Q&A with Stacey L. Silvers, M.D.

Dr. Stacey Silvers, an ear, nose and throat (ENT) specialist at Beth Israel Medical Hospital in New York, talks about chronic sinusitis, a painful condition that can significantly impact one’s quality of life, and the minimally invasive procedure called Balloon Sinuplasty that is bringing relief to more than 150,000 patients nationwide. She has been named among America's Top Physicians in 2007 and 2005 and among America's Top Surgeons in 2006, 2004 and 2003 in both Facial Plastic Surgery and Otolaryngology.

Q: What is chronic sinusitis and what symptoms do chronic sinusitis sufferers experience?

Dr. Silvers:

Chronic sinusitis is when the sinuses don't function properly. And the normal function of the sinuses is to produce mucus, to warm the air, to filter the air, and to moisten the air. If the linings of the sinuses get swollen or congested because the mucus that they naturally make doesn't get out and the air doesn't get in, patients suffer with persistent daily symptoms, which may include facial pressure, headache, congestion, postnasal drip, and chronic fatigue.

Q: What should patients do when they suffer with ongoing symptoms that won’t go away?

Dr. Silvers:

…For chronic sinusitis, initially patients will go on natural sinus washes, prescription nasal sprays, sometimes allergy medication when it's clinically indicated. When these simple, conservative medical managements fail, we then need to take the next step. And the next step is getting the doors of the sinuses open, so they function and they breathe normally. One amazing way to do that is something called Balloon Sinuplasty.

Q: How does the Balloon Sinuplasty procedure work?

Dr. Silvers:

A good comparison of what Balloon Sinuplasty accomplishes for the sinuses is angioplasty for the heart. Angioplasty for the heart just opens the blood vessels so there's better blood flow to the heart. Balloon Sinuplasty opens the sinuses so there's more air getting into the sinuses and the natural mucus that we make gets out of the sinuses. And, therefore, patients have less sinus pressure, less sinus headaches, less postnasal drip, better breathing, and less fatigue.

Q: How do physicians actually perform Balloon Sinuplasty?

Dr. Silvers:

Balloon Sinuplasty is a minimally invasive procedure, where we simply pass a balloon through the nose into the door of the sinus. We then inflate the balloon. This acts to widen the door of the sinus. The sinus will now function better, whereas air can get in and the mucus can get out, and patients' sinus symptoms are markedly improved.

Q: Can Balloon Sinuplasty be performed in an office setting?

Dr. Silvers:

One big advantage of Balloon Sinuplasty is it can be done awake, in the office, under local anesthesia. Many patients -- the one thing they fear about surgery is being put to sleep. So I think it's very comforting for patients to know that this is something that they can do in the office awake to fix the chronic problems that they've had for years.

Q: Does Balloon Sinuplasty alleviate symptoms for those who undergo this procedure?

Dr. Silvers:

The advantage of Balloon Sinuplasty is unlike a lot of prescription medications or over-the-counter medications, which have temporary fixes to chronic sinus symptoms, Balloon Sinuplasty, in many patients, can be a permanent fix to their chronic sinus problems.

Q: When compared with traditional sinus surgery which is more invasive, what does Balloon Sinuplasty mean for patients?

Dr. Silvers:

Traditional sinus surgery involves cutting at the doors of the sinuses. This can potentially lead to bleeding postoperatively, pain postoperatively, and oftentimes patients will take more time off of work. Cutting around the doors of the sinuses can also lead to scarring, and a year or a couple years after the procedure, patients can start developing sinus problems again. The advantage of Balloon Sinuplasty, which is a minimally invasive procedure, it can be done awake, under local anesthesia… and for a physician to be able to change and improve the quality of patients’ lives with such a minimally invasive simple procedure that we can do in the office is really remarkable.

As a primary care physician, I appreciate patients bringing new appropriate technology they’ve heard about to my attention. This adds to my treatment options, and hopefully helps me direct my patients to better outcomes. At the end of the day, I refer patients to specialists who can provide the best combination of knowledge and technical skill in their area of expertise. I am always excited to hear of specialists who are using innovative treatments and technologies that can provide my patients with better outcomes with less discomfort or down-time.

One of these cases recently came to my attention. I learned about a new technology, Balloon Sinuplasty, for people suffering from chronic sinusitis. Three key factors made the idea of referring on my chronics sinusitis patients to ENT doctors trained on Balloon Sinuplasty devices easy:

1. Sinus problems are a big issue in my practice

• 10% to 50% of the patients in my practice (depending on the season) have sinus issues

2. My medical therapy options don’t work for everyone

• As many as 25% of my sinus patients do not respond to medical therapy

3. Historically, I had a negative perception of sinus surgery and the unpleasant experience patients have had regarding recovery time and multiple visits for post-op care.

I am pleased that I can now inform my patients who are unresponsive to medical therapy about this new technology. I can offer them a novel treatment approach that has excellent supporting clinical data and can provide them with a much better patient experience. Knowing that my patients will get better with an innovative treatment that is both simpler and provides less discomfort is always an asset to the quality of my practice, the trust of my patients and the quality of their lives.