A general overview of Balloon Sinuplasty concepts
Over the last several decades, there have been many changes in technology that have improved our lives. In the mid 1980s, small telescopes called endoscopes allowed surgeons to visualize the inside of the nasal and sinus passages and revolutionized nasal and sinus surgery. These advances continue as technology allows ENT doctors to do more, to be more accurate, to be less traumatic, and to be more precise. Once such advancement was the development of the balloon dilating catheter and its adaptation to sinus surgery.
In the 1980s, the field of cardiology drastically changed with the use of angioplasty. This well-known procedure uses a balloon dilating catheter to open up diseased and blocked blood vessels around the heart. This was the first surgery of its kind that could treat this type of heart disease in a minimally invasive fashion. Millions of patients have benefited from this technology and had had their heart disease managed without “open heart surgery.”
This technology has been adapted into the field of Rhinology & Sinus Surgery. Long before the balloon was used in the nose and sinuses, the concept of “functional endoscopic sinus surgery” (commonly known as FESS) was introduced. It is based upon the principle that surgeons can restore the natural drainage pathway of the sinuses by relieving obstruction or blockages that contribute to the disease process. This is commonly done in a conservative fashion in order to preserve the function of the sinuses without damaging natural structures that surround them. In general, standard instrumentation is used to remove tissue including bone and its surrounding mucous membrane (the lining of the nose and sinuses) from the area of the natural openings of the sinuses. Doing this helps to treat disease and to restore the sinuses’ normal drainage pathways.
In 2005, the first commercially available product using balloon dilating catheter technology was released to treat sinus disease. Overall, the concept is simple. A guidewire is passed from the nasal cavity into the specific sinus that is being addressed. Once it has been confirmed that the guidewire is in the sinus, a balloon dilating catheter is passed over this wire to the narrowest part of the sinus drainage pathway. This high pressure balloon is briefly inflated, and the pressure of the balloon widens the outflow tract of the sinus by fracturing bone and moving it outwards, along with its mucous membrane. The final result is a dilated or widened outflow tract from the sinus that can be done without actual tissue removal. These devices are FDA approved and have been used on tens of thousands of patients . Each sinus patient should be individually examined before a determination if this is a suitable means of treatment for his/her needs. This usually involves Nasal Endoscopy and/or Sinus CT scan to carefully delineate the nasal and sinus anatomy in fine detail with high resolution imaging & can usually be performed in the office