Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia
CPT4 code
Name of the Procedure:
Nasal/Sinus Endoscopy, Surgical, with Dilation (e.g., Balloon Dilation); Frontal and Sphenoid Sinus Ostia
Summary
A nasal/sinus endoscopy with dilation is a minimally invasive surgical procedure designed to open up the sinus pathways of the frontal and sphenoid sinuses. By using a small balloon to dilate the sinus ostia (the openings), doctors can improve drainage and airflow.
Purpose
This procedure is used to address chronic sinusitis, which is persistent inflammation or infection of the sinuses. The goal is to relieve symptoms like nasal congestion, facial pain, and chronic infections by enlarging the sinus openings, allowing for better drainage and airflow.
Indications
- Chronic sinusitis not responsive to medication
- Recurrent sinus infections
- Nasal congestion and obstruction
- Sinus headaches
Preparation
- Fasting for several hours before the procedure, typically overnight
- Adjusting or stopping certain medications as advised by the doctor
- Undergoing a pre-surgical assessment, including imaging tests like CT scans
Procedure Description
- The patient is placed under local or general anesthesia.
- A thin, flexible endoscope is inserted into the nasal passage.
- Using video guidance, the surgeon locates the affected sinuses.
- A small balloon catheter is inserted into the sinus ostia.
- The balloon is inflated to dilate the sinus openings and then deflated and removed.
- The endoscope is withdrawn, and the procedure is complete.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
This procedure is usually performed in a hospital or an outpatient surgical center.
Personnel
- ENT (Ear, Nose, and Throat) surgeon
- Anesthesiologist
- Surgical nurse
- Technicians
Risks and Complications
- Bleeding
- Infection
- Recurrence of sinusitis
- Damage to surrounding tissues
- Complications related to anesthesia
Benefits
- Relief from chronic sinusitis symptoms such as congestion and pain
- Reduced frequency of sinus infections
- Improved quality of life
- Faster recovery compared to traditional sinus surgery
Recovery
- Patients can typically go home the same day
- Mild discomfort, congestion, and some bleeding for a few days
- Avoid heavy lifting and strenuous activities for a week
- Follow-up appointments for monitoring and any necessary adjustments
Alternatives
- Medication management (antibiotics, nasal steroids)
- Traditional sinus surgery (sinusotomy)
- Home remedies and lifestyle adjustments (humidifiers, saline rinses)
- Pros and cons depend on severity, patient preference, and response to other treatments
Patient Experience
- Mild pain and discomfort during recovery, manageable with prescribed pain relievers
- Expect some nasal congestion and bleeding initially
- Improvements in sinus symptoms generally noticed within a few days to weeks
- Regular saline nasal rinses may be recommended for post-procedure care