Photos by Marlene Karas/ViewDr. Ashley Sikand, who practices at Ear, Nose & Throat Consultants of Nevada, 7040 Smoke Ranch Road, talks about Balloon Sinuplasty, a technique to relieve certain sinus problems.
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One tiny balloon. One quick procedure. One big sigh of relief -- literally.
Chronic sinusitis sufferers can now find relief in Balloon Sinuplasty, an innovative and minimally invasive surgical technique that permanently opens passages.
Formerly, endoscopic sinus surgery was used. It involved cutting away and removing the bones to enlarge the opening.
Sinusitis is an infection or inflammation of the mucous membranes that line the sinus cavities. When a mucous membrane becomes inflamed, it swells. This can block the normal drainage of fluid from the sinuses into the nose and throat. Bacteria and fungi are more likely to grow and cause infection in sinuses that can't drain properly.
The CDC approximates that 32 million people in the U.S. suffer from sinusitis. Congestion, difficulty breathing, pressure in the face, post nasal discharge and fatigue are common symptoms.
Balloon Sinuplasty utilizes a small catheter threaded up into the sinus cavity with a balloon attachment. By activating the balloon at the sinus' narrowest passage way, the rapid expansion creates a larger passageway, restoring normal sinus drainage and function.
Dr. Ashley Sikand, an otolaryngologist whose northwest office is located at 7040 Smoke Ranch Road, was one of the first ear, nose and throat specialists in Las Vegas to perform the procedure in Southern Nevada. That was in January 2006. Since then, he's done about two a month.
During the procedure, a wire is snaked up the nasal cavity and placed at the narrowest spot. With the press of a button, a balloon at the end inflates quickly, much like a car's air bag, breaking the thin bones in that area of the sinus.
"It's like breaking an eggshell," Sikand said.
With the bones broken and pushed aside, the passageway is larger. The sinus remains open once the balloon is deflated and withdrawn. Sikand says he can depend on about a 7 mm opening as the result. Normal sinus passageways are 2 mm in diameter, he said.
Risk of infection is always a possibility with surgery, but because Balloon Sinuplasty involves no incisions, the risk is diminished. Patients usually sustain no bruising or swelling and are back at work the next day. "Packing" the nose after surgery to absorb bleeding is not necessary.
One of the people who underwent the procedure is Bill Rio. The 62-year-old retiree said he's had sinus problems for the past 30 years.
Besides a stuffy nose, there was constant sinus pressure. He took sinus tablets twice a day, plus he used nose spray to try to keep his passages open.
Rio's job as an architectural woodworker had him flying from his home in New Jersey to Chicago.
"When we'd descend really fast, it was bad. I'd get a headache like you wouldn't believe," he recalled.
His symptoms were exacerbated when he and his wife, Rose, moved here a few years ago. Rio went to see Dr. Sikand, who determined he was a candidate for the surgery.
Rio underwent the procedure in July and came out of surgery with no black eyes, no pain.
"I couldn't even tell he'd done anything," he said.
More to the point, his constant sinus problem was a thing of the past, he said.
Sikand's Balloon Sinuplasty surgeries are done at Summerlin Hospital Medical Center, 657 Town Center Drive. General anesthesia is involved and the operation usually takes 45 minutes.
The procedure was modeled after the balloon angioplasty procedure cardiologists use to widen the clogged coronary arteries of heart patients.
As the procedure is relatively new, there is some tweaking involved. For example, it used to be necessary to take an X-ray to ensure proper placement of the balloon.
But doctors discovered the same information could be obtained by fluoroscopy -- using the light at the end of the wire.
Now, there are two different techniques to confirm placement of the guide wire and balloon catheter. The first is with fluoroscopy, which is a type of X-ray imaging. The second is via intense light, a technique called trans illumination.
"You can tell when it's in the right position -- it lights up the room," Sikand said.
Trans illumination is a new development and has not had wide clinical application at this time.
The National Institute of Allergy and Infectious Diseases reports that Americans lose more than 73 million days of work and school, spend over $5 billion on sinus products and receive over 13 million antibiotic prescriptions for sinusitis per year.
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