Sinus Surgery Q&A
Looking for information about chronic sinusitis, Balloon Sinuplasty, or Acclarent products?
Below you will find Dr. Howard Levine’s responses to the top questions sinus patients submitted through our website.
Please be aware that the “Sinus Surgery Q&A” feature focuses on general questions & answers about Balloon Sinuplasty, chronic sinusitis, and/or Acclarent products. Acclarent does not advise, evaluate, or respond to an individual’s specific health history. "Sinus Surgery Q&A" is not a substitute for the advice and care your own doctor, who knows your medical problems, can provide. Product complaints or concerns about a past procedure should be directed to Customer Service.
Sinus Surgery Q&A
CAN BALLOON SINUPLASTY HELP ME?
Q. I have had two surgeries on my sinuses and still suffer with pain and pressure in my sinuses. There are no days when I don't have pain at some level. It really interferes with my daily life. Since I have had two surgeries, would Balloon Sinuplasty do me any good?
A. Whether Balloon Sinuplasty can help with your sinus symptoms and facial pain depends on the diagnosis and the type of sinus problem you have. See a physician skilled in Balloon Sinuplasty to determine if you are a candidate.
Q. I have constant congestion in one side of my nose, which is worse when I lie down. I have been using a CPAP to breathe at night. It also helps to use nasal spray. Is it possible that if my nose "opened" up, I could breathe better and do away with my CPAP at night?
A. Balloon Sinuplasty is an excellent and safe technology to help with the symptoms of chronic sinusitis. Some nasal breathing problems can be worsened by sinusitis and improved when the sinusitis is treated. However, many problems of nasal obstruction are not caused by the sinuses but rather are caused by nasal problems like a deviated nasal septum and enlarged nasal turbinates. See an ear, nose and throat physician to determine the cause and the best treatment.
Q. My doctor has determined I most likely have "non-allergic rhinitis". Is there a chance Balloon Sinuplasty would help me?
A. Sinus surgery, and specifically Balloon Sinuplasty, is effective for sinusitis symptoms. Some allergic and non-allergic nasal problems are worsened by sinusitis and more easily managed when the sinuses are healthy. You should see an ENT physician with expertise in Balloon Sinuplasty for an opinion as to whether your problems will be helped.
Q. Can this procedure help with allergy shines?
A. So called “allergy shiners” are discoloration of the eyelids associated with allergies. I am not aware of any medically accepted clinically effective treatment for this. Balloon Sinuplasty is an effective method of managing sinusitis symptoms and not allergies.
Q. I have bags under eyes. Could this be from sinuses? I do have sinus problems (pain behind eyes periodically, mucous draining down throat causing coughing, drainage after eating something spicy). I’m trying to determine if I need some type of sinus related procedure.
Sinus disease does not typically have eyelid swelling (“bags under the eyes”) as a major or minor symptom. You should visit a surgeon knowledgeable about Balloon Sinuplasty to undergo a complete evaluation and determine whether you have sinusitis and whether you are a candidate for Balloon Sinuplasty.
Q. I have been having nasal congestion, reduced smell and taste, post nasal drip, and sinus pressure. ENT specialist said it is due to allergies and has had me on steroid nasal drops, cetrizine and prednisone for 20 days. He mentioned last time if symptoms don't improve then he would look to carry out Balloon Sinuplasty. Would this benefit me?
A. Your symptoms could be from many causes among which are allergies or a sinus problem. When medical management fails, it is not unusual to proceed with surgery. It is difficult to know how much Balloon Sinuplasty will benefit your nasal and sinus condition without complete information about your history, physical findings and testing. You should ask your ENT surgeon what the expected benefit will be from Balloon Sinuplasty.
Q. My son is 6 years old. He has been battling sinus infections for 5 years. He has had sinus surgery twice and no change. Monday he will be having sinus surgery #3 with Balloon Sinuplasty and IV antibiotics. What is the likelihood this is his last surgery? Can you also recommend a top pediatric ENT that can help us?
A. I am sorry to hear of all the problems your son is having. Chronic sinusitis can be difficult and frustrating even with the best of care. Sinusitis in the pediatric patient can have systemic causes beyond the local sources within the sinuses. You should ask your physicians to advise you about pediatric ear, nose and throat physicians with expertise in sinus problems. You can also review the BalloonSinuplasty.com website to help find a physician who specializes in pediatric Balloon Sinuplasty.
Q. Is it recommended to try an antibiotic first, before considering Balloon Sinuplasty, even if fungus is the cause of the sinusitis?
A. For the majority of uncomplicated sinus problems medical management is usually the first choice of treatment. Fungal infections do not usually respond to typical antibiotic therapy. Secondary bacterial infections caused by the fungus are often treated with antibiotics. However, most fungal infections are managed by opening the sinus permitting it to drain and the surgical removal of the fungal debris.
Q. I had sinus surgery (septoplasty & turbinate surgery) about 4 years, ago and I still have trouble breathing. I also notice that my snoring has gotten louder and my headaches have increased. Would the Balloon Sinuplasty procedure help with my symptoms?
A. Balloon Sinuplasty is an excellent way to manage the symptoms of sinus disease. A deviated nasal septum and turbinate dysfunction is not a sinus problem, but rather a nasal problem. If you only have a deviated nasal septum, then Balloon Sinuplasty will not help. You would be wise to see an ENT physician to be evaluated and determine the cause of your problems.
Q. My sinuses look healthy on a CT scan but I still have sinus pain and congestion and feel terrible. I am about one year into allergy shots. I also had my maxillary sinuses opened and turbinate reduction. Could my problem be helped by Balloon Sinuplasty or is it just swollen and inflamed?
A. There are many reasons for sinus and nasal congestion and pain. These can relate directly to the sinuses, or be caused by nasal congestion from swelling of the turbinates. Turbinate swelling has many causes such as from allergies. Also, facial pain and congestion can be due to non-sinus problems. Balloon Sinuplasty is a safe and effective method to open obstructed sinuses. You should seek a physician skilled in the use of Balloon Sinuplasty to determine if you are a candidate.
Q. I am a candidate for Balloon Sinuplasty based on recurrent sinus infections of the maxillary sinuses. After an initial evaluation, the ENT surgeon indicated that she would be unable to access my left maxillary sinus due to a moderately deviated septum and recommended that I consider a septoplasty procedure to correct the deviation. I was wondering if the Acclarent system is able to navigate around a moderately deviated septum. Thanks.
A. The Acclarent Balloon Sinuplasty technologies can effectively reach and access tight and narrow spaces and is an excellent way to relieve obstructions associated with persistent maxillary sinusitis. There are times when a severely deviated septum will make that access difficult and the septum must be corrected. Your physician has the best ability to determine if a septoplasty is needed and can base this on a combination of your medical history, your examination, and your computed tomographic (CT) scans.
Q. I am scheduled to have Balloon Sinuplasty on Friday, under local anesthesia. I am concerned about "being awake". Should I be?
A. Balloon Sinuplasty can be safely and comfortably performed under local anesthesia. Each individual has different sinus problems that need treatment and different pain tolerances. You should discuss your particular needs and problems with your surgeon to determine if you are a good candidate for local anesthesia.
Q. Hello My son is 5 years old. He has a deviated septum and therefore often struggles to breathe through one of his nostrils. He has a lot of difficulty breathing when he has a cold. He does not have sinus issues. Would ballooning be effective in his case?
A. Balloon Sinuplasty is an effective and safe technology to manage the symptoms associated with maxillary sinus disease, which is the most common sinus to be involved in a 5 year old child. While balloon dilation has been shown to be effective for maxillary sinus disease in children, a deviated septum is a nasal and not a sinus problem. You should discuss with your physician the ways a deviated septum is managed.
Q. Once you've had Balloon Sinuplasty surgery, will you be able to stop using nasal sprays?
A. There are several different nasal sprays that physicians might use. Some are used for inflammation and allergies and others for infection. The ability to stop nasal sprays will depend on the cause of the sinusitis. You should check with your physician and understand the reasons why you are taking your spray and the chances for continued use after Balloon Sinuplasty surgery.
Q. Based on my CT scan, my ENT said he has to go with using a scope and carve bone and tissue as opposed to Balloon Sinuplasty. Should Balloon Sinuplasty always be tried first before using a scope and carving bone and tissue?
A. Balloon Sinuplasty is an excellent and safe method of dilating obstructions associated with many types of sinus disease. There are many different causes of sinus disease and your specific type may not lend itself to Balloon Sinuplasty. If you wish to explore if you are a candidate for Balloon Sinuplasty, you should seek an opinion from a surgeon who is skilled in Balloon Sinuplasty and performs Balloon Sinuplasty frequently. Note that traditional sinus surgery and Balloon Sinuplasty both employ the use of an endoscope, which is a small camera inserted into the nasal cavity to assist the surgeon in seeing inside your nose.
Q. Can the same balloon used for Balloon Sinuplasty also be used to straighten the septum from a nasal deviation after several procedures?
A. Balloon Sinuplasty is a surgical tool to open the drainage pathway of the sinuses. The balloon does not move or straighten the nasal septum.
Q. I have had a chronic sinus infection for more than eight years. My infection is fungal according to my doctor, and he said balloon sinuplasty does not work for that. Has anything changed where the balloon will work for fungal infections?
A. Balloon Sinuplasty is a surgical tool to open the sinuses and permit them to drain. At the time of opening the sinuses with Balloon Sinuplasty tools, the sinuses can be washed and irrigated to remove mucous and bacterial or fungal infections. In some instances the fungus can form a firm ball or be very thick and the irrigation will not remove the fungus. Since 2006 there are newer irrigation tools as part of the Acclarent Balloon Sinuplasty tools that may help. If you still have sinus problems you should seek a surgeon with skill and expertise in Balloon Sinuplasty.
Q. I had sinus surgery over one year ago. I have never regretted it because I can now breathe through my nose. However, I am still having sinus infections, which I expected. I’ve recently had two sinus infections and feel like I never truly get rid of it on the left side of my face. It's tender to the touch and I feel bad. Would Balloon Sinuplasty be an option for me after I’ve already had surgery?
A. The left sided facial pain you are experiencing can have several causes, among which is a sinus problem. Balloon Sinuplasty is a minimally invasive effective tool used to manage sinus problems and can be used after previous nasal or sinus procedures. It is important to determine the exact nature of your sinus history and present problem to decide if you are a candidate for Balloon Sinuplasty. Seek a surgeon familiar with Balloon Sinuplasty. Your surgeon can advise you after a complete examination that might include your ENT history, a nasal endoscopic examination and computed tomographic (CT) scan.
Q. I have been diagnosed with chronic sinusitis and after trying lots of medications, surgery was recommended. I went to a doctor that performs Balloon Sinuplasty and he told me I was not a good fit for the surgery because I have a slightly deviated septum on one side of my nasal passage. Can you please tell me if that is the case?
A. It is not clear from your question as to why you are not a candidate for Balloon Sinuplasty. If it is because of the deviated septum limiting access to the sinuses, the nasal septum can be repaired as part of the sinus surgery. Balloon Sinuplasty is a safe, durable and effective procedure to manage the symptoms of many types of sinus disease involving the maxillary, frontal and sphenoid sinuses. If the ethmoid sinus is involved, then Balloon Sinuplasty can be combined with ethmoid sinus surgery (hybrid procedure) to manage the disease. You should ask your physician why your disease cannot be addressed with Balloon Sinuplasty technology.
Q. I have had sinus infections and pressure for years. Within the past four years it has gotten really bad. I feel like I can’t breathe, which makes my chest feel heavy. I take decongestants very often, and I am now dealing with snoring. I have gone to my ENT and he has advised me that I am a candidate for Balloon Sinuplasty. Will this help with my snoring?
A. Balloon Sinuplasty is a proven and safe technology to relieve the obstructions associated with chronic sinusitis. There are numerous causes for snoring, among which can be nasal obstruction. You need to discuss with your physician the causes of your snoring and whether nasal surgery is anticipated to help this. Balloon Sinuplasty can address sinus disease, but would not be expected to affect snoring.
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. If you smoke after having the surgery, will your sinuses go back to being bad again?
A. There are many factors that can contribute to recurrence of sinus disease in spite the best of surgical procedures Smoking is never healthy for any part of the respiratory system. Cigarette smoke can be considered fine particles in the air which will be breathed in and irritate the nasal and sinus linings. There is some evidence from work done at Johns Hopkins that those who some will have a poorer outcome in their sinus surgery.
Q. I had Balloon Sinuplasty seven days ago. How long does it take for nasal soreness and pain to diminish? I am continuing the sinus irrigation as recommended by my ENT. Afterwards is when I feel the most pain and soreness.
A. The discomfort experienced after Balloon Sinus surgery will vary depending upon which sinuses were operated upon and whether any additional nasal and sinus procedures were needed in addition to the Balloon Sinuplasty to manage the sinus disease. You should check with your physician to see if the amount of discomfort you're having is an anticipated part of your recovery period.
Q. I am scheduled to have Balloon Sinusplasty in two weeks. I take Humira® for RA and took my usual dose this week. Should I reschedule the procedure for a month from now so that the Humira® has a chance to get out of my system?
A. Prior to your Balloon Sinuplasty surgical procedure you should discuss with your physician whether you should remain on or stop any of the medications you are taking.
Q. If I have the Balloon Sinuplasy done, how long will the results last, or how often will I need to have this procedure done?
A. The durability of Balloon Sinuplasty Surgery and the chance of revision may be dependent upon the kind of sinus problem that is being managed. Some sinus problems have a chance to recur no matter what type of treatment is performed. You need to discuss with your surgeon the type of problem you have and the kind of surgery being performed to determine the results and how long it might last.
Q. I had Balloon Sinuplasty and am enduring some swelling of the right cheek. Is this normal?
A. Facial swelling after Balloon Sinuplasty is usual. Swelling of the cheek has many causes some of which are not related to the sinuses. You should check with your physician who performed the surgery to find out if the swelling was expected, related to the surgery, from another cause or even of any concern.
Q. After the Sinuplasty is done, you usually have a post op about a week later. What will the post op consist of? Also, I have heard that it is normal to have a lot of drainage and blood after the procedure. How long will that last?
A. There are several different sinuses that might need to be managed as part of the Balloon Sinuplasty procedure. Also, there might be the need to do other procedures in the nose and sinuses in additional to Balloon Sinuplasty. You should check with your physician to find out how much blood or mucus drainage is expected and what to expect at your follow up office visits.
Q. I am getting Balloon Sinuplasty in a couple of weeks. What makes the sinuses stay open once they remove the balloon?
A. When inflated, the balloon micro-fractures the bone, which is then expected to heal in the newly displaced position and not "rebound". Clinical results suggest the dilation is durable.
Q. I am having Balloon Sinuplasty and my doctor has prescribed oral steroids. Do you believe that it is necessary to take this before and days after the procedure? And is this the norm or more of a precautionary measure?
A. The use and need of oral steroids will depend on the sinus problem being treated. It is not specific to Balloon Sinuplasty. You should discuss the reasons and need for the steroids with your surgeon.
Q. Does Balloon Sinuplasty change the appearance of your nose? What are the risks?
A. Balloon Sinuplasty is used to dilate the sinus openings. There are no reported cases of Balloon Sinuplasty altering the shape or appearance of the nose.
Q. Hello, Your FAQ section states that results last two years. In two years, do you need another Balloon Sinuplasty? Will headaches return? Thank you!
A. It is not that results of Balloon Sinuplasty last only two years, but rather there is now published scientific data following patients for two years. There is no clear clinical data or parameters for how long to follow and watch over any patient with sinus disease with any type of treatment. While certain types of sinus problems will resolve permanently with medical or surgical treatment, others are chronic and might cause lifelong problems. You should discuss your particular sinus problems with your ear, nose and throat physician to determine how long you could expect relief from symptoms, including headaches.
Q. I had Balloon Sinuplasty done yesterday. No pain in office and just a small headache afterwards that went away after about four hours. Feeling fine today, but am very congested feeling. No major discharge, just congested where I cannot breathe well through my nose. Is this normal? How long does it typically last?
A. Nasal congestion is a common occurrence after any nasal or sinus procedure. The length of time of the congestion will depend upon the type of surgery performed and findings at the time of surgery. You need to confer with your surgeon who will understand the details of your surgery about your anticipated post-operative course.
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 four 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.
Q. I have a ten year old son who has suffered from mucus in his throat for many years. He has to clear his throat all the time to get any relief. I have taken him to see many different doctors with no answers, but they put him on more medications. He has seen an allergy doctor and took allergy shots for two years with no improvement. He has seen an acid reflux doctor because his primary doctor thought that could be causing it. They put him on additional medications that he has been taking with no improvements. Please help.
A. It sounds as your son has had years of post-nasal drainage and throat clearing. Your son’s physicians have considered and treated the typical causes of allergies, sinusitis, and acid reflux. In addition, other causes need to be considered such as tonsil and adenoid infection, nasal turbinate dysfunction, and diverticula of the throat, to name a few. A complete evaluation by an otolaryngologist most likely has been performed, however can be revisited. And in spite of the best of evaluations and extensive medical management and even surgery like tonsillectomy, adenoidectomy and nasal surgery, the throat mucus may continue.
Q. Ever since I was five years old, I’ve had a constant runny nose, usually accompanied by a series of headaches and restlessness. I am easily irritated by dust and cold at the slightest possibility of contact. Some say it is chronic sinusitis. I don’t know what to do.
A. I am sorry you have lifelong nasal and sinus problems and headaches. It is difficult to provide advice without a complete history, nasal endoscopic examination and computed tomographic (CT) scan. My advice would be to find a respected and trusted otolaryngologist who can perform a complete evaluation and provide advice and alternatives to treatment.
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. Can Balloon Sinuplasty be performed if there's a current infection? I am going to see my doctor again but was wondering if there's any way to tell for sure if I have a bacterial infection? Also, is there any way a doctor could drain the sinuses in office to avoid antibiotics?
A. Balloon Sinuplasty can be performed while there is an infection although many physicians will prefer to get an infection under control prior to any sinus procedure. A physician can obtain a culture from the nose to determine if the infection is viral, bacterial or fungal. Balloon Sinuplasty can open the sinuses permitting them to be irrigated. Depending on the cause of the infections, this may or may not prevent the need for more antibiotics. You should discuss all your concerns with a physician skilled in Balloon Sinuplasty.
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. 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.
QUESTIONS REGARDING INSURANCE
Q. My doctor suggested Balloon Sinuplasty and she told me that it is costly. Can you please let me know the cost of the balloon?
A. You will need to check with your local physician or insurance carrier to determine the costs of Balloon Sinuplasty. These costs will vary with your insurance carrier, around the world.
Q. How much does Balloon Sinuplasty cost without insurance?
A. The cost of Balloon Sinuplasty will vary depending upon your region and physician. Check with your surgeon to determine the cost.
Q. My husband is having Balloon Sinuplasty next week. The right side of his nose is completely blocked, but the left side is not nearly as bad. The insurance has approved the procedure for the right side only. Is it normal to only do one side?
A. Sinus disease can occur on either the left or right side, or both sides of the sinuses. The operating surgeon will determine which sinuses need surgery and if it needs to be on the left, right or both sides.
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.