[F951]Functional Endoscopic Sinus Surgery

A new sinus surgery procedure has emerged in recent months. It is called sinuplasty, and it is similar in concept to angioplasty. That is, a small balloon is inserted into the sinus passages of the patient, the balloon is inflated, then deflated, and then removed. It is claimed that the passage will remain open for some time because of the small malleable bones in the part of the head where the sinuses are located. The theory is that once the balloon is withdrawn, these bones have been moved slightly and will remain in place. If this in fact proves to be true by follow-up tests and studies, this would undoubtedly be an interesting option for many sinus sufferers.

It is claimed that there is little pain in the sinuplasty procedure. I personally have had two , and the pain and discomfort involved in each was substantial. After the first operation my nose was "packed". That is, a large amount of gauze was placed in each nostril to stop bleeding and help start the healing process. Thus, all breathing has to be done through the mouth for the week or so that the gauze stays in the nose. It is very difficult to eat like this, because one cannot swallow food and breathe at the same time. Removing the gauze was another painful experience. The ENT specialist said that "this will feel like I'm pulling your brains out". He was right, and that is exactly what it felt like. With regard to pain, I feel that I'm willing to tolerate it if going through the pain will accomplish something. In the case of my two sinus operations, I was still coming down with infections afterwards, so all the pain was really for nothing.

There are no long-term, scientific studies yet to show how effective the operation is. Several are under way, however, and it will be interesting to see the results. One study of 100 patients is due to be released in September, and another with 80 participants should be released subsequently. I personally don't recommend sinus surgery to people because it seems that even if there are positive results, they only last a short time. I've heard of people having had 4 or 5 sinus operations, and one wonders what operation number 5 might accomplish that numbers 1-4 did not. The anecdotal stories of people who had suffered from chronic sinusitis and tried sinuplasty are encouraging, however. The ABC evening news ran a story about the procedure not long ago, and they interviewed a person who said her results were immediate and excellent. In any case I would recommend trying pulsating nasal irrigation with a saline solution before any surgery procedure, but if simplasty proves to be effective in the long term, this may be an excellent option for many sinusitis sufferers. If one has polyps, however, it should be noted that sinuplasty will not be an option, as the polyps will need to be removed by invasive surgery.

The sinuplasty procedure was invented by a doctor who himself had severe sinus problems, and he had the thought that something analogous to the angioplasty balloon procedure might be applicable in the sinus cavities. He is now producing and selling the medical device which is used in the procedure, and this has recently been approved by the FDA for use in operations. Only about 100 doctors in the U.S. have been trained to do this operation so far. The results of the studies mentioned above will no doubt influence if some of the over 350,000 traditional invasive sinus surgeries performed each year in the U.S. can be changed to this non-invasive variety.