Balloon sinuplasty offers sinusitis sufferers a faster path to recovery

This story first appeared in the April 2024 edition of Healthy You, a quarterly health publication and Gazette special section.

While spring can be a torturous few months for seasonal allergy sufferers, for some people, the symptoms of congestion, drainage, sinus infections and trouble breathing are a year-round problem.

“Chronic sinusitis is when the tissues, or the nasal system, has become dysfunctional for some reason — either the tissues are swollen or stay persistently swollen that they don’t move mucus along the way they’re supposed to. Or the openings to the sinuses are partly or completely obstructed so that when things flare up, there’s no place for the fluid to go or it builds up and causes issues,” said Dr. Shane Gailushas, an ear, nose and throat physician at Mercy Medical Center and founder of the Sinus and Nasal Center there.

A relatively new procedure called balloon sinuplasty offers an anesthesia-free, quick, in-office alternative to surgery for chronic sinus disease sufferers. While not everyone may qualify for the procedure, those who choose it means less time off work and an immediate return to activities with the same results as traditional sinus surgery.

Before getting a balloon sinuplasty, patients are first treated with antibiotics and allergy medicines to see if those can resolve the issues. If problems persist, doctors will look inside the nose to see if there are any nasal polyps. These are non-cancerous growths in the nose in response to inflammation that cause obstruction and need to be removed. If there are no polyps, a CT scan will show doctors the sinus cavities and openings clearly, to see where there might be tissue thickening on the lining or obstructions.

People who are great candidates for balloon sinuplasty are those with mild to moderate sinus disease and those who can’t do traditional surgery, whether from age or situations like not being able to go off blood thinners. All of the patient’s options are presented and discussed.

“The approach is really individualistic. You want to pick the things that are going to work best for that individual based on their symptoms and what you’re seeing,” Gailushas said.

The procedure

In the office, patients are given several iterations of numbing medicine on small cotton sponges placed in the nose, which is absorbed well by the tissues there. Doctors will also do an injection, just to make sure patients are comfortable, which most people won’t feel, Gailushas said.

Prior to the procedure, a 3D map is made using the CT scan, which doctors use to guide a soft coil through the nasal passages. The deflated balloon is then slid along the wire into the opening, inflated for five to eight seconds, depending on the sinus being worked on, then deflated and everything is pulled out.

By opening the balloon in the cavity, Gailushas says the nasal tissue is “shocked” into expanding, as opposed to physically making the opening bigger by removing tissue as is done in a traditional surgery.

While patients might experience swelling for a while after the procedure, once that goes away, the nasal cavities will remain more open than before.

“You’re trying to get the sinus opening to reset and function better, and that leads to better sinus flow and better mucus clearance, and subsequently the sinus disease is easier to manage,” Gailushas said.

Liz McMann, 42, of Cedar Rapids, chose balloon sinuplasty over traditional sinus surgery because, as a mother of two who works full-time, the recovery time would be faster. It would also be significantly less expensive.

McMann had what felt like a stuffy nose for years that wouldn’t go away. After two rounds of antibiotics and taking both Allegra and Flonase at the same time didn’t help, she got a CT scan.

“They were able to see through the imaging that one of my nasal cavities was half-full of mucus, just kind of sitting in there festering,” McMann said.

After getting her balloon sinuplasty, which McMann says took less than half an hour, she says her breathing and sleeping have improved a lot.

Maintenance and care

While balloon sinuplasty creates a “reset” for your sinus tissue, “below all of this, there is always some inflammatory issues,” Gailushas said. “Whether someone has allergies — in Iowa, we have a lot of people who are sensitive to fungus and molds — if we don’t treat that underlying problem, the balloon sinuplasty won’t last.”

Gailushas continues to see patients after the procedure to help them continue to manage their allergies.

Sinus disease can develop slowly over time, with changes tending to be subtle. Patients get used to a new “normal” in how they breathe. “Sinus issues are generally chronic at their heart. You can’t escape pollen, and in Iowa you can’t escape it for sure,” Gailushas said.

“My favorite thing is when people say, ‘I went through my spring, and usually I’m like this, but this time I was way better!’ or ‘I was able to sleep at night and my spouse says I don’t snore!’ I love those stories,” he said.