Stuffed up: Northeast Mississippians fighting chronic sinus problems have a new option

By Michaela Gibson Morris/NEMS Daily Journal

What’s good for the heart can bring relief to aching sinuses.
Cardiologists have long used a tiny balloon to open clogged coronary arteries.
Ear, nose and throat specialists are now using a similar balloon to combat chronic sinusitis.
“It’s something you can do for patients without putting them to sleep to help with chronic sinus problems,” said Dr. Robert Yarber, a Tupelo ear, nose and throat specialist.
Yarber started using the Balloon Sinuplasty for his patients this past fall, but the procedure has been around for just over a decade.
“The safety and effectiveness has been well established,” Yarber said. “The costs have come down, so it’s more reasonable for patients.”
Source of problem
The sinuses, which are hollow spaces in the skull, serve a number of functions. Without them, your head would be much heavier and your voice less resonant.
The sinuses are linked to the nose and produce mucus, to keep the nose from drying out and to trap germs and dust before they get to the lungs. There are four sets of sinus cavities clustered around the nose, eyes and just in front of the ears.
Acute sinus infections are a temporary inflammation of the sinus lining. Common symptoms include a congested nose, thick mucus drainage down the back of the throat and tenderness or pain in the face, head and teeth. Thick yellow or green discharge is common, and sinusitis can reduce the senses of taste and smell.
Saline nasal sprays, antibiotics, nasal steroid sprays, decongestants and over-the-counter pain medications are the first line of treatment.
When the symptoms last longer than 12 weeks, the sinusitis becomes chronic.
Patients are usually referred to Yarber and other ear, nose and throat specialists for help with chronic sinusitis after they’ve fought it unsuccessfully for three to six months.
“Some have lived with it for years,” Yarber said.
Surgery options
The ear, nose and throat specialists will use a CT scan to identify which sinus cavities are having trouble and to gage the severity of the sinusitis, Yarber said. The balloon procedure usually works best for people with mild chronic sinusitis.
In traditional sinus surgery, tissue is removed, and for people with severe chronic sinusitis it is often the best choice, Yarber said. Most people return to light work in three or four days.
Many people avoid sinus surgery based on experiences that go back decades.
“The sinus surgery we do now is not as bad,” Yarber said. “It’s not as painful; the techniques have improved.”
With the balloon procedure, the physician uses a guide wire to reach the affected sinus cavity. A tiny balloon is inflated to expand the opening of the sinus passage so it can drain normally. Saline solution is sprayed into the sinus cavity to help flush out pus and mucus.
The balloon procedure is typically done in the office setting for adults, Yarber said. Patients are treated with a local anesthetic delivered by nose spray to numb the nasal and sinus cavities.
“After they’re numb, it’s pretty well tolerated,” Yarber said.
Most people are able to return to work the next day and receive lasting relief. One large multi-center study showed 95 percent of patients reported sinus symptoms improved over an average follow-up period of nine months.
“In five years, I think this will be the primary way to treat kids,” who usually aren’t considered for traditional sinus surgery, Yarber said. Children and teens usually have the procedure under sedation in an outpatient or ambulatory surgery setting.
Relief
Christy Peters of Planters-ville lived with sinus problems for years.
“I can’t remember not having problems,” Peters said.
But over the course of 2011, her sinusitis intensified.
“I was going to the doctor every month for antibiotics,” to fight a constant sinus infection, Peters said. The pain was so intense in her teeth and jaw, that she couldn’t chew on one side of her month.
She was referred to Yarber and asked him for options to address the problem. The Balloon Sinuplasty was a good fit.
“I really didn’t want to be put to sleep; it was the easiest way,” Peters said. “I had no problem with it.”
She was sore and tender for two days after the procedure in October, but didn’t take any pain medication. She had the procedure on Friday and was back at work on Monday.
“I haven’t had any problems,” Peters said. “I’ve had a little bit of allergies, but I haven’t had any major pain.”
michaela.morris@journalinc.com