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Sinus infections that last for weeks and keep coming back…a stuffy nose that interferes with sleeping…and sinus headaches that make you feel like hiding under the covers…these are the symptoms that bring people into a specialist’s office for help. An ear, nose, and throat doctor (ENT) is an expert on sinus problems and coming up with solutions to help patients feel better.
One of the most effective solutions available today is a balloon sinuplasty procedure. Read more about this revolutionary procedure that can be done right in your doctor’s office and can resolve stuffiness and recurrent sinusitis within the first week after surgery.
Balloon sinuplasty is a minimally invasive endoscopic procedure that effectively opens the sinus cavity using balloons. This procedure relieves nasal congestion, recurrent infections, and sinus discomfort. Persistent sinus problems can be caused by a number of issues, but the most common reasons include allergies and a deviated septum.
The FDA first approved balloon sinuplasty in 2005 after medical trials showed that it was an effective alternative to traditional endoscopic sinus surgery. Although it took some time for insurance providers to cover the cost of this procedure, today balloon sinus surgery is usually covered by most insurance plans. The idea to use balloons first started in cardiac (heart) procedures to open up blood vessels and increase circulation. When used inside of the nasal cavities, balloons open up the area — reducing swelling and draining excess mucus. Once the sinuses are cleared out, the nasal passageway is open, allowing air to easily pass in and out of the nostrils.
The surgeon will make sure that you are comfortably sedated during your procedure. A local anesthetic will be used to numb the entire nasal passageway and sinuses so that you’ll be very comfortable upon waking up from surgery. Once you’re asleep, the doctor will pass an endoscope through the nostrils to gain access to your sinus cavities. An endoscope looks like a thin cord, and it has a camera on the end of it so that your doctor can see inside of your nose. The feed from the camera is displayed on a TV monitor inside of the procedure room so that your surgeon can see what he or she is doing. After the doctor is in the right place, a balloon is inflated inside of the sinus cavity. All of the edges of the balloon press against the walls of the sinuses to drain away fluid and mucus that have accumulated, and to widen the cavity to allow for easier breathing. Without treatment, people with severe sinus congestion can experience trouble sleeping, dry mouth (from breathing through the mouth), sinus headaches, jaw discomfort, and bad breath (from constant sinus infections and postnasal drip).
The nose is divided into left and right sides by a thin piece of tissue called the nasal septum. This structure provides stability to the inner nose, allowing for air to easily pass through the nostrils and for mucus to properly drain out.
A deviated septum occurs when an injury to the septum causes it to split, tear, or puncture. This can happen from a sports injury, broken nose, facial trauma, or extended use of cocaine. When trauma is the reason for a deviated septum, the nose may appear crooked. Although some people choose to repair a deviated septum for cosmetic reasons alone, most people seek surgery to restore proper function to the nose.
When the septum is deviated, chronic and recurrent sinus infections are an every day struggle. With the sinuses constantly “stopped up,” they become a breeding ground for bacterial and viral infections that don’t go away (even with antibiotics and decongestant use).
Further aggravating the situation is the fact that a deviated septum makes it almost impossible to fully empty the sinuses simply by blowing the nose. For people with this condition, constant stuffiness and sinus infections are a huge aggravation.
Nighttime can also be particularly difficult because a deviated septum can cause a stuffy nose that gets even worse when laying down to sleep. To get enough air, the person often has to breathe through their mouth, causing dry mouth, snoring, and other sleep disturbances.
For most people with a deviated septum, sinus surgery is often the only way to get relief. An ENT doctor is specially trained to not only repair a deviated septum, but to also perform sinus-clearing procedures like the balloon sinuplasty. These can usually be done at the same time so that patients don’t need to have 2 separate surgeries.
Because this procedure has been so successful in relieving sinus infections, most insurance plans cover the cost. However, not all plans have gotten on board. Check with your health insurance company to see if you’re covered. Often times, the doctor’s office can check for you when you come in for your consultation.
The amount you owe for surgery will entirely depend on your individual coverage and benefits, along with the overall cost that your doctor charges for the procedure. Try to find an ear, nose, & throat doctor (otolaryngologist) who can perform this procedure in their office; this will greatly reduce the cost versus having it done at the hospital.
If your insurance covers some or all of your procedure, your out of pocket costs will be based on your HMO or PPO benefits, which may include co-pays for surgery and the individual/family deductible amount stated on your plan. Generally, surgery costs about $7000 with medical insurance or about $20,000 without insurance.
If you anticipate having trouble paying for your portion of the procedure, a medical credit card might be an option to consider (such as CareCredit). Most doctor offices usually accept CareCredit and other similar financing. Medical credit cards often have an interest-free period of 6, 12, or 18 months, which can save you money in the long run.
During the recovery period, you will have some soreness, nasal stuffiness, and blood-tinged mucus for about one week after surgery. Thankfully, this procedure is minimally invasive and does not require a long recovery period. Most people are able to return to work and light duty (such as household chores) several days post-op.
After surgery, you can expect to breathe more clearly, have less nasal stuffiness, and fewer sinus infections. For people with seasonal allergies, balloon sinuplasty can provide daily relief from nasal congestion and a runny nose. Your ENT doctor may recommend that you take a daily antihistamine for allergy relief and to minimize nasal discharge.
Some people recover in about a day while others need a full weekend. Your recovery time will depend on the severity of your sinus issues and your individual response to surgery. Your doctor will discourage you from blowing your nose for a couple of days, so be prepared to be “stuffed up” until you’re allowed to blow your nose.
It’s a good idea to sleep or lie down with your head elevated because it will help your nose drain properly and avoid mucus backup. After a few days, you’ll be able to lie down flat to sleep.
Generally, your doctor will let you know if applying an ice pack is appropriate, but it is usually unnecessary. For discomfort, you can take an over the counter pain reliever. After a day or two, you’ll likely find that you don’t need to take them anymore.
Congestion after balloon sinuplasty is a normal side effect and does not mean that the surgery didn’t work. Because an endoscope and balloons were used inside of the nasal cavity, it is normal for the body to respond to this minor trauma by becoming inflamed and swollen. This swelling is what causes a post-operative stuffy nose for up to one week afterwards.
Once your doctor clears you to blow your nose, you’ll likely see a bit of old blood in your nasal discharge. This is normal and expected. Once you clear your nose out, you’ll be pleasantly surprised at how clear your nose is. For many folks, it may be the first time in months that they are able to get a normal amount of air in and out of their nose!
Patients will notice nasal tenderness in the nostrils and sinus cavities for a few days after surgery. Although the endoscope is small, soreness is a normal side effect of having an endoscope inside of the nose.
The sinus cavities will also feel sore because balloons were used to press on and expand the sinuses. You may feel tenderness in the cheeks, forehead, or nose, as these are the locations of the sinus cavities that your doctor may have treated.
Soreness can easily be managed using anti-inflammatory medicines that you probably already have around the house. These can include ibuprofen, acetaminophen, and naproxen sodium. Talk to your doctor about which medication is best for you and the appropriate dosages.
As mentioned earlier, one of the side effects of this procedure is nasal congestion. It may seem ironic that a procedure meant to clear up nasal congestion would actually cause it. However, this is a normal response to surgery and is only a temporary issue. Once healing is complete, nasal stuffiness will improve and the sinuses will be free and clear.
Depending on the type of sedation your doctor uses, you may feel groggy after surgery until the medication clears out of your system. You’ll need to have a responsible adult with you on the day of surgery to drive you home and to care for you afterwards. It’s important to have someone to help you out because you’ll need a few days to feel like yourself again.
After any surgery, low energy is a common side effect and balloon sinuplasty is no exception. You’ll likely feel tired and fatigued as your body puts more energy into recovering and healing. Take it easy and rest. Make sure to keep your schedule clear so that you can sleep when you want to and not exert too much energy during this time.
Another side effect from surgery is bloody discharge from the nose. For a few days you won’t be able to blow your nose, but you may notice a little bit of bloodstained mucus draining from the nostrils. This is normal and shouldn’t be cause for alarm. Your doctor will let you know how much bleeding is normal; if you exceed that amount you will know when it’s time to call the doctor.
No procedure is without some risk of complications. Balloon sinuplasty is known for having fewer complications than traditional sinuplasty. Your doctor will advise you on the proper use of nasal lavage and washing, which is an essential part of the recovery and healing process.
If you have a sinus infection at the time of your procedure, your doctor will probably prescribe an antibiotic after surgery to help you get rid of the infection. Medications like this must be taken on time and for the prescribed length of time. Sinus infections can be a side effect of the surgery itself if patients do not follow all post-op instructions properly.
Very rarely, balloon sinuplasty can cause damage to the internal sinus compartments that separate the sinus cavities from the brain. To correct this complication, additional surgery may be required. Another rare complication that can occur is loss of the ability to smell. On occasion, some people also notice a difference in the appearance of their nose after surgery.
All of these potential side effects are important to discuss with your doctor so that you can make an informed decision.
According to Medical News Today, the following studies showed positive feedback and results from balloon sinuplasty surgery:
Alen N. Cohen, M.D., is the Founder and Director of the Southern California Sinus Institute. Dr. Cohen has over 15 years of experience as a Board Certified Nose & Sinus Surgeon and Head & Neck Surgeon. Throughout his career, he has done over 4,000 nose and sinus procedures and 2,000 balloon sinuplasty surgeries.
Castle Connolly, Super Doctor, and Los Angeles Magazine have awarded Dr. Cohen the prestigious title of “Best Sinus Surgeon in Los Angeles.” He is known for performing superior procedures and offering outstanding safety and results.