Relieving the pressure

Michael Lathrop couldn’t take the sinus headaches anymore.

The Arlington man had a blocked sinus passage for years that wasn’t responding to therapeutic drug treatment.

“I was having severe headaches associated with my sinuses,” he said. “I was having repetitive sinus infections.”

Lathrop had standard sinus surgery in the early 1990s, but this time opted for a new method �” Relieva Balloon Sinuplasty.

“The first time I didn’t work for a week, but spent a lot of the first few days sleeping,” Lathrop said. “This time I didn’t even need all the pain medication they gave me. I was up and about and able to function the next day.”

He said he would definitely opt for balloon sinuplasty if he ever needed the operation again.

“The first time was a lot worse than this time around,” Lathrop said. “The main difference was less pain and no packing.”

Dr. Timothy Kuo, a Fremont ear, nose and throat specialist, began performing balloon sinuplasty at Fremont Area Medical Center in August. Since then, he has used the method in at least 50 percent of the sinus operations he performs.

“It’s not a new procedure, it’s a better tool,” Kuo said. “Sinus surgery deals with making bigger openings for spaces in your skull, your nasal cavity. We want to preserve as much tissue as possible.”

Sinusitis is an inflammation of the sinus lining caused by bacterial, viral and microbial infections as well as by blockages of the sinus opening. If mucus drainage does not occur, the condition can lead to infection and inflammation of the sinuses.

Common symptoms of sinusitis include: facial pain, pressure, congestion or fullness; nasal obstruction or blockage; discolored nasal discharge; discolored post-nasal discharge; loss of smell; headache and fatigue. It is estimated that chronic sinusitis is more common than arthritis or high blood pressure, studies have shown.

“The beauty of this balloon is it’s a lot safer and causes the least amount of tissue injury,” Kuo said. “This is actually tissue sparing. It’s fundamentally done the same way.”

Sinus surgery can put the eye sockets, eyeballs and brain at risk if the surgeon would penetrate incorrectly. The balloon technology limits the chance for injury, as the lead will not even puncture skin.

Conventional surgery is done with endoscopic tools that remove bone and tissue to enlarge the sinus opening. They are more rigid and could lead to injury. This leads to post-operative pain and bleeding and requires nasal packing to control.

Relieva Balloon Sinuplasty is a catheter-based technology designed to navigate the sinus cavity in most cases without tissue or bone removal. The guide catheter is lit on the end and helps guide the balloon into the sinus the surgeon is trying to access. The balloon inflates to a pressure of about 12-14 atmospheres to dilate the blocked area allowing it to drain when irrigated.

In comparison, the normal pressure in a car tire is 2-3 atmospheres.

“What determines whether I use the balloon or not is what sinus I have to access,” Kuo said. “If I had to remove tissue or polyps, I wouldn’t use it. It’s a surgeon decision and preference as to how to get the sinus back to normal health state.”

During traditional sinus surgery, a lot of tissue is damaged that doesn’t need to be, he said. That leads to more bleeding, pain and recovery time.

“The less tissue trauma, the speedier the recovery,” Kuo said. “With traditional instruments, you’re actually removing some of the bone.”

The surgery is performed under general anesthesia and he said the balloon will eventually help speed up surgery.

“This is very useful on congenitively narrow sinuses,” Kuo said. “It would also be useful to irrigate mucus, fungus and infection.”

Two-year recovery data from Acclarent, the company that makes the Relieva Balloon Sinuplasty device, shows 94 percent of patients are still doing well two years after the operation.

“In general the recovery from this is much quicker than when you have to remove tissue,” Kuo said.