Thursday, June 20, 2013   




Balloon to reduce trauma

David Ho

Tuesday, August 07, 2012

Most people are familiar with the coronary artery procedure called angioplasty. It uses a balloon to expand the narrowed part of the coronary artery which supplies oxygen to the heart.

Now there is a similar technique for the nasal sinuses. It is called sinuplasty and was introduced in Hong Kong only this year. Like angioplasty, it uses a small balloon to dilate the narrowed sinus openings to relieve sinusitis.

Though the procedure may be new to the SAR, the equipment was introduced in 2006 in the United States and Australia.

The Alfred Hospital in Melbourne, where I was an ENT consultant, did a safety and feasibility study for sinuplasty the same year. This research was published in April 2006 in the Annals of Otology, Rhinology and Laryngology.

The equipment from Arthrocare, which is under Johnson & Johnson, is now in its second generation with improved ergonomics and sensitivity.

The indications for sinuplasty are more limited compared to traditional functional endoscopic sinus surgery, or FESS.

Sinuplasty still uses endoscopes to operate but it does not take away any tissue or bones - it just dilates the opening.

The rationale is that if there is less trauma to tissue, there will be less scarring and the patient can recover quickly.

However, this is also its limitation in treating sinusitis.

Sinuplasty cannot remove nasal polyps nor treat ethmoid sinus (the pair of sinuses between your eyes) disease. So, these patients tend to be treated only with FESS.

There have been only about 20 cases done in Hong Kong private hospitals so far.

I did one case last week and it took about 1 hours to perform a septoplasty and sinuplasty as I opened up four sinuses (left and right maxillary sinuses and left and right frontal sinuses). I performed the operation in the early evening, my patient stayed in hospital overnight and left in the morning after breakfast.

It was great that the patient could leave the hospital in less than 24 hours. In Australia, I used to do some of these sinus operations and the patient could even leave the hospital on the same day - but only for certain cases.

There will be more and more sinuplasty cases done for patients, as it should, in theory, take less time and be less traumatic to the nose. However, it will only be suitable for about 40 to 50 percent of all sinusitis patients.

Please ask an experienced ENT sinus surgeon to explain to you your condition and see which technique - sinuplasty or FESS - is suitable in your case.

Dr David Ho is an Australian- and Hong Kong-registered ENT specialist. As consultant specialist in Melbourne, he taught ENT trainees to perform sinus surgery and he specializes in difficult sinus cases or redoing sinus surgeries. E-mail: davidhoent@hotmail.com


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