In-Office Treatment of Chronic Sinusitis

The following represents a greater than 2 year longitudinal assessment of a single patient undergoing in office balloon sinus dilation in 2016.  In order to effectively demonstrate the clinical outcome, we have summarized the findings below.

Clinical History: Pt presented with a history of right sided facial pain / headache.  Over the course of the past year she underwent treatment for migraine without relief.  Furthermore, medication aimed at treating nasal congestion and sinus pressure(steroid sprays, antihistamines) was also provided, in addition to antibiotic therapy.  Unfortunately, her right sided facial pain / headache persisted despite such efforts.  Seeking further options, the patient presented to GNO Snoring and Sinus.

Physical Exam: Clinical and physical exam revealed a component of pressure and discomfort overlying her right maxillary(cheek) and frontal sinus region.  There was also a component of right upper dental pain as well.    A nasal endoscopy was then performed revealing a normal left sinus drainage pathway, however, the right drainage pathway was noted to have significant swelling – preventing proper ventilation of the sinus cavities.  An in-office CT Sinus was then performed (Picture A)revealing total blockage of the right sided maxillary/ethmoid/frontal sinus, with mucosal thickening of the sphenoid sinus as well(Picture A).  This resulted in an accurate diagnosis of right sided chronic sinusitis as the cause of her facial pain / headache.

Treatment: The patient underwent in-office balloon sinuplasty of her right maxillary/frontal/sphenoid sinus.

Before:

Preop CT Scan: (2/17/2016)

 

After:

Treatment: In Office Balloon Sinuplasty: (3/9/2016)

1-Month After: PostOp CT Scan: (4/6/2016)

19-Months After: PostOp CT Scan: (10/22/2018)

Summary: Following the in-office sinus dilation, the patient noted a significant decrease in right sided facial pain/headache.  This is evident from the improved sinus drainage noted in Picture B, allowing her sinus passages to ventilate properly after in-office treatment.  There is noted residual sinus thickening at certain regions, and this is not uncommon after a sinus procedure, as the sinus cavities will continue to ventilate secretions over time as the inflammation continues to decrease.  The patient has been followed closely and underwent a CT Sinus in 10/2018 to further assess improvement.  As can be seen(Picture C) – there is persistent ventilation and near total clearance of not only the maxillary but also the ethmoid and frontal sinuses on the prior affected right side – demonstrating the long term ventilation provided.

To learn more about in-office sinus dilation and various other office based procedures available at GNO Snoring and Sinus, please contact us to learn more.