Millions of people suffer from chronic rhinosinusitis. For those who have failed medical management with antihistamines and other over-the-counter or prescription medications, surgical treatment may be necessary to improve the natural drainage of the sinuses. The technical aspects of surgery have advanced her medically over the last several years.
Sinus surgery started out many years ago as a surgery which needed several days of recovery and often required packing to be placed into the nose. Today, the latest technology allows for sinus surgery to be performed on an awake patient in an office setting without the need for packing. The technology is called a balloon sinuplasty and has shown to be effective at long-term followup.
For patients who suffer from chronic rhinosinusitis, the first step to determining if surgery is necessary is to obtain imaging of the sinuses with a CT scan. If there is an anatomic obstruction to the natural flow of the sinuses, surgery may be needed to open the sinus drainage pathways. In some patients, the nasal anatomy needs to be improved.
For patients with favorable anatomy, the balloon sinuplasty technique can be used. The technique uses balloons similar to those used in heart surgery which are placed through the nose into the natural openings of the sinuses. The balloon is then inflated and the opening is widened. This can be used to open the maxillary, frontal, and sphenoid sinuses. The ethmoid sinuses must be dealt with in other ways.
For patients with nasal polyps or who require the middle part of the inside of the nose call the nasal septum to be straightened, balloon sinuplasty can still be undertaken but is often performed with more than local anesthesia. For patients with more favorable anatomy, anesthesia can be provided in an office setting while the patient is awake inside of the nose and the balloon sinuplasty technique can be undertaken. This allows the patient to minimize the risk from general anesthesia and allows the patient to drive to and from the procedure as long as no other medications are given.
To determine if you are an appropriate candidate for awake sinus surgery, consultation with an ear, nose, and throat doctor who performs the procedure is necessary. The same technique can be performed using general anesthesia or with other procedures that may be necessary to completely address chronic rhinosinusitis in certain patients. As with all surgeries, there are risks inherent to this surgery and specific to each patient.