In this episode of BackTable ENT, Dr. Gopi Shah and Dr. Ayesha Khalid, rhinologist with Cambridge Health Alliance in Massachusetts, discuss balloon sinuplasty indications, techniques, and post-operative management.

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SHOW NOTES

First, Ayesha reviews the history of balloon sinuplasty. Originally used in cardiology, otolaryngologists adopted balloons as a less-invasive option to widen sinus ostia. Over time, balloon sinuplasty transitioned from being an operative procedure to one that can be done in-office with select patients. In Ayesha’s experience, facial pain and nasal stuffiness are the symptoms most responsive to balloon sinuplasty.

Then, the conversation shifts to application of balloon technology. Rather than thinking about balloon procedures and traditional functional sinus surgery as mutually exclusive, Ayesha sees them as complementary tools. Patients with straightforward sinusitis or barotrauma often improve with an in-office balloon procedure and sinus rinses. When scheduling an in-office balloon procedure, Ayesha counsels on the odds of success (over seventy percent) and possible need for further surgery. For example, patients with polyp disease might be better suited to a more traditional sinus surgery. Even in these cases, Ayesha uses balloons to widen ostia, as they inflict less trauma than traditional sinus instrumentation. Ayesha then walks listeners through her preparation for and performance of an in-office balloon procedure.

Finally, Ayesha fits balloon sinuplasty into the larger context of sinusitis treatment. She emphasizes the importance of sinus rinses for sinusitis patients both pre-and post-operatively. She sees patients one week, one month, and then three months following any balloon procedure. Depending on the nature of their disease, patients sometimes require steroids or biologics after their balloon, but most report improvement of their sinus symptoms. Ayesha leaves listeners with advice on expanding one’s procedural toolkit as a practicing ENT.