New procedure may help those with chronic sinus infections

Herald Health CorrespondentJune 18, 2013 

Bridget Jones, a teacher's assistant at Bayshore High School, could hear the eggshell-thin bones in her sinuses cracking during in-office surgery to solve the chronic infections she'd been having for months.

The sound was expected because the purpose of the surgery was to permanently widen her sinus passages. A balloon catheter was threaded into her nostrils and up into the sinuses in her forehead and below her eyes.

After the tiny plastic balloon expanded, Jones' sinus passages were 10 times wider. Fluid that was repeatedly becoming infected could drain out, leaving her sinuses open and clear.

Physician Axay Kalathia, who did the surgery in his office at Ear, Nose and Throat Associates of Manatee, explains the procedure, called balloon sinuplasty, as being similar to stretching open a doorway.

For Jones, sinus blockages had been a constant source of sickness and rounds of antibiotics hadn't helped.

She was having chronic severe headaches, her eyes were puffy and her shoulders would hurt. Frequently, she was tired and groggy.

The balloon procedure, completed in about an hour, was done on a Friday last April. By Saturday, she noticed a difference in her breathing and on Monday she was back to work.

"I felt like a new person," said Jones.

Balloon sinuplasty was developed eight years ago and most often was done in outpatient-surgery centers. The procedure now is migrating into doctors' offices where physicians such as Kalathia use it to treat patients with persistent sinusitis that isn't responding to medications or other non-surgical treatments.

Kalathia began offering balloon sinuplasty in earlier this year and so far has treated nearly 40 patients.

Years ago, surgery for chronic sinusitis was a major ordeal. Doctors cut away bone and tissue to widen sinus passages after reaching them through a facial incision. The idea was that if blockages could be removed, the sinuses could drain and infections would be less likely.

The surgery became less drastic when doctors began using endoscopy, a technique that allowed minimally invasive surgery through the nose.

"The balloon is the next revolutionary change," said Kalathia. "In the past year, it has been becoming more and more popular."

Most sinus infections go away by themselves after two to three days or can be treated with antibiotics, said Kalathia. But some people aren't so lucky. Every small cold turns into a sinus infection that can last for weeks.

When the infections are chronic, recurring again and again, surgery becomes another option, said Kalathia.

Unlike traditional sinus surgery, balloon sinuplasty is done under local anesthesia and most people describe it as feeling only moderate pressure, he said. It also involves no cutting; expansion of the balloon widens the passageway without having to remove tissue.

Using a high-tech balloon catheter to prop open sinus passages is similar to balloon angioplasty that widens blocked arteries.

"For sinuses, it's not like heart disease where you have to do the procedure or else. It's more of a quality of life issue," said Kalathia.

However, not everyone is a candidate; balloon sinuplasty can't be used for problems such as nasal polyps.

There is also no guarantee that sinus infections will disappear completely, either. But if they do occur, they will be less frequent and should clear up in a few days, said Kalathia.

Jones has stayed healthy since her surgery two months ago. She doesn't know why she started having chronic sinus infections last year. But through skin tests at her doctor's office, she learned she has allergies.

"I'm 42 and didn't know I had allergies," she said. "But I'm allergic to everything."

But the chronic headaches, severe congestion and tiredness have disappeared and she expects them to stay away.

Susan Hemmingway, Herald health correspondent, can be reached at shemmingway@hotmail.com.

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