HEALTH MATTERS: Relief for sinus sufferers More than 37 million people are afflicted with sinusitis each year, making it one of the most common health conditions in America.

    Sinusitis is usually preceded by a cold, allergies, or irritation from environmental pollutants. In fact, symptoms of sinusitis are often confused with a cold or allergies. Signs of sinusitis include facial pressure and pain; a thick yellow- green nasal discharge and nasal congestion. Symptoms may also include fever, headache, pain in the upper teeth, bad breath and coughing.

    Unlike a common cold, which runs its course within 10 days, sinusitis lingers until it is treated by a physician. If you suspect you have sinusitis, it is critical to see a physician for diagnosis and treatment.

    The physician will examine the face for signs of swelling and redness associated with sinusitis and may test for tenderness by pressing the sinus areas. A large number of people who are a diagnosed with acute sinusitis are prescribed antibiotics to cure the infection and prevent future complications. The majority of cases clear up within weeks.

    For those who suffer from chronic sinusitis, however, treatment is not as easy. Patients who have frequent sinusitis or have an infection that lasts for three months or more may be suffering from chronic sinusitis.

    In those instances, a physician may refer you to an ear, nose and throat doctor who may order a CT scan of the sinuses to confirm that an infection is present and to determine which sinuses are involved. The doctor may prescribe intensive antibiotic therapy along with an oral or nasal decongestant. (It is important to note that prolonged use of nonprescription nasal sprays and drops is not recommended.)

    In severe cases where medications continue to fail, endoscopic sinus surgery may be necessary to help open the nasal passageways.

    With the advent of balloon sinuplasty, many patients now have a surgical option that is less invasive than traditional sinus surgery, which at times involves incisions or drilling into the sinuses to open up the sinuses.

    Balloon sinuplasty is an endoscopic procedure that involves using a small, flexible catheter — picture a coffee stirrer — with a minuscule deflated balloon at the tip that is inserted through the nose into the infected sinus cavities. Once positioned in the sinus, the balloon is inflated to about the size of a coffee bean and gently restructures and widens the sinus walls, while maintaining the sinus lining. The balloon is then deflated and removed. The procedure is similar to balloon angioplasty, which is routinely performed to clear clogged arteries.

    While all surgeries involve some risk, balloon sinuplasty is a relatively low-risk, pain-free procedure. The procedure requires general anesthesia to prevent the patient from moving and typically takes less than an hour. Bleeding that is typically associated with sinus surgery is reduced because doctors are not removing bone or tissue, but are simply stretching the sinuses.

    Like all medical procedures, recovery from balloon sinuplasty varies from patient to patient but many people return to normal activities after 24 hours.

    Balloon sinuplasty cannot currently be performed on the ethmoid sinuses because they comprise a number of small chambers that are not able to accommodate the balloon. In addition, balloon sinuplasty does not remove polyps or other nasal obstructions that may be contributing to sinusitis. In those cases, traditional sinus surgery is often necessary, and many times balloon sinuplasty is performed in conjunction with traditional sinus surgery.

    Of course the best way to address sinusitis is to prevent infection from the start. To avoid developing sinusitis during a cold or allergy attack keep the sinuses clear by:

    • Using a nasal steroid spray and/or a nasal antihistamine spray.

    • Using saline spray to wash pollen and debris out of the nose.

    • Gently blowing your nose, blocking one nostril while blowing through the other.

    • Drinking plenty of fluids to keep nasal discharge thin.

    • Avoiding air travel. If you must fly, use a nasal spray decongestant before take-off to prevent blockage of the sinuses allowing mucus to drain.

    • Avoid contact with things that trigger allergic attacks. If you cannot, use over-the-counter or prescription antihistamines and/or a prescription nasal spray to control allergy attacks.

    • Using an oral decongestant or a short course of nasal decongestant.

To find a physician with Princeton HealthCare System who performs balloon sinuplasty, call 888-742-7496 or visit www.princetonhcs.org.

Dr. David Goldfarb is board certified in otolaryngology and is Chief of Otolaryngology at University Medical Center at Princeton.