September 1, 2012 Saint Peter's Healthcare System Community Calendar Featured Article.

John Hanna D.O.

The discomfort can be, and usually is, exhausting. Unable to take a deep breath through your nose, you breathe through your mouth, which often keeps you from resting when you sleep because your slumber is interrupted by dry mouth. And when you are awake, you seem to have a headache. You sound perpetually nasal, especially at this time of the year when allergies irritate the sinus passages. These are just some of the symptoms of sinusitis, an inflammation of the sinus lining of the nose.

The inflammation can be caused by bacteria, a virus or by a blockage in the nasal passage. Pressure from congestion causes the headache and that nasal sound in your voice. Other symptoms include facial discomfort, nasal discharge, fatigue, and possibly eye infections. You just can’t breathe normally, which means you are not taking in as much oxygen as you would if you weren’t stuffed up.

New technology available at the CARES Surgicenter, part of the Saint Peter’s Healthcare System, makes it possible to open sinus passages much in the same way arteries in the heart or in the body’s peripheral vascular system are opened. Instead of using endoscopic instruments such as microdebriders which require cutting away at tissue, the procedure, called sinuplasty, uses balloons to open and drain the sinus passages. The technique is similar to the one used during angioplasty, when balloon technology is used to open blocked blood vessels. Sinuplasty is performed by an otolaryngologist, a physician specializing in the ear, nose and throat.

When inflated, the balloon widens the sinus cavities by squeezing the bones and tissues out of the way, allowing the sinus to drain properly and clear any infection, explains John Hanna, D.O., an otolaryngologist in practice in East Brunswick and a member of the Saint Peter’s University Hospital medical staff.

“It’s tougher than the cardiac balloon because it needs to move bone and firmer tissues,” he says explaining the procedure. During the surgery, in which the patient is under general anesthesia, the balloon is inflated for only a couple of seconds. A thin tube with a light and a video camera called an endoscope makes it possible to see the results in real time.

The advantages of this type of surgery include faster recovery. Unlike traditional sinus surgery, balloon sinuplasty requires no cutting and no removal of bones and tissue. This maintains the natural structure of the sinus cavity and reduces pain, blood loss and risk of complications. Most people can go home the same day.

What is sinusitis?

Statistics show that approximately 37 million people a year suffer from sinusitis, making it one of the most common medical problems in the U.S. The sinuses are spaces behind the bones of the upper face, between the eyes and behind the forehead, nose and cheeks. They are covered with a mucus layer and cells that contain little hairs on their surfaces called cilia that help trap and push out bacteria and pollutants. Each sinus has an opening that allows mucous to drain, which is necessary if your sinuses and you are to remain healthy. When your sinuses do not drain well, a buildup of mucus usually occurs causing mild to severe inflammation and its uncomfortable symptoms.

Most cases of sinusitis are acute, coming on suddenly following a cold, an allergy attack or an irritation caused by an environmental pollutant. It lasts for a few days. However, if symptoms do not go away for several weeks, chronic sinusitis could be the problem.

The majority of chronic sinusitis sufferers can be treated with balloon sinuplasty alone, Dr. Hanna says. Patients with multiple growths in the sinuses or blockages in hard-to-reach areas may need a combination of the balloon and traditional surgeries. Sinuplasty can be repeated if blockages return.

“Research has shown convincing long-term success rates,” Dr. Hanna says. “Patients are very happy with the results.”

For more information about the CARES Surgicenter, visit www.saintpetershcs.com/caressurgicenter. To find an otolaryngologist affiliated with Saint Peter’s, visit www.saintpetershcs. com/findaphysician.