Breathing Easier with a New Procedure
Chronic sinusitis is very common, affecting about 14 percent of the U.S. population or 37 million Americans.
"Every year, I'd get several sinus infections," Smith recalls. "They became so predictable I could almost mark them on the calendar. The winter months were the worst because of the dry air and being inside heated buildings. My job required me to do a fair amount of traveling internationally throughout the year, so those long flights also made me more susceptible. I always seemed to get sinus infections at the worst times, like when I had to do presentations to customers."
He took antibiotics to subdue the infections, and did frequent sinus rinses as a preventive measure. "I also tried some of the prescription nasal steroid sprays, but that was like trading one problem for another," he says. "I went from having sinus infections to a chronic post-nasal drip and sore throat."
Smith had talked with his doctor several years ago about sinus surgery, but had decided against it. "I didn't want to get involved with anything that was that invasive and required that much recovery time," he says. "Then around 2004 while doing some research online, I read about a less-invasive procedure. I thought the concept made sense, but as I remember it was still in trials and only available in a couple of locations."
Meanwhile, his symptoms gradually grew worse. "The infections and sinus headaches became more frequent and my breathing became a bit labored—my wife noticed that I was mouth-breathing all of the time," says Smith. "I was also snoring much more at night which affected my sleep. I finally got to the point where I thought, ‘I don't care what it takes; I've got to do something.'"
To Smith's surprise and relief, the procedure he had discovered online, called balloon sinuplasty, was now being offered at Dartmouth-Hitchcock. "Instead of surgically removing bone and tissue, as is done with more traditional functional endoscopic sinus surgery, we use a small, flexible balloon catheter to open the nasal passages," says otolaryngologist Giridhar Venkatraman, MD, the only specialist who is currently performing the procedure in the region.
The technique is very similar to that used by cardiac specialists when opening partially clogged arteries, says Venkatraman. "The general principle is the same, but rather than using X-ray imaging we use a special fiber-optic-lighted guidewire that illuminates the sinus cavities," he explains. "We thread the guidewire through the nostrils and into the sinus. Once we're sure the guidewire is in the right spot, we feed the catheter and balloon over the guidewire, and pull the guidewire out."
The balloon is then inflated with saline to apply localized, high-intensity pressure. "Most of the tissue of the sinus openings is made up of a combination of soft tissue and very soft bone," says Venkatraman. "Applying that kind of pressure allows us to push against the bone and crack it a little bit. This prevents the bone from re-growing into the same position, and keeps the sinus passage open."
The procedure offers a number of significant benefits over conventional sinus surgery, including less bleeding, less pain and discomfort, and faster recovery time for patients. Smith had the same-day procedure done last October and saw immediate results. "There was a dramatic difference between going in and coming out," he recalls. "Then when I got home and removed the little bit of packing they gave me, I was amazed at how well I could breathe. I probably had some noticeable discharge for about 4 hours, but that was no big deal."
Since having the procedure, Smith has had more energy and has become more active, which has helped him to lose a few pounds. And he's sleeping much better. "I still snore, but nothing like I used to," he says. "I still have to do sinus rinses when it's dry. And I have a little bit of drainage trouble, due to some scar tissue I developed on the right side. I'm going to go in before winter and see Dr. Venkatraman to take care of that."
"But I'm very happy with the outcome—it just goes to show you that new technologies are constantly becoming available, so you don't always have to accept living with issues that affect your quality of life," Smith adds. "Dr. Venkatraman and everyone at Dartmouth-Hitchcock have been responsive, knowledgeable, and professional. They really work at making the quality of the whole care experience the best it can be."
Balloon sinuplasty for chronic sinusitis