Approximately 15 percent of adults in the United States experience debilitating symptoms of chronic rhinosinusitis (CRS), which include congestion, runny nose, and headache. Far fewer, however, seek the advice of a physician. Satish Govindaraj, MD, Chief of Rhinology and Sinus Surgery, at the Mount Sinai Health System, discusses a variety of innovative treatments that have significantly improved the quality of life for tens of thousands of patients each year.
Satish Govindaraj, MD, Chief of Rhinology and Skull Base Surgery at the Mount Sinai Health System
What is chronic rhinosinusitis?
Most of us have had a runny or stuffy nose at some point in our lifetime. When these symptoms last for a few days or even weeks you may be diagnosed with a condition known as acute sinusitis. Chronic rhinosinusitis (CRS), however, occurs when the sinuses passages—four pairs of hollow cavities in the nose and head—swell and are unable to properly drain for a period of three months or longer.
What are the symptoms?
Patients with CRS typically experience persistent nasal drainage, congestion that impacts their ability to breathe, headache, facial pain or pressure, fatigue, and difficulty smelling or tasting. These symptoms can have a tremendous impact on your ability to work and enjoy leisure time.
What treatments are available?
When the sinus passages swell and are unable to drain, mucus gets stuck and can become infected. The key to treating CRS is to reduce this inflammation. The first line of defense is always medical management, including nasal saline irrigations that flush out the nasal passageways, topical steroids sprayed into the nose to reduce swelling, and oral antibiotics which treat infection. If medical management fails, numerous surgical options are also available. Mount Sinai’s ear, nose, and throat specialists (otolaryngologists) are highly trained in a variety of minimally invasive procedures that can be performed in the office setting without making an incision.
Am I a candidate for balloon sinuplasty?
We partner with patients to develop an individualized treatment plan based on their unique anatomy, symptoms, procedure tolerance, and medical history. Patients with CRS are typically eligible for balloon sinuplasty if their symptoms have not improved with medical management and they have had four or more sinus infections in one year.
How does balloon sinuplasty work?
Balloon sinuplasty opens up the nasal passageways. During this in-office procedure, a thin wire or probe with an attached balloon is guided through the nose into the swollen sinus cavity. When the balloon is in the correct spot, it is inflated and dilates the blocked passageway—similar to the way a stent is used to open up a clogged artery. The sinus cavity is then irrigated or flushed with salt water to allow the trapped mucus to drain out.
What distinguishes Mount Sinai with balloon sinuplasty treatment?
Many of our ear, nose, and throat physicians are fellowship trained in sinus surgery and receive additional education in performing the balloon sinuplasty procedure. Mount Sinai surgeons also specialize in using image-guided CT scans to precisely navigate tiny instruments through the nasal passageways. As a large, tertiary medical center reputable for managing complex cases, patients can feel safe knowing there is a multidisciplinary team at every surgeon’s fingertips. We have multiple locations throughout New York City, making it easy to find care close to home.
What are the benefits of balloon sinuplasty?
Research shows numerous advantages to having a balloon sinuplasty, compared to traditional sinus surgery. These include:
- Faster recovery time — patients report fewer missed days of work or school
- Use of local sedation rather than general anesthesia — the procedure is performed in a doctor’s office rather than an operating room using numbing agents and IV sedation when necessary
- Shorter operating time — depending on how many sinus cavities are affected, the procedure typically takes one hour
- Comparable outcomes to more invasive sinus surgeries in patients with mild to moderate chronic sinusitis
- Fewer side effects, including pain, soreness, and congestion — the surgery does not require an incision or any tissue or bone to be removed
- Minimal follow-up care — there is no nasal packing after the operation
What is the follow-up treatment? Will my CRS return?
A balloon sinuplasty procedure causes minimal disruption to daily life—most patients return to work the next day. In an abundance of caution, individuals who have sinus surgery should not exert themselves physically for a few days. Follow-up appointments are typically made in one to two weeks. The overwhelming majority of patients who have balloon sinuplasty notice a significant improvement in their symptoms. The length of time individuals experience benefit depends on the severity of their disease and whether or not they have other compromising disorders such as allergies or immune system conditions. To ensure success, it is important that patients continue to take their medication regularly after surgery and properly irrigate their sinuses with nasal rinses.