What is balloon sinuplasty?
Sinus balloons are devices similar to those used in angioplasty that are used to dilate the openings of sinuses. A guide wire is passed through the nostril and into the specific sinus that is being addressed. Once it has been confirmed that the guide wire is in the sinus, a balloon dilating catheter is passed over the wire to the narrowest portion of the sinus drainage pathway. The high pressure balloon is briefly inflated, and the pressure of the balloon micro fractures bone and moves it outwards, dilating the sinus drainage path without actually removing any tissue. The use of this minimally invasive technique may result in less postoperative pain, and a quicker recovery time. However, balloon sinus dilation cannot be used in all situations, and it cannot be used in all the sinuses.
What to do BEFORE surgery
Here are a few things you can do before surgery to help things go more smoothly:
- Purchase a Neil Med® Sinus Rinse Kit for saline rinses you will perform after surgery . These are available at grocery stores, pharmacies, big box stores, and Amazon.
- Eliminate ALL medications that thin your blood for two (2) weeks before surgery, unless directed otherwise by your surgeon. Please see this list-Medications to Avoid Prior to Surgery
- Stop smoking at least 3 weeks before your surgery date.
- No food 8 hours prior to surgery. No liquids for 4 hours prior to surgery.
- Arrange for a ride home after the procedure
This minimally invasive approach can be performed either in the operating room under general anesthesia, or in the office with the use of local anesthesia in an awake patient. With general anesthesia, you will be asleep for the entire surgery. Surgery typically lasts 1 hour. When your surgery is over, you may go home.
What to expect AFTER surgery
You can expect some nasal stuffiness and crusting for weeks after surgery. If balloon sinuplasty is performed alone with no other surgical interventions most patients are back to work or school the next day.
- Some oozing from the nose may be noted for the first several days after surgery. If bleeding is more than minimal use Afrin decongestant spray every 6-8 hours for 1-3 days.
- Use mild non-aspirin pain relievers (Tylenol) as treatment for pain.
- Drink plenty of fluids to prevent dry mouth. A bedside humidifier may be helpful.
- Beginning the day after surgery rinse your nose with saline rinses at least three times a day but may be performed more often.
- Avoid any strenuous activity, lifting more than 10 pounds, exercise, straining, or nose blowing for at least 10 days after surgery. Your surgeon will let you know when you are clear to resume these activities.
- Cough and sneeze with your mouth open.
- You may some thick discolored drainage from your nose for several weeks after the procedure. This occurs as the sinuses begin to clear themselves. This is normal and does not indicate an infection
CALL YOUR DOCTOR IF:
- You are bleeding excessively.
- You have decreased or double vision, swelling of the eyes, a stiff neck, or extreme fatigue.
What are the risks of Sinus Surgery?
As with any surgical procedure, FESS has associated risks. Although the chance of a complication occurring is small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.
Bleeding: The most common risk of sinus surgery is bleeding. Most sinus surgery involves little blood loss. If there is significant bleeding surgery may need to be stopped.
Scar tissue formation: Most patients heal well following surgery. However, some patients form scar tissue which can block the nasal passages or sinuses. Most scar bands can be removed through a simple office procedure, but some patient may require a repeat surgical procedure to remove scar.
Recurrence of disease: Most patients do well with surgery, however some patients can continue to have sinus problems following surgery. In some patients sinus surgery improves the frequency and severity of infections but they may require continued medical care. In some instances, additional “touch-up” surgery may be necessary to optimize your surgical outcome. This may be necessary in 5-10% of cases.
Spinal fluid leak: The sinuses are located near the brain. This means there is a rare chance of creating a leak of spinal fluid (the fluid surrounding the brain) or injuring the brain. Also called a cerebrospinal fluid (CSF) leak, the reported incidence of this is less than 1% of cases. Should the rare complication of a CSF leak occur, it may create a potential pathway for infection, which could result in meningitis. If a CSF leak were to occur, it might require surgical closure and extend your hospitalization.
Visual problems: There have been isolated reports of visual changes or loss after sinus surgery. The potential for recovery in such cases is not good. In addition, orbital (eye) injury resulting in double vision, blurring vision, or excessive tearing from the eye are additional potential complications. Fortunately, such a complication is rare. The reported incidence is less than 1% of cases.
Other risks: Other uncommon risks of surgery include alteration of sense of smell or taste; persistence and/or worsening of sinus symptoms and facial pain and swelling or bruising of the area around the eye.