Sinusitis Treatment Breakthrough - Balloon Angioplasty

[webslave]

Sinusitis is extremely common in men with CPPS/pelvic myoneuropathy. This is probably due to the fact that we also have a much higher incidence of allergies than the general population. The good news is that there is a simple surgical procedure on the horizon to help with sinusitis:

Using Balloon Angioplasty to Open Sinuses
By LAURA JOHANNES
October 3, 2006; Page D3, WSJournal

Balloon angioplasty is now being used to open sinuses. Acclarent Inc., which sells a balloon device used to treat patients with chronically clogged sinuses, says the gentle action of the tiny balloon is less traumatic for patients than traditional sinus-clearing surgery, in which metal instruments are used to remove bone and tissue. Otolaryngologlists say the balloon treatment is safe and works very well -- at least in the short term -- but caution that only a select group of patients who need surgery can completely avoid the traditional cutting and scraping.
* * *

Every year, about 37 million Americans suffer from sinusitis, a painful condition caused by infected and inflamed sinuses, according to the National Institutes of Health. The condition causes headaches and sometimes pain between the eyes and in the jaw, ear and neck.

Patients often get relief from decongestants, antibiotics or steroid sprays to reduce inflammation. But when those methods don't work, many turn to surgery in which bone and soft tissue are removed to clear the sinus passages.

The most commonly used procedure, called functional endoscopic sinus surgery, provides significant relief to most patients. However, it can be unpleasant, and some patients take mild narcotics to dull post-surgical pain and headaches. The traditional surgery also can require one to three return visits to the doctor for a much-dreaded procedure called debridement, in which metal instruments remove scabs caused by the initial surgery. The surgery is fairly safe, but in very rare cases, it can result in brain or eye damage due to a puncture through the sinuses.

In the balloon surgery, no tissue is removed. Instead, a balloon is inserted into clogged drainage holes in the sinuses. As it is inflated, the balloon pushes away soft bone and tissue, creating a larger hole and allowing mucus to drain. Both balloon surgery and the more traditional surgery are usually done under general anesthetic. However, a growing number of doctors are doing the balloon procedure with only local anesthetic. Neither procedure generally requires a hospital stay, and both are covered by most insurance plans.

The balloon, in theory, can leave much of the patients' natural tissue in place. Until recently, however, nose angioplasty technique was backed with little scientific evidence. That changed last month, with several presentations at the American Academy of Otolaryngology -- Head and Neck Surgery in Toronto.

Acclarent, of Menlo Park, Calif., presented results from a study of 115 patients. Of the sinuses that researchers were able to see clearly six months after surgery, 98% remained open. No significant side effects were reported.

Also presented at the scientific conference was a retrospective look at 70 patients half of whom had the balloon surgery and half of whom had the traditional surgery. That study, performed by independent researchers, found patients who had the balloon surgery experienced equal relief from sinusitis symptoms. They also used less narcotic pain medication following the surgery and reported much higher satisfaction, says study author Michael Friedman, chairman of head and neck surgery at Rush University Medical Center in Chicago.

But the catch, some doctors say, is that the balloon cannot be used to treat the ethmoid sinuses, honeycomb-like structures located between the eyes that are a major cause of sinus misery. Doctors say at least 85% to 90% of patients who seek surgery for sinusitis have ethmoid clogging, often with problems in the other sinuses as well. Also, patients with nasal polyps, which often accompany sinusitis, must have them removed using traditional surgical methods.

Acclarent agrees that its device can't remove polyps or treat the ethmoid sinus, but said it is working on new technology to treat the ethmoid. Some otolaryngologists say they don't use the balloon because most of their patients need traditional ethmoid surgery anyway. Others are doing a hybrid procedure where the ethmoid is removed manually and other clogged sinuses are treated with the gentler balloon method.

Doctors also caution that, while early results from the balloon surgery look promising, follow-up data have so far only been reported up to six months. No one knows yet whether the sinuses will close up again, necessitating further surgery. Acclarent says it is now conducting longer-term studies and plans to publish the results.

[james-d]

I had my first/only sinus surgery a year ago (alright 10 months ago) and I have had great results - I used to get 6 - 12 sinus infections every 6 months - I have only had one minor one in the past year - and it cleared up easily.

I was afraid of the surgery - and the recovery was very hard fo me (harder then most according to my Dr.) - but well worth it.

I was totally afraid of it and the side effects though.

I must admit - after the surgery I could not smell anything for about 4 months - that was very weird - but its back now....

[webslave]

Balloon angioplasty?

[james-d]

no - just standard surgery - through the nostrals - hollow out the sinuses - horrible recovery period - then - no more infections!

[webslave]

Some caveats and reservations about the new procedure
http://www.ahrp.org/cms/content/view/161/27/

Flash animation of the procedure:
http://www.acclarent.com/professional/flash.html

Latest news on procedure
http://www.acclarent.com/about/news.html

[james-d]

interesting stuff - thanks for the update.