Sinuplasty Archives - John Austin, MD, FACS

Balloon Sinuplasty

September 1, 2017

What is Balloon Sinuplasty?

In the early 2000’s Balloon Sinuplasty (balloon sinus dilatation) was developed and made popular first in Europe and then in America. The procedure uses principles designed and expanded upon by radiologist and cardiologist in the dilatation and stenting of vascular diseases. Balloon dilation sinuplasty reshapes and expands the drainage pathways of the maxillary and frontal sinuses.

Why choose Balloon Sinuplasty?

The advantage of Balloon Sinuplasty (sinus dilation) over endoscopic sinusitus surgery includes less pain and bleeding, a convenient one day office procedure, no general anesthesia, quick recovery, minimal time away from work, a decrease in health care cost, and near instant lasting relief.

Am I a good fit for Balloon Sinuplasty?

The ideal patient for Balloon Sinuplasty is a patient with either recurrent or chronic sinusitis due to anatomic, allergic, or environmental problems. Most patients experience predominant symptoms of facial pain, headaches, upper dental pain, and forehead pain. Often times the pain associated symptoms are worse during periods of weather change or sudden temperature or barometric pressure changes. Balloon Sinuplasty risks are minimal.

How does Balloon Sinuplasty work?

Balloon Sinuplasty requires a CT scan to define the anatomy of the sinuses and rule out more serious sinus or respiratory problems. Patients generally already have been treated with a nasal steroid spray, antihistamines, and an antibiotic. Your ear, nose and throat doctor will usually have the patient continue the nasal steroid spray up to and right after Balloon Sinuplasty.

The procedure is done in the office after the patient has taken a prescription sedative like valium (diazepam). It typically takes less than an hour to topically anesthetize the sinus outflow tracts and safely perform the balloon dilatation. Patients are observed for a short period of time and then discharged home with a friend or family member. Balloon Sinuplasty recovery is minimal– the majority of patients can return to work the next day.

Almost 70% of Balloon Sinuplasty patients will have long term improvement in symptoms.

How much does Balloon Sinuplasty cost?

Balloon Sinuplasty is typically covered by insurance. Call our office today to get a free estimate based on your insurance coverage. You can also click here to check to see if Balloon Sinuplasty is covered by insurance.

The Sinuses

The sinuses are hollow cavities in the bones of the face that are lined by mucosa. Mucosa is the soft pink tissue that lines the inside of the mouth. There are four sinuses: the paired frontal sinuses, maxillary sinuses, ethmoid sinuses, and a single sphenoid sinus. There are several functions the sinuses perform. These include production of mucus that helps the nose humidify and clean the air that we breath. This mucus also collects pollen, pollutants, viruses, and bacteria and helps clear it through the digestive system.

What causes Sinus Infections?

Sinus infections are an inflammation of the lining tissue of the sinus and their drainage pathways. Typical symptoms include headache- pressure like pain of the face, forehead, cheeks, and pain around or behind the eyes, dental pain, and tenderness of the face. Some people experience loss of smell, bad breath, cough, fever, sore throat, and discolored nasal drainage. Some patients experience fatigue and malaise.

The causes of sinusitis are the common upper respiratory viruses, allergies to pollens and mold, environmental irritants like air pollution, or tobacco smoke. Blockage like a deviated septum, polyps, or narrow anatomic drainage pathways can also cause sinusitis. If the mucus produced by the sinuses does not drain into the nose it will eventually stagnate and become infected with viruses and bacteria. Sinus infections are categorized as an acute infection, recurrent infections, and chronic infections.

In general an acute infection last less than four weeks. Recurrent infections are defined as 4 infections in a year. There are periods of relief in between infections. Chronic infections are symptoms that last more than 12 weeks. Symptoms may improve but generally do not completely resolve. Medical treatment includes the use of nasal irrigation (saline rinses, netti pot, holistic irrigants), oral decongestants, topical decongestants, topical steroids, mucolytics, and immune modifiers ( antihistamines, leukotriene inhibitors, steroids).

The goal of medical treatment is to reduce swelling, thin mucus, establish drainage, and treat the infection. There are several unwanted side effects of medical therapy including nasal dryness and bleeding. Antibiotics are expensive and can cause diarrhea and lead to the development of antibiotic resistant bacteria. Decongestants can cause rebound congestion, elevated blood pressure and a rapid pulse, nervousness and trouble sleeping. Antihistamines can cause drowsiness and thickening of nasal secretions. Oral steroids are limited to short durations of therapy due to numerous side effects including depressed immune system, elevated blood sugars, joint complications, acne, and weight gain.

Types of Sinus Surgery

Due to the severity of sinus infections and their effect on the health of patients that suffer from recurrent and chronic sinus infections Otolaryngologist have developed novel surgeries with limit invasive side effects to treat sinusitis. In the early 1980’s Endoscopic Sinusitus Surgery (nasal surgery) was popularized in America. Today approximately 500,000 Americans have outpatient endoscopic sinus surgery performed each year.

Although different names and techniques are described for this procedure it generally entails a general anesthetic and at least a week of limited activity for recovery. Several postoperative visits are necessary, and patients have to clean their sinuses regularly with sinus irrigants, and topical steroids are used for several weeks after surgery. There is a short period of postoperative pain and mild bleeding after surgery. Patients will require several postoperative visits fordebridement of crusts and mucus.

Traditional Sinus Surgery Process

Balloon Sinuplasty Process

Dr. John Austin is a Balloon Sinuplasty expert

Dr. Austin performed his Fellowship in Head and Neck Surgery at the prestigious University of Texas and MD Anderson Cancer Center in Houston, Texas. After his training he served as an Assistant Professor for four years in the Head and Neck Surgery Department, at MD Anderson and has been a practicing ENT (and sinus doctor) for more than 20 years. Dr. Austin performs only the latest techniques in sinus surgery and Balloon Sinuplasty.

Dr. Austin has two convenient ear, nose and throat office locations in Brownsville and Harlingen.

To find out if you are a candidate for Balloon Sinuplasty, make an appointment with Dr. Austin today!

Is Balloon Sinuplasty Right For You?

July 28, 2016

Are you tired of dealing with chronic sinusitis? Balloon Sinuplasty might provide the permanent relief you’re looking for—performed in our office by Dr. John Austin, it’s minimally invasive, safe and effective.

Balloon sinuplasty is a therapeutic technique that has been used for years to safely dilate the openings of the 3 primary sinuses of the face; the frontal, the maxillary and the sphenoid sinuses. It uses a small balloon inserted into the ostia of the sinuses to enlarge the openings of the sinuses. It is considered an atraumatic way to improve the health of the sinuses.

The procedure is usually done in our office with light oral sedation. It does not require a general anesthetic or a trip to the operating room. Patients can return to their routine activities as soon as the day after the procedure. There is minimal discomfort associated with the procedure. Most ENT physicians will prescribe a light anti anxiolytic medication like Valium or Xanax. Some also prescribe a low dose of a narcotic. These medicines are taken soon before arrival to the physician’s office. A friend or family member will then drive the patient home.

Sinusitis Symptoms

Facial pain
Facial congestion or pressure.
Headaches
Fatigue
Nasal blockage or discharge
Tooth pain
Discolored nasal drainage
Temperature
Bad breath
Bloody nasal discharge

What is a sinus?

The sinuses are hollow air containing cavities in the skull that are lined with a tissue called mucosa. Mucosa is the same tissue that lines your mouth and throat. Mucosa is generally a soft tissue that is moist and has many microscopic organs called glands. It is also lined with very small ciliary cells that can move the mucus produced in the sinus into the nose through small openings know as ostia. When the sinuses are healthy you are not even aware that they are there.

The sinuses can be irritated by blockage of their outflow tracts by swelling of the mucosa. This swelling can be produced by reactions to pollen, pollution, dust, mold, viruses, and bacteria. If the sinuses stay blocked the mucus they produce will back up in the sinus. If the mucus stays plugged for long it will become infected. Both viruses and bacteria can cause infections. On rare occasions mold can even cause infections

What benefit will balloon sinuplasty provide?

Balloon sinuplasty uses a small balloon to gently and safely reshape and open the sinus drainage pathways, thus restoring the natural aeration and drainage of the sinuses. Balloon sinuplasty offers quick recovery. Most patients return to their regular activities same or next day. This procedure is done without general anesthesia.

Sinus dilatation keeps the sinus passage open producing a long term relief from the problems of sinusitis. This can include less facial and sinus pain, improved breathing and less congestion. Patients will notice a decrease in nasal drainage, less trips to the doctor, and fewer courses of antibiotics.

What does Balloon Sinuplasty Cost?

Most often balloon sinuplasty is covered by insurance (including Medicare) and you will only be responsible for your co-pay or deductible. A computed tomography (CT) scan must be obtained and submitted to the insurance company for pre-authorization, along with the physician’s clinical findings. Our office will contact your insurance company for approval before the procedure is scheduled.

Our in-office procedure is usually much less expensive for the patient than a procedure in an operating room.

How do I get started?

Call our office today to schedule an examination with Dr. John Austin. You can also click the button below to schedule your appointment online.

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Is Sinusitis Causing My Facial Pain?

July 22, 2016

When I see a patient with facial pain my goal is to determine if there is some underlying problem of the nose or sinus system that may be causing that pain. The pain sensors in the muscles, bones, tendons, and cartilage of the face are some or the most sensitive in the entire body. Think about it, your lips and tip of your nose just barely have to be touched to trigger the sensitivity of a sneeze or the pain that something is too hot.

Sensitivity is not specificity. What does that mean? In the face it means that a sensation may be triggered in one part of the face but felt in another. A classic example is a “brain freeze” when you eat something cold. Pain in one part of the face, mouth, throat or neck can be triggered from a different location.

Sinus headaches are a common source of vague facial pain. Some people will feel sinus pain very specifically. They will notice pain in their cheeks or forehead. The pain can be variable. It may be sharp pain that is constant. It may be a dull aching pain. Sometimes nothing makes it worse; sometimes positional changes will make it worse. Weather and temperature changes can be associated with sinus pain. Chewing can make it worse; sneezing can produce very sharp sinus pain in some people. Sudden temperature changes can trigger facial pain that is originating in the sinuses.

Our 3 largest sinuses: the maxillary, frontals, and sphenoid have small openings that pass into the nose. It is important for these sinus openings to stay open and communicate with the nose. If they become blocked they become susceptible to developing a negative pressure that can produce a vacuum effect in the sinus, in turn this can produce pain symptoms by stimulating nerve endings in the sinuses and the associated tissue around the sinuses. Often times patients with facial pain, especially a pressure type pain will notice that their pain is worse when they bend over or lay down. They also will notice that their headaches will increase when there is a change in barometric pressure during periods of rain. Acute temperature changes can also trigger their headaches. An example in the summer is walking from outdoors into a room that is air conditioned.

Another problem will develop if the sinuses don’t communicate through their natural openings, namely infections. The sinuses produce mucus. That mucus is moved into the nose by natural forces. If that mucus cannot drain into the nose it will back up in the sinuses. It will eventually be contaminated by viruses and bacteria and can become infected. When the sinuses are infected several symptoms can occur. These include facial pain, pressure, discolored nasal secretions, malodorous breath, dental pain, pain around the eyes, temperature and facial swelling.

The new minimally invasive technique called Balloon Sinuplasty (or balloon sinus dilation) can be used to dilate the openings of the sinuses. By enlarging the sinus openings, the sinuses will be able to communicate with the nose in a normal fashion. This improves the health of the sinus, allows the mucosa to cleanse itself, allows the mucus produced in the sinus to be eliminated through the nose, and generally keeps the system in a healthy equilibrium.

For many patients Balloon Sinuplasty produces a long-standing resolution of the problems. It is a quick, one-day procedure with minimal risks and is performed in the office with no downtime for recovery or side effects. It is considered much more natural than continual antibiotics, nasal steroid sprays, and extensive sinus surgery. Nasal Balloon Sinpulasty cost is typically covered by insurance, so please call our office for more info.

Click here to learn more about Austin’s Balloon Sinuplasty and sinus pain expert, Dr. John Austin or simply click here to schedule an appointment.

Mouth Breather – Causes, Symptoms and Treatments

June 3, 2015

Image credit

If you are a mouth breather, you may assume that the worst side effect is getting grief from others about your habit. However, as a mouth breather, there are some serious and significant problems associated with your breathing.

Breathing, even if you don’t think of it often, is a complex process which must be coordinated at all times. Your nose is a vital organ despite what you may think. As the American Academy of Otolaryngology states, the nose “…processes the air you breathe before it enters your lungs. Most of this activity takes place in and on the turbinates, located on the sides of the nasal passages.” Consider the last time you had a cold. Most likely your sleep was disrupted during the night leading to reduced cognitive functioning, low energy levels and change in mood the next day. This is the constant battle facing a person who is a mouth breather.

What Causes one to be a Mouth Breather?

There are three types of mouth breathing: obstructive, habitual and anatomic. The most common cause of mouth breathing is obstructions. Nasal airway passageways may be partially or completely obstructed. Some women find that during the third trimester of pregnancy they experience what is known as pregnancy rhinitis. Frequent causes of mouth breathing include:

Chronic Allergies

Particularly in children, chronic allergies lead to nasal airway obstruction. Though everyone experiences either allergies or a cold that causes mouth breathing, chronic allergies lead to mouth breathing being the normal way of getting air.

Adenoid Hypertrophy

Your adenoids are composed of tissue that connects the nasal cavity to the throat. Adenoids exist to fight off infections due to viruses or bacteria that enter your body through the nose. However, sometimes adenoids can be enlarged and when this happens they can lead to mouth breathing. Other complications from enlarged adenoids include loud snoring, sleep apnea and breathing that sounds labored.

Turbinate Hypertrophy

Turbinates are masses of tissue in your nose that warm and moisten the air you inhale. When your inferior turbinates become abnormally large they can cause a nasal obstruction that leads to mouth breathing. Other experiences that may appear with turbinate hypertrophy are a persistent runny nose, and nasal obstruction that worsens when you lay down.

Deviated Septum

The septum is a wall that separates the left nasal cavity from the right nasal cavity. Your septum is composed of cartilage in the front and bone in the back. It is completely normal to have one nasal cavity to be larger than the other, in fact nearly 80% of people experience a deviated septum according to the American Academy of Otolaryngology. However, there are some deviated septums are so severe that they lead to nasal obstruction. When you cannot breath properly through your nose, you become a mouth breather.

What Symptoms Does a Mouth Breather Experience?

Mouth breathers often wake up with a dry mouth and throat. Dryness is also experienced in the daytime as well, but can be temporarily remedied by moistening the lips. While a dry mouth and throat seem annoying but harmless, other symptoms mouth breathers experience are far more problematic to their health. Symptoms of mouth breathing include:

Poor quality of sleep
Daytime fatigue
Low energy
Reduced cognitive functioning
Excessive snoring during sleep
Habitual bad breath
Sore throat
Dental conditions
Gingivitis

Additionally, a mouth breather has an increased risk of cardiovascular disease. Mouth breathing reduces the amount of oxygen found in the blood, which can lead to high blood pressure and other heart complications.

What Treatments are Available to Mouth Breathers?

Mouth breathing is not a new medical threat. In a paper published by the Proceedings of the Royal Society of Medicine in 1913, W.W. James states that: “[t]he ill effects produced by nasal obstruction and mouth-breathing are so significant that in all branches of medical science the establishment of normal respiration is regarded as of the utmost importance.”

In children it is often the dentist who notices and diagnoses mouth breathing. A child mouth breather exhibits gingivitis and possible facial and dental development. Treatment for mouth breathers is performed by an ear, nose and throat doctor. The treatment necessary for mouth breathing is dependent on the cause of mouth breathing. Some of the possible treatments for mouth breathing are:

Septoplasty – During a septoplasty, your doctor will straighten and correctly position the septum.
Rhinoplasty – Not always done for cosmetic reasons, a rhinoplasty operation reshapes and modifies the nasal bones and cartilage.
Turbinate Reduction Surgery – Turbinate reduction surgery often takes place at the same time as a rhinoplasty. These surgeries, as the name implies, reduce the size of the turbinates. There are several options for turbinate reduction surgery. One possibility is radiofrequency reduction, which shrinks the size of your nasal turbinates without having to remove any nasal tissue or bone.
Adenoidectomy – This surgery is most often performed on children and is completed at the same time as a tonsillectomy. During an adenoidectomy, the adenoids are completely removed.

If you are a mouth breather, it is important to seek medical attention as soon as possible to rectify the cause of your mouth breathing. A trusted ENT doctor, Dr. John Austin, has been practicing as an Austin ENT for 20 years. Dr. Austin has a broad range of expertise and treats patients who suffer from many ENT conditions, including mouth breathing. Contact one of his three office locations today to begin the process of normal respiration.