If you are having probems with your nose or sinuses, the Arkansas Sinus Center has a solution. Typically, the first line of treatment for nasal or sinus problems is medications, such as antihistamines, nasal sprays, antibiotics, or steroids. Sometimes these medications are either not enough or they help for a short time and then the problem comes back. Repeated courses of antibiotics or steroids may be a sign of a chronic problem that can be improved with a nasal procedure. We offer a full range of nasal and sinus procedures to start giving you relief with a focus on in-office treatment to save you time and money.
Read below to find out more about Balloon Sinuplasty, Endoscopic Sinus Surgery, Septoplasty, Turbinate Reduction, Nasal Polypectomy, and Medical Management.
Balloon sinuplasty (or balloon sinus dilation) is a minimally-invasive sinus procedure that can be performed on patients with chronic or recurrent sinusitis. Tiny balloons are placed in the natural openings to the sinuses and then expanded to enlarge the sinus passageways. The goal is to improve ventilation and drainage of the sinuses and restore proper functioning. For the patient, this means a decrease in sinus infections, facial pressure, and sinus congestion. The dilation provides lasting results by enlarging the bony opening to the sinuses. It is less invasive than traditional sinus surgery and can often be performed in the office setting without general anesthesia. Additional benefits of balloon sinuplasty over traditional sinus surgery are a quicker recovery, less pain, and lower cost to patients and insurance companies. It can also be safely performed on children suffering from chronic sinus symptoms. Importantly, studies have shown that balloon sinuplasty has equivalent outcomes to traditional sinus surgery in patients with uncomplicated chronic sinusitis.
First introduced in 2005, Dr. Kirsch and Dr. Fraley have both been performing balloon sinuplasty procedures for several years. Initially done in the operating room, improvements in balloon technology now allow the procedure to be performed in the office setting with minimal discomfort and less expense. Balloon sinuplasty has both good long-term results and an excellent safety record. It is covered by most major insurance companies, including Medicare. If you are having recurrent or prolonged sinus infections, balloon sinuplasty may be the best treatment option for you.
Endoscopic Sinus Surgery is a procedure used to open blocked sinus passageways. Whereas balloon sinuplasty achieves this through dilation, endoscopic sinus surgery achieves it by removing bone and tissue through the nose. It is typically used in patients with more extensive sinus disease than can be treated with balloon sinuplasty alone. Like with balloon sinuplasty, the goal of endoscopic sinus surgery is to restore the natural drainage and function of the sinuses with a subsequent decrease in sinonasal symptoms. Most of the time, it is performed in the operating room under general anesthesia, although select cases can be performed in the office. If necessary, it can also be performed using image guidance technology where the patient's CT scan is loaded into a computer and used to pinpoint specific locations in the nose and sinuses during the surgery. Pain and recovery is greater than with balloon sinuplasty, typically requiring several days to a couple weeks off of work.
A septoplasty is the procedure to straighten a deviated or crooked septum. It is typically performed to address nasal congestion or to improve access to the sinuses during sinus surgery. It is performed completely through the nose, leaving no bruising or external scarring. The crooked pieces of septal bone or cartilage are removed or reshaped to improve or equalize airflow through the nose. Depending on the severity of the deviated septum, this procedure can also be performed in the office without the need for general anesthesia. It is often combined with a turbinate reduction for maximum improvement in nasal breathing. Recovery time is slightly longer than a balloon sinuplasty, requiring a few days to a week off work.
Nasal turbinates are long shelves of bone and tissue that protrude into the nasal cavity. When enlarged, they can cause significant nasal congestion. Turbinate reduction is a procedure that reduces the size of these turbinates to relieve nasal congestion and improve nasal airflow. It can easily be performed in the office with minimal pain or bleeding. When done in the office, a small shaving device is placed into the enlarged turbinate and used to shrink if from the inside. The procedure takes between 15 and 30 minutes and requires little to no recovery time. It can also be combined with other procedures such as balloon sinuplasty or septoplasty. Turbinate reductions are also effective at improving CPAP tolerability by decreasing resistance through the nose.
Sinus surgery, balloon sinuplasty, and polypectomy can relieve the physical obstruction of the sinuses from both bony and tissue overgrowth. However, the benefits of these procedures can be lessened due to swelling, scarring, and polyp regrowth. One of the latest advances in sinus treatment is the PROPEL implant, a dissolvable steroid-eluting stent placed at the time of sinus procedures. As it dissolves, it delivers steroids directly to the sinus tissues to decrease inflammation and scarring. For those patients with more severe or recurent sinus problems, this can lead to improved and more durable results. If appropriate in your case, we can place PROPEL implants in the operating room as well as select patients in our office.
Nasal polyps are one of the more challenging aspects to managing sinus problems since they cause significant symptoms and often recur. SINUVA is a new therapeutic option that was FDA-approved in 2018 to treat recurrent nasal polyps. Similar to PROPEL, the SINUVA device is a steroid-eluting implant that is placed directly in the sinuses. Whereas PROPEL is made to be used at the time of sinus surgery, SINUVA is designed for patients who have already have sinus surgery and now have recurrent polyps. The device is placed in the sinuses during an office. After placement, SINUVA delivers steroids directly to the polyps, shrinking and dissolving them without additional surgery. It stays in place for up to 90 days, providing sustained relieve from congestion and obstruction. Additionally, the device has been shown to improve a patient's impaired sense of smell. If you have recurrent nasal polyps, SINUVA may be an effective, non-surgical option to address your symptoms.
We realize that although sinus surgery or procedures are a very effective tool for addressing sinus problems, they are not a universal "cure." Surgery addresses the anatomical problems with sinuses, but medications are often necessary to control the inflammation or swelling. This is especially true for nasal polyps. Proper medical management can not only alleviate the need for sinus procedures in many cases, but it is often the key to long-term success after sinus procedures. Our physicians are highly trained in knowing which medications or therapies are best suited to each individual patient. This can include allergy medications, prescription nasal sprays, nasal rinses, and even nebulized antibiotics and steroids delivered directly into the nose.