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If you have a question about chronic sinusitis or Balloon Sinuplasty, please complete the information below and it will be submitted to Howard Levine, MD.

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Note: This section provides general information only and should not be construed as medical advice or diagnosis. It is meant as an additional resource for people interested in learning more about chronic sinusitis. The information presented in these pages are not intended to replace the care of your own physician. Before you make any decisions about treatment options, you should consult your physician or other qualified medical professionals.

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Recent Expert Answers

CAN BALLOON SINUPLASTY HELP ME?

Q: I’ve been using an OTC nasal spray for years and am experiencing the rebound effect from this. Does Balloon Sinuplasty help to lessen the rebound symptoms? I’m afraid of having sinus surgery because I've heard it can damage the nerves in your nose and contribute to a stuffed up nose and difficulty breathing.

A: Excessive use of over the counter decongestant sprays can lead to rebound causing more frequent use of the spray and in greater doses. Congestion in the nose is related to nasal structures called turbinates. Normally the turbinates swell and contract throughout the day. With the rebound effect, the decongestant spray initially shrinks the turbinates making breathing easier; however, after the spray wears off there is even more swelling of the turbinates, which can block breathing. The Acclarent Balloon Sinuplasty technology can open the sinus passages that drain into the nose. In a few instances, sinusitis can cause turbinate swelling. You need to see an otolaryngologist to see if you have a turbinate or sinus problem. If it is only a turbinate problem, Balloon Sinuplasty does not help the problem since it is designed for sinus and not nasal or turbinate problems.

Q: For several years I’ve had major sinus drainage into my throat causing a chronic cough. A CT sinus scan revealed a blocked sinus cavity related to the bone structure. How can a sinus cavity be blocked, while I still experience "Niagara Falls" mucous flowing into my throat? I have evidence of sinus infection but several courses of antibiotics have not helped. My doctor is suggesting Balloon Sinuplasty. Will this stop the flood?

A: The paranasal sinuses drain into the nasal cavity through small channels. These channels can become obstructed from many causes. Some of these include inflamed membranes, infected mucous membranes, or bone structure. Repeated sinus infections and/or allergies can contribute and worsen the obstruction. It is the body’s natural defense to create and secrete mucous in response to each of these. Generally, these symptoms are initially treated with combinations of antibiotics, decongestants, nasal saline spray and steroids by mouth or spray. If this medical management is unsuccessful and computed tomography (CT) demonstrates obstruction, surgery is frequently recommended. Balloon Sinuplasty has been shown to be a safe and effective minimally invasive method to expand and dilate the sinus outflow. You should discuss the options you may have with your physician.

Q: Is Balloon Sinuplasty recommended or approved in children? If yes, what age range? My 4 year old has had chronic sinusitis since her birth at 25 weeks gestation, despite aggressive antibiotic treatment, allergy injections, and nasal sprays.

A: Acclarent Balloon Sinuplasty technology has been successfully and safely used by doctors in pediatric patients. Peer reviewed studies detailing the successes have appeared in the medical literature. Balloon Sinuplasty permits opening of the sinus flow with minimal tissue trauma. Acclarent Balloon Sinuplasty is indicated for the dilation of pediatric maxillary sinuses. You should to discuss Balloon Sinuplasty with your child’s physicians (Pediatric Ear, Nose and Throat and Primary Care Physician) to obtain a full understanding of risks and benefits to determine whether this procedure is right for your child. Prematurity may result in other health conditions that need to be carefully weighed in assessing the suitability of Balloon Sinuplasty for your son or daughter.

BALLOON SINUPLASTY RECOVERY

Q: With Balloon Sinuplasty, is there a stent that keeps the sinus open once the balloon is deflated?

A: Balloon Sinuplasty opens the maxillary, frontal and sphenoid sinuses by creating microscopic fractures in the bony outflow of these sinuses. A stent is not used to maintain the opening.

Q: I had Balloon Sinuplasty 4 weeks ago, and I’m still experiencing maxillary sinus pressure. How long does it take before the pressure and pain go away?

A: I am sorry you are continuing to have facial pressure. It is difficult to say when the pressure will resolve. Healing and discomfort from nasal and sinus surgery can resolve immediately in some situations and in others take from 6-8 weeks depending on whether there were other nasal and/or sinus procedures performed, the cause of the sinus problem, and your past history. You should consult your surgeon to find out what the expected healing time will be.

MANAGING SINUSITIS

Q: I’m four weeks pregnant and have had a sinus infection for the past three months. Before I discovered I was expecting, my ENT doctor and I discussed Balloon Sinuplasty and scheduled the procedure. Now that I am pregnant, is it still safe for me to undergo Balloon Sinuplasty?

A: You will need to discuss with your physicians (otolaryngologist and obstetrician) the safety of elective sinus surgery. There may be reasons why it is wise to proceed with sinus surgery to prevent infections and minimize the need for medications. On the other hand, there may be reasons to treat each episode medically until after your delivery.

Q: I’m over 59 years old and have faced sinusitis problems all my life. I feel miserable from dizziness. I had a deviated septum and polyps removal surgery about 30 years ago, but now the CT shows the following: Scans show fluid in the left maxillary sinus. There are opacified left mid ethmoid air cells as well as scattered mucosal thickening of ethmoid air cells bilaterally. There is an opacifiied right posterior ethmoid air cell. There is a hypoplastic right sphenoid sinus with mucosal thickening. There are zones of mucosal thickening in the left sphenoid sinus. The frontal sinuses are clear. My doctor wants to perform bilateral turbinectomy and endoscopic sinus surgery. Do you think the CT results show the need for surgery?

A: It is difficult to know from the computed tomographic (CT) scan of your sinuses whether surgery is indicated. These CT changes may all be from a new and ongoing infection or changes and healing effects from your previous surgery of 30 years ago. It is important for physicians to consider the evidence from at least three sources in determining whether surgery is needed. In addition to the findings of the CT scan, physicians must consider the patient’s history of the problem and also the nasal endoscopic findings. Also, since dizziness is an unusual complaint with sinus problems, you should ask your physician how this relates to the sinus problems and the chances of it resolving with sinus surgery.

SINUS SYMPTOMS

Q: I had previous correction of a deviated septum several years ago. Within the last year, I can barely breathe again out of my left nostril and both of my eyes burn horribly, especially the left eye. I have been treating myself for dry eye with no luck. Could chronic sinusitis cause my breathing issues and my eyes to burn?

A: Sinus problems can manifest themselves with nasal obstruction and facial pain over the sinus areas like the forehead. There are other possible causes for your symptoms, some of which include a recurrence of the deviated septum, allergies, and headaches of non nasal and sinus causes. I would recommend you see an otolaryngologist who can obtain a complete history, perform a nasal examination that may include a nasal endoscopic examination, and obtain a computed tomographic (CT) scan of the sinuses. This type of evaluation will permit an accurate diagnosis and lead to the correct treatment.

Q. My eyes swelled up 2.5 years ago, and an eye specialist diagnosed it as Grave's Disease. However, my naturopath believes that I have upper respiratory issues instead. My vision has not declined, but I have big bags under my eyes, which an eye surgeon says is fluid accumulation, so cosmetic surgery is not an option -- only orbital decompression. I also have tremendous sinus pressure all throughout the sinus region. Could the bags be from sinus congestion/inflammation/blockage, rather than anything to do with my eyes?

A. Graves Disease of the thyroid can have associated swelling of the tissues around the eye causing eye protrusion alone or with swelling of the eyelids. This is typically managed by keeping the thyroid under control as best as possible. In addition if there is either cosmetic deformity or functional deformity resulting in visual change then surgery is considered such as orbital decompression and/or eyelid surgery. On occasion the sinuses can be congested and worsen the problem. However, managing a true sinus problem rarely corrects the eye swelling. Balloon Sinuplasty is intended for use by or under the direction of a physician. Balloon Sinuplasty Technology has associated risks, including tissue and mucosal trauma, infection, or possible optic injury. Consult your ENT physician for a full discussion of risks and benefits to determine whether this procedure is right for you.

Note: The opinions expressed are for general information only and should not be construed as medical advice or diagnosis. The opinions are meant as an additional resource for people interested in learning more about chronic sinusitis. The information, opinions and recommendations presented in these pages are not intended to replace the care of your own physician. Before you make any decisions about treatment options, you should consult your physician or other qualified medical professionals.

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