Chronic sinusitis affects tens of millions of patients annually (including my own household). Over the years we have continued to refine treatment options, both medical and surgical. The latest incarnation of surgical treatment is the use of small balloon catheters (taken from the cardiac angioplasty world) to more gently stretch the sinus openings, usually done in the office. I did my first balloon procedure in 2006 in the operating room and in 2010 in the office. Now I do them exclusively in the office.
This technique has two distinct advantages: a) improved safety from “surgical misadventure” or anesthesia complications and b) almost zero downtime from work and school.
The big disadvantages are that in many cases the balloons simply “aren’t enough” to adequately solve the problem. A badly deviated septum, ethmoid sinus infection, nasal polyps, and allergies are problems not treated with balloons.
Personally I use balloons for treatment often in the office, citing the advantages above. For certain localized infections, milder infections, and frail patients this is an awesome tool.
However our busy practice sees lots of “second opinion” consults after unsuccessful treatment elsewhere. Many of these patients simply need a more aggressive surgical option. And unfortunately many of these patients were “sold” on balloon treatment for purely economic reasons.
There is an unfortunate trend in my community for certain ENT’s to buy tv/radio advertising to market their balloon treatments. Why? This procedure pays well and only takes a few minutes. Some doctors have built an entire practice around doing this.
The problem is abuse and mismanagement. Just this past week I have seen: a)a patient who got 7 procedures in six months for what turns out to be migraines not even infections, b) another patient with three procedures in 1 year, and c) a patient who got a balloon procedure after a 5 minute initial consultation with never having tried antibiotics or having gotten a CT scan – she actually suffered from allergies without any sign of infection (she stated the procedure only took about 10 minutes altogether which means she probably even had a sham operation).
So yes, I am a fan of balloon dilation for many of my patients. I only hope that the technology does not get crushed by the misuse and overuse that is becoming rampant. I have had some great successes with balloons, even for severe infections, but like any other surgical tool it must be used properly.
Good luck with your sinuses and beware of ANYBODY pitching a medical procedure on the radio 🙂