1. Why can’t I breath through my nose? There are many causes of a blocked nose. They can be divided into two categories. The first one is obstruction due to swelling of mucous membranes. The second is blockage caused by a mechanical cause such as a physical impediment to air flow. Mucous membrane swelling may occur with an infection such as a cold or sinus infection as well as allergies. Causes of a physical blockage include a deviated nasal septum, nasal polyps, and enlarged turbinates. The specific cause in each case can be determined by a thorough history and exam that frequently includes a telescopic view within the nose. Sometimes a CT scan of the nose and sinuses is helpful in pinpointing the cause of nasal blockage. Once an accurate diagnosis or cause has been established, successful treatment can be started.
2. What are sinus headaches? True sinus headaches are due to increased pressure within the sinuses around the nose (cheek areas and above the eyes). This pressure sensation occurs because there is a blockage or obstruction of the sinus openings through which the sinuses drain. This may occur due to a cold or allergies initially. Taking oral or topical decongestants for 2-3 days should improve the symptoms. Some headaches may at first appear to be sinus headache but may actually be a form of migraine, especially if they are associated with nausea, severe headache or worsen with bright lights.
3. What is in-office sinus surgery? The origin of modern in-office sinus surgery began with the development of balloon sinus dilation. This is done by using a balloon to unclog blocked sinuses. The concept is to use minimally invasive techniques to open up the nose and sinus passages for better breathing and drainage while keeping the patient comfortable without general anesthesia. Dr. Sikand, along with Dr. Sillers in Alabama, is a pioneer in developing this system. They published the first studies on balloon sinuplasty and sinus surgery in the doctor’s office.
4. How does balloon sinus dilation work? Sinus problems occur when the natural openings of the sinuses become blocked. This prevents normal drainage and ventilation of the sinuses. It leads to symptoms such as pressure headaches, sinus congestion and persistent infection. Treatment is aimed at opening up the blocked or obstructed sinus and clearing any associated infection. Sometimes this is achievable with medication. When the blockage fails to clear with medication, a system of gently unclogging the natural sinus opening using a balloon that permanently enlarges the drainage pathway is used. This is typically performed comfortably, in the office using local anesthesia.
5. Is balloon sinus dilation covered by my insurance? Most health insurance companies cover balloon sinus dilation in the office. These plans include Medicare, Aetna, Cigna, Humana, Culinary, UMR, and Healthscope. We are happy to announce that in November of 2017, Anthem Blue Cross Blue Shield of Nevada began coverage of this service! There are a few Blue Cross plans that do not cover this in the office setting such as Independence PPO, Blue Cross Blue Shield Medicaid, and Blue Cross Blue Shield of Arizona. We will check your insurance benefits prior to any procedure and obtain authorization if it is necessary.
6. What should I expect following my in-office sinus procedures? Each recovery will vary depending upon the specific nasal/sinus condition being treated as well as individual response to the treatment. However, in general, it is common to have some bloody discharge on the day of the procedure since nose packing is not used. This usually stops the next day. You can also expect to have a stuffy nose as the mucus membrane inside the nose will swell at first following the procedure. The congestion resolves over several days and nose breathing continues to improve for several weeks after the procedure. Most patients do not have significant discomfort after the procedure but pain relievers are prescribed for the first 1-3 days. Acetaminophen (Tylenol) is effective as well. Ibuprofen and other anti-inflammatory medication should be avoided for the first week as they may cause bleeding.
In our experience use of gentle saline nasal rinses is extremely effective in reducing nasal stuffiness and congestion after the procedure. The rinses should be used 4-5 times daily during the first 14 days starting the day after the procedure. A post procedure kit including the saline rinse is provided to all of our patients as well as detailed written and verbal instructions.
You should not expect bruising, nasal swelling, discoloration, or any nasal packing. Typically, patients can resume most normal activities within 24 hours. Each individual is unique and we will inform you if any change in recovery or after care is anticipated.
7. Will treating your sinuses help manage asthma? Under the concept of the unified airway, optimizing sinus treatment including relief from congestion, post nasal drainage and facial pressure has significant benefits for people who also have asthma. Numerous journal articles now underscore the advantages of correcting diseased sinuses in decreasing asthma attacks, reducing chronic cough, and improving breathing. Nevada Sinus Relief works in concert with both lung specialists and allergy & asthma physicians to provide solutions for patients who have these frequently related conditions.
8. How long does it take to recover from surgery? On average, it can take 1-3 days. We recommend that you take it easy the remaining day of your procedure. Most patients resume their normal activities the following day, but some have reported they needed an extra day or two.