Balloon offers relief to sinus pain
Debbie Jones-Megliola is enjoying life much more now that she is rid of the drumming pain that elevated the threshold of her headaches to a throbbing intensity.
"We tried every antibiotic out there, and it didn't help," said Jones-Megliola, 38, a mom and specialty medical assistant-scheduler at Sheridan Community Hospital in Montcalm County.
"When I was out with my daughter, the constant pressure didn't make it very fun."
The source of the Carson City resident's discomfort was chronic sinusitis, an infection or inflammation of the sinus cavities that results in a constant stuffed nose.
Over time, drainage is blocked, and problems mount, which may include facial pain, headaches, bad breath, upper jaw pain, sore throat, sensitive eyes, swelling of the eyelids and general fatigue.
A technique called balloon sinusplasty accomplished what a battery of antibiotics could not for Jones-Megliola.
Relief following the procedure was instant and recovery was swift, she said.
"I had no packing, no pain and no pain medicine. I resumed normal activity the next day," she said.
Approved by the Food and Drug Administration in 2005, balloon sinusplasty is a distant cousin to an angioplasty procedure that clears blocked arteries, according to Dr. Andrew Barak.
Barak is one of only five or so ear, nose and throat surgeons in the Grand Rapids area trained to use the catheter system developed by Menlo Park, Calif.-based Acclarent Inc.
The procedure, covered by most insurance companies, is considered a middle ground between medication and traditional surgery, Barak said. It requires no incisions or cutting and leaves no bruising or swelling.
Done as outpatient surgery that requires general anesthesia, the procedure starts by threading a guide-wire catheter into the nostrils and up into the blockage.
The catheter is equipped with a tiny balloon, which is inflated to about a quarter of an inch in diameter once inside the passage.
The balloon fractures the bones and spreads them apart, allowing the sinuses to be drained, Barak said. Once the passageway is open, the balloon is deflated and withdrawn.
"The other real bonus of this procedure is that, typically, I do not need nasal or sinus packing after this operation and patients can resume normal activities next day," Barak said.
"The goals of this procedure are less bleeding and (less) scar tissue caused by exacerbations."
Sinusitis affects about 37 million Americans each year, according to the American Academy of Otolaryngology, making it one of the most common infections.
The nasal malady sends 18 million to 22 million people to doctors' offices annually and catapults annual health care expenditures into the $8 billion range.
Not every patient qualifies for balloon sinusplasty, Barak said. Those who have polyps, deviated septum or ethmoid sinus disease are not candidates for the procedure. The catheter cannot fit every sinus cavity, either, Barak said.
"Basically, you're going to offer this option to patients who fall into certain criteria.
"Those who've had a history of recurring sinus infections may qualify, but cannot have a history of overwhelming sinus polyps or extensive sinus surgery, such as tumors, and cystic fibrosis patients, or a condition when the sinus bone becomes very hardened by prior infections or trauma, or facial injuries such as from car (accident) injuries."
Early results show promise, said Dr. Howard Levine, an ear nose and throat surgeon and director of the Cleveland Nasal Sinus and Sleep Center. A six-month study of 115 patients showed 98 percent of patients' nasal passages remained open.
The technology underwent years of research and development to ensure patients' safety, Levine said.
The sinuses are close to the brain and to the eyes and major blood vessels that go to the heart and the brain," he said.
"The technology uses a structural guide wire that's delicate and flexible. It can't pierce an egg yolk, it's such a flexible wire."
It's too early to determine whether the procedure will need to be repeated for some patients, said Dr. Sheila M. Ray, ear, nose and throat surgeon in Southgate and president of the Michigan Otolaryngology Society.
"It's always possible the scar tissue could reinfect or reclose, but (the procedure) seems to be having very good results having those openings stay open," Ray said.
