Computer Guided Balloon Sinuplasty:  The Latest Evolution of an Amazing Procedure

Balloon sinuplasty is an in-office procedure that has produced significant relief to tens of thousands of chronic sinus sufferers since its inception in the middle of the last decade.  It works by guiding a very thin balloon into specific blocked areas of the affected sinuses, inflating the balloon, then deflating it and removing it. This has been shown both in lab tests and in clinical studies to provide a long-term resolution of the sinus blockage.

Dr. Nachlas performing Computer Assisted Balloon Sinuplasty at the Nose and Sinus Institute of Boca Raton.

A little over four years ago the first in-office computer guided balloon sinuplasty was performed.   This represented a significant evolution in balloon sinuplasty development. This technology enabled the surgeon to place the balloon within a one-millimeter accuracy at precisely the region or regions that required unblocking.  This was the latest advance to balloon sinus placement which initially required fluoroscopic guidance. Fluoroscopic guidance was then replaced by light guidance and finally has culminated in precise stereotactic computer guided devices.

Improved Pre-surgical Planning in 2018

New for 2018 is the Acclarent computer guided wire, which, when combined with the accompanying software improvements, now allows the surgeon to plan and mark the area of the sinus that requires dilation.  During the procedure, the computer then assists in the guidance of the wire to that precise location, at which point an audible and visible signal confirms placement.

While this seems like just another evolution of an already excellent answer for those suffering from chronic sinusitis, it is a major advance that takes the precision of this procedure to a whole new dimension.  Being able to stereotactically guide a thin wire to a predetermined point ensures pinpoint accuracy never before attainable with wire-guided balloon sinus procedures.

What are the Patient benefits of improved Computer Guidance?

What does this mean to the patient?  For some, it may not dramatically alter the already excellent typical outcomes of balloon sinuplasty.  For others, it may give the surgeon the extra precision to ensure that the exact area is adequately dilated, producing a better outcome for the patient.

Balloon sinuplasty started in the middle part of last decade.  The technology initially required a puncture wound beneath the upper lip and was used for maxillary sinus (the sinus in the cheek) blockage.  This was replaced shortly thereafter with endoscopic techniques through the nose. These allowed all sinuses to be addressed. Since it’s inception, the balloon placement has gradually been streamlined, with both rigid balloons which have become increasingly narrower over the years, as well as wire-guided balloons offering an added advantage of less traumatic navigation around angles.  Both have been used very successfully in unblocking sinuses. Computer (stereotactic) guidance in all surgical fields is an adjunct tool to guide instruments to the exact point of desired treatment. This guidance is done by registering instruments to a computer which contains the MRI or CAT scan of the surgical field. In minimally invasive sinus surgery computer guidance has been utilized since the early 1990s.   For in-office balloon sinuplasty procedures, this technology has been available since 2014. With the 2018 release of the computer-guided wire for wire-guided balloon sinuplasty, the procedure has now advanced far beyond the fluoroscopic or light guided alternatives.

Is computer guided balloon sinuplasty right for you?  

If you are one of the 30,000,000 Americans suffering from chronic sinusitis and have been unsuccessful in obtaining relief from standard medical or allergic therapy, then it is worth investigating.  Your sinus physician can evaluate you by examining your nose with a small endoscope and a CAT scan of your sinuses. The physician can then assess whether you would be a good candidate. The procedure typically takes around 30 minutes in the office, is performed with conscious sedation so that the patient feels no discomfort, and patients return to their normal activities within a day or two.  It is covered by most insurance companies and by Medicare.


About Dr. Nachlas

Dr. Nachlas is a double board-certified physician (American Board of Otolaryngology and the American Board of Facial Plastic and Reconstructive Surgery) specializing in advanced surgery of the nose and sinuses.  He was the Assistant Chief of Service in the Department of Otolaryngology/Head and Neck Surgery at the Johns Hopkins Hospital in 1985 when minimally invasive sinus surgery was introduced into the United States at that institution.  He has remained at the forefront in advances in the treatment of the nose and sinuses and is one of the country’s experts in balloon sinuplasty. He performed the first in office computer-assisted balloon sinuplasty in the United States in his Boca Raton office in 2014 and currently has one of the largest experiences with this technique in the country.  To find out if you are a candidate for this procedure, please call Sandy Friedman, Director of Patient Relations of the Nose and Sinus Institute of Boca Raton, at (561) 939-0909.


Tagged sinusitis treatments, balloon sinuplsty, Balloon Sinuplasty dilation