Surgeons use balloons to dilate sinuses

As kids, we learn balloons are fun. Balloons are colorful, festive and celebratory.

But it turns out they're also cutting edge, at least when it comes to sinus surgery.

"We can insert a small, flexible wire, pass the balloon over the wire, and then inflate the balloon to dilate the opening," said Dr. Tracy Jakob, a Memorial Hermann Katy ear/nose/throat physician. "There are no raw edges, no tissue removal, and we can irrigate the sinus."

Basically, sinuses are air pockets that connect to nasal passages via small tubes.

The balloon procedure dilates those tubes, meaning better drainage and fewer infections.

The balloon is slowly inflated while the surgeon monitors how much pressure is required to effectively dilate a patient's sinus.

When the correct pressure is achieved, the balloon is deflated, and the sinus is washed out.

"When you blow up the balloon, there are a lot of micro-fractures occurring in the bone, which is very thin like an eggshell, without disrupting the tissue lining the bone," Jakob said. "Since you're not disrupting the tissue, there's no raw edge left to bleed."

There are no problems with the balloon crushing the bone because the doctors use a sinus endoscope. The endoscope lets them see, on a monitor, the inside of the sinus. They pass the balloon through and inflate a little at a time. They can see when to stop.

Depending on how many sinuses are being dilated, the procedure takes 15 to 45 minutes, while the patient is under general anesthesia.

That being said, only certain sinuses can be dilated with the balloon.

It's not effective for patients with polyps, growths or tumors blocking the sinuses.

The first step

That's why the first step for patients is to undergo a CT scan.

Or, in the case of 15-year-old Katy resident Holly Harrison, dental X-rays.

While at the orthodontist to be fitted for braces, Holly's X-rays revealed lower sinuses that looked completely solid, said her mother Cherie.

"I was surprised, but I guess it made sense because I always had pain in my ears when I ran," Holly said.

Jakob performed Holly's surgery in February.

"When I woke up, I was just really happy," Holly said. "I could smell a box of chocolates nearby. I was amazed."

Not to mention….

"Apparently I don't snore anymore," Holly said.

Her only regret was not doing it sooner, although ENT doctors are a little more conservative when it comes to pediatric patients.

"It's certainly not something we start with," Jakob said. "We use it when medical therapy has failed. For children with chronic stuffy noses, we first try allergy medications, antibiotics, nasal saline irrigation or prescription nasal sprays. When we find children need to be on that type of therapy on a regular basis, we worry about resistant organisms from the frequent use of antibiotics. An besides that, we really want to give them relief."

A general rule of thumb, Jakob said, is that surgical intervention should only be considered for youths who suffer stuffy noses for three straight months.

But it is not yet recommended for children under the age of 3.

Option for adults

While Jakob has operated on several pediatric patients, balloon sinuplasty is an attractive option for adults who have grown up hearing the horrors of traditional "roto-rooter" surgery, the one associated with a miserable and lengthy recovery.

"It does not need to be like that," said Dr. Tara Morrison, also an ENT at Memorial Hermann Katy. "So many people have heard that and refuse to be treated. But now we have this new technology that is such a great option. It is so user-friendly. There's no cutting into anything."

Morrison's patient Dana Moody can attest to that.

Moody, a 41-year-old Katy resident, underwent balloon sinuplasty Dec. 13, 2010.

Moody is an airline attendant.

If you've ever been on an airplane with a stuffed-up nose, you can imagine what her daily life was like.

"Usually if you have sinus pressure, it's on the descent, not at altitude," Moody said. "So, I knew something was wrong. It got bad enough that I finally had to go to an ENT."

At 30,000-feet, Moody had pain in her jaw and her eyes. She also had frequent sinus infections, but the pain at high altitude made her think there was more going on.

A CT scan showed that a sinus cavity on one side of her face had never fully developed.

The opening was not wide enough to allow for proper drainage. This led to frequent sinus infections, because sinus fluid that does not properly drain becomes stagnant and was the reason behind her pain.

Moody was warned by well-meaning family and friends about the traditional surgery, and Moody even went online and discovered that many years ago, surgeons got to the sinuses by cutting through the cheekbone.

"I told everyone my procedure was going to be non-invasive," Moody said.

She said she had little pain after surgery.

" And I could smell things. I didn't even know I had a problem smelling until then," she said.

For more information visit www.memorialhermann.org. Both Jakob and Morrison have been using the procedure for a couple of years.

For videos, pictures and graphics about balloon sinuplasty, visit www.balloonsinuplasty.com.