Greater Peoria Metro Area, IL

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Balloon Sinuplasty A Breakthrough in Endoscopic Surgery


By Sara Browning

Midwest Ear, Nose & Throat
Associates is helping patients overcome chronic sinus symptoms through
an effective in-office procedure.

Spring allergy sufferers can
now experience relief at the hands of Midwest Ear, Nose & Throat
Associates’ skilled doctors with Balloon Sinuplasty (BSP), a safe and
effective procedure designed to alleviate uncomfortable and painful
symptoms for chronic sinusitis patients. Sinusitis causes the mucous
membranes of the nose, sinuses, and throat to become inflamed. Mucus
builds up when swelling obstructs the sinus openings, preventing normal
drainage. Symptoms include thick yellow or greenish discharge, nasal
obstruction or congestion, tenderness or swelling around the eyes,
cheeks, nose and forehead and a reduced sense of smell and taste.

Symptoms can significantly impact a person’s quality of life,
obstructing daily activities with headaches, difficulty breathing and
sleeping, irritability, fatigue, and nausea. Although most sinusitis
cases are acute, individuals may have chronic sinusitis if symptoms do
not resolve with certain medications, including antibiotics, nasal
steroid sprays, topical nasal therapies, decongestants and/or oral
steroids, or if symptoms persist longer than 12 weeks. BSP restores
individuals to an increased quality of life whether symptoms are chronic
or patients suffer from recurrent acute infections.

Exploring BSP In-Office
Functional endoscopic sinus surgery (FESS) was the standard of care
for sinus surgery since the 1980s. The goal was to open blocked sinuses
and allow them to drain by enlarging the sinus opening through the
removal of bone and tissue. “With conventional sinus surgery, the
removal of bone and tissue could lead to bleeding and scarring,” says
Dr. Ryan Hendricker, Otolaryngologist at Midwest Ear, Nose & Throat

Fortunately, BSP has proven to be a safe and
effective alternative to traditional surgery. Although BSP has been
performed in an outpatient setting, the procedure is now available to
patients in the doctor’s office.

“Balloon Sinuplasty is a new
technology used to enlarge the natural sinus drainage pathways,” says
Dr. James Hertenstein, Otolaryngologist with Midwest Ear, Nose &
Throat Associates. “Balloon Sinuplasty performed in the doctor’s office
allows patients the option of symptom relief without undergoing
conventional surgery which removes sinus bone and mucous membrane.”

Restoring Good Health
According to Dr. Hendricker, Midwest Ear, Nose & Throat
Associates is transitioning to perform BSP In-Office “as much as
possible” due to the vast array of patient benefits.

in-office procedure is less invasive than traditional sinus surgery.
With Balloon Sinuplasty technology, you’re not cutting and removing
tissue. Also, general anesthesia used during surgery carries the risk of
producing heart and lung complications, which is eliminated with the
local anesthesia used during in-office sinuplasty.”

Additionally, patients who undergo BSP In-Office experience the
procedure in comfortable surroundings rather than the hospital operating
room. “Before Balloon Sinuplasty In-Office, patients always had to
undergo an operating room procedure, which involved packing and the risk
of bleeding,” says Dr. Hertenstein. “Before the in-office procedure, we
would have been very reluctant to offer sinuplasty in the operating
room for someone who only had a recurring sinus infection as opposed to a
patient with more severe symptoms, such as symptoms of chronic
sinusitis. But with this new in-office technology, there’s no

Patients also benefit from a fast recovery period.
“While recovery time varies depending on the patient,” says Dr.
Hendricker, “patients who undergo the in-office procedure experience a
much quicker return to a fully functional status. Patients can return to
work and normal activities within 24 to 48 hours as opposed to several
weeks of recovery with traditional surgery. Within a few days, patients
begin to notice a difference in their sinuses.”

Cost control is
another plus. According to Dr. Hertenstein: “Undergoing the procedure in
the office is a tremendous savings when it comes to avoiding operating
room costs.”

A majority of patients who have experienced BSP
In-Office say they would recommend the procedure to friends and family.
“Balloon Sinuplasty has been performed in more than 12 thousand office
procedures, so while it is new, it has a good, solid track record of
safety,” says Dr. Hertenstein. “Most patients report clinically
meaningful improvement in sinus symptoms and quality of life
indefinitely and without ever requiring a repeat of the procedure due to
the fact that the procedure remodels the anatomy in a permanent

Undergoing the Procedure
During BSP procedure, Ear, Nose and Throat (ENT) doctors open inflamed
sinuses in the same way heart surgeons open a blocked artery during
balloon angioplasty. Otolaryngologists insert a small, flexible balloon
catheter into the nose to open the blocked sinus passageways and
facilitate drainage of the mucus buildup. Once the catheter is inserted,
the balloon is inflated to expand the sinus opening. Saline is sprayed
into the inflamed sinus to flush out the pus and mucus. Finally, the
catheter is removed from the open sinuses.

Says Dr. Hertenstein.
“The natural sinus opening is enlarged to anywhere from six to eight
millimeters in diameter without cutting and with minimal bleeding. A
normal opening is usually three millimeters in diameter, so this
procedure significantly improves ventilation for the treated sinuses.”

“The procedure actually remodels the opening structurally so that
the changes are long term,” adds Dr. Hendricker. The procedure takes
approximately one hour to complete, part of which time is spent applying
a combination of topical anesthetics, such as cotton with anesthetics,
which is placed in the patient’s nose.

Most insurance companies
and Medicare provide coverage for BSP. “This is a whole new category of
treatment we can offer patients,” says Dr. Hertenstein.

Is Balloon Sinuplasty Right for You?
Individuals experiencing recurring episodes of acute sinusitis or
recurring sinus infections may be candidates for BSP In-Office and
should make an appointment with either Dr. Hendricker or Dr. Hertenstein
to discuss possible treatment options.

“It’s important for us
to see the patients in consultation to discuss patient symptoms, perform
a detailed and thorough examination of the patient and possibly obtain
additional diagnostic imaging,” says Dr. Hertenstein.

the benefits of in-office Balloon Sinuplasty are numerous, not every
patient, as Dr. Hendricker describes, is an “in-office case.” “We hold
patient consultations to determine if individuals meet the profile of an
in-office procedure. Consultations help us frame patient options, but
there is never any guarantee a patient will be a candidate for Balloon
Sinuplasty In-Office. Sometimes we need to resort to traditional

Says Dr. Hertenstein: “For a large population of folks
that have been reluctant to seek out an ENT doctor, it’s nice for them
to know that there is a procedure that’s less invasive. They no longer
have to be apprehensive about getting the health care they need.”

Dr. Ryan Hendricker and Dr. James Hertenstein are board-certified
otolaryngologists and providers with extensive Balloon Sinuplasty
experience. Dr. Hendricker was named Clinical Assistant Professor at the
Department of Otolaryngology at The Ohio State University prior to
becoming a partner at Midwest ENT. Dr. James Hertenstein is a Fellow of
the American College of Surgeons. Both Dr. Hertenstein and Dr.
Hendricker are clinical instructors of Otolaryngology at the University
of Illinois College of Medicine.

Ear, Nose & Throat Associates is located in Peoria at 8600 N. State
Route 91, Suite 300 and in Morton at 1600 S. 4th, Suite 120. For more
information on Midwest Ear, Nose & Throat Associates,
contact 309-691-6616 for general inquiries or to schedule an appointment
at either location. If you wish to learn more, visit

      A Four Step Procedure

  1. A guide wire and balloon catheter are inserted into the inflamed sinus.
  2. The balloon is inflated to expand the sinus opening.
  3. Saline is sprayed into the infected sinus cavity to flush out pus and mucus.
  4. The system is removed, leaving the sinuses open.