31295 Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa

Name of the Procedure:

Nasal/Sinus Endoscopy, Surgical, with Dilation (e.g., Balloon Dilation); Maxillary Sinus Ostium, Transnasal or Via Canine Fossa

Summary

This surgical procedure involves using an endoscope to view the nasal and sinus passages and then dilate the maxillary sinus opening. A balloon catheter is typically used to enlarge the sinus passage, which can be done through the nasal cavity (transnasal) or via the canine fossa.

Purpose

This procedure aims to treat chronic sinusitis or sinus blockage by enlarging the sinus openings, improving drainage and ventilation, and reducing recurrent infections or inflammation.

Indications

• Chronic sinusitis unresponsive to medical treatment.
• Recurrent sinus infections.
• Sinus blockage causing significant symptoms such as facial pain, nasal congestion, or headaches.

Preparation

• Patients may need to fast for a few hours before the procedure.
• Medication adjustments, particularly blood thinners, may be necessary.
• Pre-procedure imaging studies like CT scans may be required to assess the sinus anatomy.

Procedure Description

1. The patient is positioned, and an endoscope is inserted into the nasal cavity to visualize the sinus areas.
2. A balloon catheter is guided to the maxillary sinus ostium.
3. The balloon is gently inflated to dilate the sinus opening.
4. The balloon is then deflated and removed.
5. The area is checked for patency and any minor bleeding is managed.

Tools and equipment used include an endoscope, balloon catheters, and saline irrigation. Sedation or local anesthesia is typically applied to minimize discomfort and anxiety.

Duration

The procedure usually takes between 30 minutes to 1 hour.

Setting

It is commonly performed in an outpatient clinic or surgical center.

Personnel

• ENT (Ear, Nose, and Throat) surgeon.
• Nurses.
• Anesthesiologist (if general anesthesia or sedation is used).

Risks and Complications

• Bleeding.
• Infection.
• Adverse reaction to anesthesia.
• Damage to surrounding tissues or structures.
• Recurrence of sinusitis.

Benefits

• Improved sinus drainage and ventilation.
• Relief from symptoms like facial pain, nasal congestion, and headaches.
• Reduced frequency of sinus infections. Benefits are often noticed within a few days to weeks following the procedure.

Recovery

• Patients may experience mild discomfort and nasal congestion.
• Pain is generally managed with over-the-counter pain relievers.
• Elevate the head when resting and avoid strenuous activity for a few days.
• Follow-up appointments are typically scheduled to monitor healing.

Alternatives

• Continued medical management with antibiotics, nasal corticosteroids, and saline irrigation.
• Traditional sinus surgery (e.g., Functional Endoscopic Sinus Surgery [FESS]), which is more invasive.
• Each alternative has its own pros and cons related to efficacy, recovery time, and potential risks.

Patient Experience

Patients may feel pressure or mild pain during the procedure if under local anesthesia. Post-procedure, they can expect some nasal congestion and mild discomfort, which is manageable with pain relievers. Full recovery typically occurs within one to two weeks, with gradual improvement in sinus symptoms.