Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium
CPT4 code
Name of the Procedure:
Nasal/Sinus Endoscopy, Surgical, with Dilation (e.g., Balloon Dilation); Frontal Sinus Ostium
Common Names: Balloon Sinuplasty, Balloon Sinus Dilation
Summary
A nasal/sinus endoscopy with balloon dilation is a minimally invasive procedure used to treat chronic sinusitis. A small, flexible balloon catheter is inserted into the sinus passage and then inflated to widen the sinus opening, which helps improve drainage and relieve sinus pressure.
Purpose
Medical Conditions: Chronic sinusitis, sinus infections, nasal congestion. Goals: Relieve sinus pressure, improve sinus drainage, reduce symptoms such as headaches and facial pain, and decrease the frequency of sinus infections.
Indications
Symptoms: Persistent nasal congestion, recurrent sinus infections, facial pain or pressure, reduced sense of smell. Patient Criteria: Patients with chronic sinusitis not responding to medication, those experiencing frequent sinus infections, or those with anatomical blockages in the sinuses.
Preparation
- Instructions: Fasting may be required a few hours before the procedure.
- Medication Adjustments: Some medications may need to be paused.
- Diagnostic Tests: A CT scan of the sinuses is often done to assess the anatomy and severity of the condition.
Procedure Description
- The patient is placed under local or general anesthesia.
- An endoscope is inserted into the nasal cavity for visualization.
- A flexible balloon catheter is guided to the frontal sinus ostium.
- The balloon is inflated to dilate the sinus opening.
- The balloon is then deflated and removed, leaving the sinus passage widened.
- Saline may be used to flush out mucus and other debris.
Tools: Endoscope, balloon catheter, saline flush Anesthesia: Local or general anesthesia, depending on the case.
Duration
Approximately 1 to 2 hours.
Setting
The procedure can be performed in a hospital, outpatient clinic, or surgical center.
Personnel
- A board-certified ENT (Ear, Nose, and Throat) surgeon performs the procedure.
- Nurses and an anesthesiologist assist during the procedure.
Risks and Complications
- Common Risks: Bleeding, infection, nasal congestion, slight discomfort.
- Rare Risks: Damage to the sinuses or surrounding tissues, persistent symptoms, anesthesia complications.
Benefits
- Expected Benefits: Significant relief from sinus symptoms such as congestion, pain, and pressure.
- Symptom relief can be noticed almost immediately, with continued improvement over a few weeks.
Recovery
- Post-Procedure Care: Use of saline nasal sprays to keep sinuses moist, avoiding strenuous activities.
- Recovery Time: Most patients can return to normal activities within 1-2 days.
- Follow-up: Scheduled visits to monitor healing and address any concerns.
Alternatives
- Medications: Antibiotics, nasal corticosteroids, decongestants.
- Other Procedures: Traditional sinus surgery, functional endoscopic sinus surgery (FESS).
- Comparison: Balloon dilation is less invasive with quicker recovery compared to traditional surgery but may not be suitable for all patients.
Patient Experience
- During Procedure: Local or general anesthesia ensures comfort.
- After Procedure: Minimal discomfort, akin to a mild sinus infection. Pain management includes over-the-counter pain relievers.