High pressure balloons have been used for decades for various medical indications. Most well-known is their use in angioplasty, a method of remodeling the inside of blood vessels in the heart and other areas. More recently, this technology has been adapted as a minimally invasive tool in sinus surgery. Balloon sinus dilation, also known as sinuplasty, has been available for a little over a decade, becoming even more widely used in the past 5 years as additional studies have been performed to demonstrate the safety and efficacy of this technique.
During the procedure, an initial guide is directed into the sinus opening using small endoscopes. A light fiber within the guide helps confirm proper placement, as the light can be seen shining through the skin overlying the target sinus. Then, a balloon is advanced over the guide into the sinus opening and inflated with saline. When inflated to a high pressure, the balloon displaces the surrounding tissue to widen the sinus opening. In contrast to standard sinus surgery techniques that involve removal of tissue, the balloon technique does not remove any tissue. It fractures the thin bones surrounding the sinus opening and pushes these bone fragments out of the way, leaving the overlying mucus membrane lining largely intact.
Because no tissue is removed, healing is faster and there is less pain, leading to a faster recovery period. The balloon technique is commonly employed as a part of in-office sinus surgery, being performed under local anesthesia and creating a more comfortable, more convenient and more cost effective option for sinusitis patients.
Balloon sinuplasty is not appropriate for every patient. Patients with severe mucosal disease or nasal polyps, for example, generally do better with standard sinus surgery techniques, which create larger openings to allow more effective topical medical therapy.