Have you been having trouble every time you catch a cold? What starts off as a simple sniffle turns into a few weeks of discomfort or even debilitating sinusitis? Chronic sinusitis, or the incidence of having heavy blocks in your nasal passageways, affects more than 37 million people in the USA annually. With the rise in the incidence of allergies and pollution, urban India is also facing a huge rise in this condition.

So what exactly is sinusitis? We have four types of sinuses on each side of the face- hollow cavities around the cheek bones and eyes. These cavities are covered with a mucus layer and cells that contain a lining of cilia or tiny hair, which trap and push out the bacteria and pollutants that enter the cavities. Each sinus has an opening, which allows accumulated mucus to drain out. When this drainage is blocked, that’s when a mucus buildup starts to occur. Due to allergies etc. many people suffer from improper drainage, microbial infections etc. which causes accumulated mucus and/or inflammation of the membrane in their sinuses. These cases result in chronic sinusitis or as acute sinusitis.

Debilitating condition

Sinusistis, especially if it’s an acute case, can be a very debilitating condition. Pains and aches around all of the cavities, intense headaches, fatigue, congestion in the nasal passages and sinuses, loss of smell, heavy headedness – separately, one may be able to handle them, but when they come in together, these effects can be totally debilitating. Statistics say that chronic/ acute sinusitis is actually more debilitating than congestive heart failure or chronic back pain! US statistics say it results in 18-22 million doctor visits every year.

ENT specialists call this condition Rhinosinusistis, which could be classified as acute (when the episode lasts for less than 4 weeks) or as chronic (when the episode lasts for more than 12 weeks).

Surgical Consult

Statistics from the US show that there are 1.4 million surgical consults for chronic rhinosinusitis annually. Of these, 900,000 decline surgery – either because they are ineligible for the Functional Endoscopic Sinus Surgery (FESS) or because they do not feel comfortable about doing it.

In any sinus surgery, what the ENT surgeon focuses on will be to clear the blocked sinuses, and restore normal drainage and function to the sinuses. In conventional sinus surgery, or FESS, specialized instruments are placed into the nose along with a small endoscope to help the surgeon see inside the nose and nasal cavities. The surgeon will remove bone and tissue to enlarge the sinus opening. The other drawbacks of this procedure, which was noted over a period of two decades was that FESS also led to post-operative pain, scarring, and bleeding with possibility of complications like inadvertent entry into orbit, anterior cranial fossa etc. Also, if a patient has an atypical anatomy, this method is more difficult to use. And the patient often has to deal with the cumbersome side effects of having to use nasal packs to stop the bleeding and will have to encounter a delay in returning to his/her normal lifestyle.
This is where technology has brought in an even better solution – Balloon Sinuplasty.

Technology enhanced Surgery options Relieva Balloon Sinuplasty™ Technology

Balloon Sinuplasty has been in use for more than 7 years with over 6,800 surgeons trained in BSPTM and over 200,070 patients treated and 600,210 sinusotomies performed in the United States.

After being available and used by ENT specialists for seven years, clinical research proves that the Relieva Balloon Sinuplasty method of surgically addressing chronic rhinosinusitis is a proven, minimally invasive option for dilating blocked sinuses.

How does it work?

• A small, flexible, sinus balloon catheter is placed into the nose to reach the sinuses. The sinus balloon catheter is gradually inflated to gently restructure the previously blocked nasal passage, maintaining the integrity of the sinus lining and restoring normal sinus drainage and function.
• There is minimal bleeding, and many patients have been able to return to normal activities within 24 hours.

The Advantages:

• Safe and Effective – research shows that it’s much less riskier than other surgical methods in relieving sinusitis symptoms. Published data in leading ENT journals show that study participants experienced no adverse events and received significant relief from their symptoms at multi-year follow-up.
• Minimally Invasive - The technology uses small, soft, flexible devices that enter entirely through the nostrils. These devices gently open blocked sinus openings, and in many cases, without tissue or bone removal.
• Patient Friendly – It is less invasive, there is less trauma, less pain, less recovery time (just 24 hours for most patients), less scarring and less follow-up procedures.
• Reduced Bleeding – Most often there is no tissue or bone removed when thistechnology is employed, which means less bleeding.

• Does Not Limit Treatment Options - Since this technology is an endoscopic tool, it can safely be used in tandem with other medical therapies or sinus surgery techniques. It also does not limit future treatment options if a patient has progressive disease.

• Can be used by special case patients – like those who are prone to excessive bleeding or those in the ICU.

It is essential that sinusitis be treated as early as possible so that it does not develop into a chronic, and debilitating condition; and will also serve to protect against other complications from arising. Treating early also means that the patient will be able to get relief from simpler measures like medications or Balloon Sinulasty, and can avoid more radical and invasive measures.

Dr Anita Krishnan
MBBS,DLO(A.F.M.C), DNB (ENT),PGDMLE
Consultant ENT Surgeon and Endoscopic and Balloon Sinuplasty Surgeon
NOVA SPECIALTY SURGERY
KORAMANGALA
BANGALORE