Balloon Sinuplasty Surgery for a Deviated Septum: Plain English Guide for Patients

In this plain English guide to balloon sinuplasty surgery for a deviated septum, we cover everything you need to know about this common surgical procedure:

What is balloon sinuplasty surgery?
What happens during balloon sinuplasty surgery?
Balloon sinuplasty approach utilizes balloon
What should I expect after balloon sinuplasty surgery?
What are the risks of balloon sinuplasty surgery?
What are the pros & cons of balloon sinuplasty surgery?

And much more. Let’s get started:

Table Of Contents

What is Balloon Sinuplasty Surgery?

Balloon Sinuplasty Surgery Procedure Steps

Effectiveness of Balloon Sinuplasty Surgery

What to Expect After Balloon Sinuplasty Surgery?

Balloon Sinuplasty Surgery Recovery

Precautions After Balloon Sinuplasty Surgery

Balloon Sinuplasty Pain After Surgery

Balloon Sinuplasty Surgery Side Effects

Pros and Cons of Balloon Sinuplasty Surgery

Balloon Sinuplasty Surgery Pictures

Balloon Sinuplasty Surgery Videos

Frequently Asked Questions – Balloon Sinuplasty Surgery

What is Balloon Sinuplasty Surgery?

Balloon sinuplasty surgery is an alternative approach to treat chronic rhinosinusitis (inflammation of nose and sinuses) due to blockage of sinus opening. It uses a small, flexible balloon catheter which when inserted into the sinus and inflated, enlarges the sinus opening. This allows draining of the accumulated mucus (slimy substance) in the sinus, relieving from sinus congestion and associated infections.¹Lofgren DH, Shermetaro C. Balloon Sinuplasty. [Updated 2020 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan

Balloon Sinuplasty Surgery Procedure Steps

The steps that followed during a balloon sinuplasty procedure are²Stewart, A. E., & Vaughan, W. C. (2010). Balloon Sinuplasty Versus Surgical Management of Chronic Rhinosinusitis. Current Allergy and Asthma Reports, 10(3), 181–187.

step 1

The sinus region is anesthetized and a guidewire is inserted into the sinus with the help of an endoscope (a thin, flexible tube with a camera).

step 2

The correct positioning of the guide wire in the sinus is confirmed. A deflated balloon catheter is inserted along the guide wire into the sinus opening (sinus ostia).

step 3

After confirming the position, the balloon is slowly inflated.

step 4

The balloon is inflated until the sinus opening is enlarged, permitting draining of accumulated mucus from clogged sinus. Saline is injected through the catheter to flush the sinus and remove the remaining mucus and pus.

step 5

The device is then removed.

Effectiveness of Balloon Sinuplasty Surgery

Studies of balloon sinuplasty surgery show that the surgery is effective in enlarging the sinus opening without excessive removal of soft tissue or bone, or even injuring the surrounding structures. With this technique, individuals experience minimal trauma, pain, and bleeding, and tend to recover faster when compared to conventional procedures.

Research suggests that reduction in the symptoms were observed in ~95% of individuals and ~73% of individuals were symptom free.³Taghi, A. S., Khalil, S. S., Mace, A. D., & Saleh, H. A. (2009). Balloon Sinuplasty™: balloon-catheter dilation of paranasal sinus ostia for chronic rhinosinusitis. Expert Review of Medical Devices, 6(4), 377–382.

What to Expect After Balloon Sinuplasty Surgery?

After the balloon sinuplasty procedure, patients can expect⁴Hur K, Ge M, Kim J, Ference EH. Adverse Events Associated with Balloon Sinuplasty: A MAUDE Database Analysis. Otolaryngol Head Neck Surg. 2020 Jan;162(1):137-141.

Mild bleeding (largely oozing type) from the nose for the first few days.
Small swelling and tenderness in the region of cheeks, beneath the eyes and the nose in the first few days, which will subside gradually.
Nasal and sinus congestion or feeling of fullness may be present in the first week after the surgery.
Tiredness and weakness may be experienced in the initial days.

Balloon Sinuplasty Surgery Recovery

To recover from balloon sinuplasty surgery, patients are advised to⁵Lofgren DH, Shermetaro C. Balloon Sinuplasty. [Updated 2020 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan

Take medications as prescribed.
Apply ice/gel pack over eyes and upper cheeks as much as possible for the next 48 hours for 20 minutes intermittently post-surgery (this helps reduce swelling).
Perform nasal rinsing with saline as per the instructions.
Visit doctor for follow up visits after 1 week, 3 months, and a year after the surgery.
Take up follow up CT (computed tomography) scans as advised by the doctor.
Visit the doctor for assessment of vision and mental heath status in the following weeks after the surgery.
Visit the doctor for evaluation of the quality of life before and after the surgery using several assessment tools (e.g. Sino-nasal outcome tests, Wong-Baker Faces Pain Scale).

Precautions After Balloon Sinuplasty Surgery

After the balloon sinuplasty procedure, patients should follow these precautions for 7-10 days after the surgery:⁶Endoscopic Sinus Surgery - CSOHNS

Avoid blowing of nose to allow the clot to form for an uneventful healing. The patient can sneeze keeping the mouth open.
Avoid performing any vigorous activity and lifting heavy objects after the surgery.
Take antibiotics and painkillers on time as prescribed (based on the requirement).
Visit the doctor for cleaning (debridement) of blood clots and crusts in the nose (as advised).
Avoid smoking or taking alcohol.
Avoid use of hot water or steam on the face.

Balloon Sinuplasty Pain After Surgery

Research suggests that after balloon sinuplasty surgery the level of pain that patients feel is less in comparison to conventional surgeries. Balloon sinuplasty causes minimal intrusion to the bone and mucosa while enlarging the sinus opening. As a result, reduced postoperative pain and morbidities are observed.⁷Catalano, P. J. (2013). Balloon Dilation Technology: Let the Truth Be Told. Current Allergy and Asthma Reports, 13(2), 250–254.

Balloon Sinuplasty Surgery Side Effects

Potential side effects of the balloon sinuplasty surgery include pain, and redness and bruising of skin beneath the eyes for short duration. In rare cases, a leak of cerebrospinal fluid (the liquid surrounding the brain and spinal cord) is observed.⁸Taghi, A. S., Khalil, S. S., Mace, A. D., & Saleh, H. A. (2009). Balloon Sinuplasty™: balloon-catheter dilation of paranasal sinus ostia for chronic rhinosinusitis. Expert Review of Medical Devices, 6(4), 377–382. Its occurrence is very rare and observed in 0.01% patients.⁹Cingi, C., Bayar Muluk, N., & Lee, J. T. (2018). Current indications for balloon sinuplasty. Current Opinion in Otolaryngology & Head and Neck Surgery

Pros and Cons of Balloon Sinuplasty Surgery

When deciding whether or not to have this procedure done for your deviated septum, consider these pros and cons:

Pros of Balloon Sinuplasty Surgery:¹⁰Stewart AE, Vaughan WC. Balloon sinuplasty versus surgical management of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2010 May;10(3):181-7.

Minimal intrusion without excessive removal of bone or tissue.
Reduced pain, bleeding, postoperative discomfort, and postoperative medications.
Faster recovery than the conventional procedures.
Can be performed under local anesthesia. General anesthesia is not required.

Cons of Balloon Sinuplasty Surgery:¹¹Levine, H., & Rabago, D. (2011). Balloon Sinuplasty: A Minimally Invasive Option for Patients with Chronic Rhinosinusitis. Postgraduate Medicine, 123(2), 112–118. doi:10.3810/pgm.2011.03.2269

High cost of the device (The balloon sinuplasty device (Acclarent, Menlo Park, CA costs ~$1,200 for the single-use device system).
Not recommended for individuals with nasal polyps, fungal sinusitis, or neoplasm (cancer).
Fewer devices approved by FDA.

Balloon Sinuplasty Surgery Pictures

Here are some excellent photos that show the balloon sinuplasty procedure:

source

Balloon Sinuplasty Surgery Videos

Here are some excellent videos that show the balloon sinuplasty procedure:

Frequently Asked Questions – Balloon Sinuplasty Surgery

Here are answers to the most commonly asked questions related to balloon sinuplasty surgery:

Is balloon sinuplasty a major surgery?

The short answer is No.

The balloon sinuplasty surgery can be performed in office settings under local anesthesia and doesn’t require any hospitalization. Patients are treated under “Day care” and discharged with oral antibiotics and postoperative instructions.¹²Raghunandhan, S., Bansal, T., Natarajan, K., & Kameswaran, M. (2012). Efficacy & Outcomes of Balloon Sinuplasty in Chronic Rhinosinusitis: A Prospective Study. Indian Journal of Otolaryngology and Head & Neck Surgery, 65(S2), 314–319.

How long does balloon sinuplasty surgery take?

Research suggests the average time taken to perform balloon sinuplasty surgery is ~75 minutes.¹³Levine HL, Sertich AP, Hoisington D et al (2008) A multi-center registry of balloon catheter sinusotomy outcomes for 1,036 patients. Ann Otol Rhinol Laryngol 117:263–270.

What is the recovery time for balloon sinuplasty surgery?

Research suggests that ~85-90% of the patients got relief from symptoms in the first week after the surgery. Most patients resume work within 24 hours after the surgery.¹⁴Catalano, P. J. (2013). Balloon Dilation Technology: Let the Truth Be Told. Current Allergy and Asthma Reports, 13(2), 250–254.

What is the cost of balloon sinuplasty surgery in the USA?

The cost of balloon sinuplasty surgery is ~$10,000 in the USA.¹⁵Levine, H., & Rabago, D. (2011). Balloon Sinuplasty: A Minimally Invasive Option for Patients with Chronic Rhinosinusitis. Postgraduate Medicine, 123(2), 112–118. doi:10.3810/pgm.2011.03.2269

1
Lofgren DH, Shermetaro C. Balloon Sinuplasty. [Updated 2020 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan
2
Stewart, A. E., & Vaughan, W. C. (2010). Balloon Sinuplasty Versus Surgical Management of Chronic Rhinosinusitis. Current Allergy and Asthma Reports, 10(3), 181–187.
3
Taghi, A. S., Khalil, S. S., Mace, A. D., & Saleh, H. A. (2009). Balloon Sinuplasty™: balloon-catheter dilation of paranasal sinus ostia for chronic rhinosinusitis. Expert Review of Medical Devices, 6(4), 377–382.
4
Hur K, Ge M, Kim J, Ference EH. Adverse Events Associated with Balloon Sinuplasty: A MAUDE Database Analysis. Otolaryngol Head Neck Surg. 2020 Jan;162(1):137-141.
5
Endoscopic Sinus Surgery - CSOHNS
6
Catalano, P. J. (2013). Balloon Dilation Technology: Let the Truth Be Told. Current Allergy and Asthma Reports, 13(2), 250–254.
7
Cingi, C., Bayar Muluk, N., & Lee, J. T. (2018). Current indications for balloon sinuplasty. Current Opinion in Otolaryngology & Head and Neck Surgery
8
Stewart AE, Vaughan WC. Balloon sinuplasty versus surgical management of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2010 May;10(3):181-7.
9
Levine, H., & Rabago, D. (2011). Balloon Sinuplasty: A Minimally Invasive Option for Patients with Chronic Rhinosinusitis. Postgraduate Medicine, 123(2), 112–118. doi:10.3810/pgm.2011.03.2269
10
Raghunandhan, S., Bansal, T., Natarajan, K., & Kameswaran, M. (2012). Efficacy & Outcomes of Balloon Sinuplasty in Chronic Rhinosinusitis: A Prospective Study. Indian Journal of Otolaryngology and Head & Neck Surgery, 65(S2), 314–319.
11
Levine HL, Sertich AP, Hoisington D et al (2008) A multi-center registry of balloon catheter sinusotomy outcomes for 1,036 patients. Ann Otol Rhinol Laryngol 117:263–270.