and cheeks.

It can persist for 12 or more weeks. Common symptoms that occur are purulent nasal drainage, loss of smell, fatigue, pressure in the ears, nasal congestion, facial pain and pressure, and headaches. It is a common condition that affects lakhs of people in India & abroad.

It makes patients feel tired constantly and experience unrelenting pressure in the head for long periods, leading to terrible headaches. In pressure change situations such as Flying, Diving, Underwater swimming & High altitudes , a terrible ache is experienced in the head & ears. This happens due swollen & tight passageways to the sinuses which cannot equalize the pressure well enough.

While there are advantages to the new device, it may have drawbacks. Chang said some sinus experts wonder how long sinuses will remain open after the procedure. And the device may not work to remove polyps caused by chronic inflammation. Even in extensive nasal polyposis when traditional surgery is needed to remove polyps, Balloon sinuplasty device can be used along with endoscopic surgery methods and make it safer.

A study by Christopher Melroy, a surgeon in Savannah, Ga., found that the complication rate for the device was .0035 percent for the 28,500 people treated.

The device has caused no major complications or deaths in our experience and has provided an alternative, safer treatment for people with chronic sinusitis. It can provide care to patients that don't want traditional surgery.

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