Dr. Lee Mandel Treats Sinus Headaches with Balloon Sinuplasty When Appropriate - South Florida Sinus and Allergy Center

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Dr. Lee Mandel Treats Sinus Headaches with Balloon Sinuplasty When Appropriate


 
Sinus headaches feel like headaches caused by sinus infections. They can be throbbing and you may feel as though you have pressure pushing on your forehead, cheeks, and eyes. Symptoms can include the following.

  • Increased pain when bending forward
  • Stuffy nose
  • Fatigue
  • Feeling of achiness in your upper teeth

Acute sinusitis and minor sinus headaches can usually be treated with home therapies or non-invasive medications, but chronic sinusitis needs a more comprehensive treatment to lower the risk of complications such as more serious infections.

Proper Diagnosis of Sinus Headaches versus Migraines

Before Dr. Lee Mandel diagnoses sinus headaches or treats patients with balloon sinuplasty for sinusitis, he ensures the headaches are not migraine or tension headaches, especially since the majority of patients who go to a doctor because of sinus headaches actually have migraines. Increased pain when bending forward is a symptom common to both types of headaches, but migraines are associated with bright light, and they can cause nausea and vomiting, unlike with sinus headaches.

First Approaches to Treat Sinus Headaches

The first treatments for sinus headaches can include home remedies such as staying hydrated, letting the sinuses drain overnight by sleeping upright, and keeping the sinus cavities moist with water vapor from a bowl of hot water or a hot shower.

Your doctor may then recommend nasal decongestants or corticosteroids or over-the-counter pain relievers. If these treatments do not work and sinus headaches continue for at least 8 weeks, they are considered chronic. You may be a candidate for surgical treatment such as balloon sinuplasty.

How Balloon Sinuplasty Works

Patients receive local anesthesia. The doctor places the balloon catheter at the target site in the sinus, whether frontal, sphenoid, or maxillary. During this process, suction helps clear out the passageway. Once positioning is verified, often using a light or CT imaging, the doctor inflates the balloon to hold the sinus passageway open, and removes the device.

Effectiveness and Safety of Balloon Sinuplasty

Balloon sinuplasty is considered to be a low-risk treatment. This is especially true when compared to traditional functional endoscopic sinus surgery, which uses metal instruments to cut tissue to open up space in the sinus. In contrast, balloon sinuplasty uses a balloon to make room.

Balloon sinuplasty has a complication rate of less than 0.1 percent. The procedure is highly effective, with only 5 percent of patients needing to return for a second procedure. In the cases for which balloon sinuplasty does not work, patients are still eligible for other treatments; balloon sinuplasty does not preclude other strategies.

Within days, patients can be back at work and their regular lifestyles, without sinus headaches. This cost-effective treatment is convenient, since it can be done in the doctor’s office and under local anesthesia.

Sinus Dilation Procedure / Balloon Sinuplasty

If you have chronic or recurrent sinusitis, treatment may begin with conservative approaches such as warm, moist air, antibiotics, oral steroids, and nasal sprays. You may need surgery if these approaches do not relieve symptoms, or symptoms return.

Balloon sinuplasty is a type of surgery that uses a balloon instead of a wire catheter to dilate your sinus passages. Your ear, nose, and throat doctor may offer it in her office. This is how the procedure works.

Diagnosis and Scheduling

Symptoms that last for at least 8 weeks or that return are indicative of chronic sinusitis. Once your ear, nose, and throat doctor tries other remedies and is unsuccessful in permanently eliminating symptoms, you may be scheduled for a sinus dilation procedure known as balloon sinuplasty.

Patient Prep

Doctors may prescribe antibiotics and anti-inflammatory medications before the procedure to get inflammation under control. Patients may receive a sedative when they arrive at the clinic to relax them. The procedure occurs under local anesthesia, which can be administered through a nasal spray.

Preparation for the Procedure: Choosing a Dilation System

The doctor chooses a dilation system to use. Entellus Medical Balloon systems include the XprESS Ultra, XprESS LoProfile, and XprESS Pro Multi-Sinus Dilation systems. Each is capable of treating frontal, sphenoid, and maxillary sinuses. They differ in their balloon sizes and suction strengths. The XprESS Ultra and XprESS LoProfile have LED light fiber, while the XprESS Pro allows for CT image guidance.

Placing the Catheter

The procedure begins with the insertion of the balloon catheter into the inflamed sinus. The doctor can use the light fiber or CT image guidance systems to help place the balloon catheter properly. The doctor can confirm proper placement using fluoroscopy. The device also needs to be positioned, or oriented, properly. During this time, the doctor uses suction to clear the area to improve visualization ability.

Inflation of the Balloon

Once the catheter is properly positioned, the suction is removed. Then the balloon is inflated to dilate the site of treatment. The doctor pushes the plunger rod until the markings indicate that the balloon is sealed. This may take multiple tries.

Next, the doctor removes the treatment device and repeats the process in every other treatment site that requires it. At the end of the process, materials such as excess tissue and bone are removed to allow for proper healing.

Patient Recovery and Prognosis

Balloon sinuplasty is a low-invasive procedure. After the procedure, patients can often return to work within one or two days. Travel is usually possible within two or fewer weeks. Success rates are high, and only about 5 percent of patients need to repeat the procedure due to symptoms returning.