BASQUE RESEARCH
 Basque research, development and innovation web site

News

Contact:

Jesús Zorrilla Ruiz

Clínica Universidad de Navarra

Contact details:

jzorrilla@unav.es

(+34) 948-296.497 / 948-255.400

2009/11/3

Balloon sinuplasty resolves certain sinusitis surgery cases

Specialists at the University of Navarra Hospital have applied a new therapeutic technique with excellent results. The technique, known as balloon sinuplasty, enables the treatment of certain cases of acute and chronic rhinosinusitis (sinusitis) without polyposis, with minimum impact on the patient, avoiding surgery and thus reducing possible side effects. According to Doctor Peter Baptista, doctor at the University of Navarra Hospital Ear, Nose and Throat Department, the procedure can also be used in numerous cases of rhinosinusitis as a complementary tool in normal endoscopic surgery.

Rhinosinusitis is the inflammation of the paranasal sinuses, cavities located in the interior space of the cheekbones, above and below the eyes and at the interior of the nose. Within the nasal sinuses mucous is secreted which, under normal conditions, drains to the outside through the nostrils. The inflammation of these cavities obstructs this expulsion of mucous to the exterior, causing an infection that can manifest itself at different degrees, being highly incapacitating at an extreme level.

It is an illness with high prevalence. According to data from the European Academy of Allergy and Clinical Immunology, the rate of rhinosinusitis in western countries is between 5 and 15% of the population.

Traditional and new techniques

The most common procedure for treating the most complex cases of rhinosinusitis is endoscopic surgery. As doctor Baptista explains, it is a technique used when the case requires a surgical operation. Although it involves minimally invasive surgery, it is an operation involving opening up the paranasal cavities, eliminating and remodelling bone tissue in the process. It is a technique which, in short, manages to maintain the orifices minimally or sufficiently open and, although it uses endoscopy (without external open surgery wounds), it does involve certain traumatic effects.

Balloon sinuplasty, on the other hand, means a step forward in the treatment involving the minimum affectation possible for the patient. The procedure is carried out using endoscopic equipment. Its distal end has a guide which is inserted through the nostril and the function of which is open the way to the affected paranasal sinuses.

When the specialist confirms that this guide is at the exact location where the operation is to take place, the deflated balloon is inserted. Once inside the paranasal duct, the surgeon inflates the device using a manometer. The balloon is made from a highly resistant material, enabling the effective stretching/widening of the obstructed duct(s). The dilation of the balloon provokes microfractures in the bone tissue that enables drainage of the infected cavities to be re-established, explained the specialist. Once the dilation of the duct is achieved and the paranasal cavity reopened, the balloon is deflated and immediately removed. The ear, nose and throat specialist then eliminates the mucous accumulated as a result of the infection.

The instrument also has an optic fibre which enables the observation of the interior of the cavities in detail, with an image-enlarging camera. This new procedure is less aggressive than the conventional endoscopic surgery and, thus, patient recovery is more rapid, affirms doctor Baptista. In fact, it is a technique that normally does not require a hospital stay of more than one day.

Combining the two procedures

The specialist emphasises that balloon sinuplasty is a procedure only applicable in certain cases of rhinosinusitis. In patients for which it is not possible to use it as sole treatment, there remains the possibility of combining it, as a support tool, with conventional techniques, especially for cleaning out the inside of the paranasal cavities. It then acts as an additional tool to conventional endoscopic surgery. It is useful for facilitating the widening of the cavities, especially in the frontal sinuses. There are cases where the space is so small that surgery results in bleeding and, with time, a greater amount of scar tissue which, in turn, makes passage through the paranasal ducts more difficult. Balloon sinuplasty achieves the expansion of the ducts with hardly any bleeding and, so, with less scar tissue forming and leaving the passages clear to the cavity where the infection is, explains doctor Baptista.

In short, he explains, this is an operation that requires considerable dexterity by the surgeon, given the narrowness of the ducts and the complicated nature of accessing the cavity.

Patients with chronic rhinosinusitis and polyps

For cases of chronic rhinosinusitis or in the presence of polyps, there currently exists the possibility of undertaking the implant of a device (balloon) in the etmoidal sinuses (located at each side of the middle and upper third part of the nasal cavity) and which carries a receptacle containing a corticoid pharmaceutical, suitable for provoking a disinflammatory effect. This procedure is a variant of sinuplasty which, in some cases, can manage to avoid surgery for these affections, explained the specialist.

Comments

2009/11/3 | McDade

surgical options

Hi. Really good post. Sinus infections (especially chronic ones) are no fun at all and can definitely lead to other issues (not to mention pretty much take over your life).
Dealing w/ chronic sinusitis is another story. Sinus surgery has long been the only option when all else fails. However there are now some other ways to turn. Balloon sinuplasty is gaining traction – lots of info out there.
Anyway. Knowledge is power – do your homework and talk to your doctor. Find the solution that fits your condition best.
Take care.