Sinus surgery may be effective but it is also one of the most feared elective procedures to treat sinusitis, a common health complaint that affects about 14 percent of the adult U.S. population.
People have heard horror stories about the discomfort and yards of packing material that used to be a part of traditional sinus surgery.
But recent advances in sinus treatments now allow many sinusitis suffers the option of balloon sinuplasty. The high tech procedure was once a part of the operating room just like traditional sinus surgery.
A local otolaryngologist, Dr. Ronald A. Krueger, founder of Northwest Sleep and Sinus Clinic in Mukilteo, now offers the state-of-the-art treatment in his office with only local anesthesia.
“I was the first in the state, authorized by Acclarent, to perform the procedure in-office,” Krueger explained. “You need 100-plus cases in the operating room to be comfortable with performing this in the office.”
Krueger’s authorization came after he had performed balloon sinuplasty more than 200 times in the operating room. Currently he is the only local doctor performing this treatment in the office. The only other local doctor offering the option has since retired from active practice.
Balloon sinuplasty is done by placing a tiny, flexible balloon catheter into the problem sinus then slowly inflating it to open the passage without cutting bone or tissue. The wire that carries the balloon is small. It’s referred to as a wire yet the texture is so soft that it feels more like a string.
“You can’t even break an egg yolk with it,” Krueger said.
The wire is topped with a tiny light that can even be seen from outside the skin to ensure proper placement. Once inside, the deflated balloon follows. The balloon is also very soft and smooth in texture so that when it inflates it doesn’t really tear the mucosa, Krueger explained.
There is minimal bleeding and a low complication rate. Many patients are back to their normal activities the next day — something that usually doesn’t happen with traditional sinus surgery.
That is because the standard procedure involves cutting away bone and tissue inside the sinus to create better drainage. After traditional surgery, there is usually a need to later remove dead tissue inside, another thing that patients dislike. For many years ENT doctors used to pack the sinuses with gauze after surgery too, some still do.
“We’ve gone away from packing,” Krueger said. “Even on traditional surgery, I’ve found lots of alternatives to packing.”
By contrast, the after care for balloon sinuplasty is simple — saline. That, along with a little antibiotic and steroid are the only medications generally associated with the procedure, Krueger said. And unlike standard surgery, there is no need to come in to take away damaged tissue again after surgery.
The one limitation to the procedure is that it is unable to reach one set of sinuses, the ethmoid sinuses located within the ethmoid bone. But Krueger has noticed that when the other sinuses around the ethmoid are treated, the ethmoid sinuses often begin to clear as well.
“If I was going to have sinus surgery myself, this is what I would have done myself,” Krueger said.
Krueger has noted long standing relief among the patients he has been treating since 2007. “As I have checked, followed and evaluated over the years, they have remained as open, if not more open, than my traditional surgery patients,” he said.
Candidates for the procedure include those with chronic sinusitis that isn’t responding to medication or those with recurring sinus infections. Many people don’t realize that they have sinusitis as it is often mistaken for allergies.
Symptoms of sinusitis include facial pain, headache, nasal congestion, a feeling of pressure around the eyes and post-nasal drip. An ear, nose and throat doctor or otolaryngologist can accurately diagnose sinusitis.
Krueger also donates his time to the Mukilteo-based chapter of an organization called Healing the Children. The nonprofit provides medical care for impoverished children around the world. Krueger served on the board for more than a dozen years and has made numerous trips down to Guatemala to do medical and surgical mission work.
More information about sinusitis and balloon sinuplasty are available at Krueger’s website, www.doctorkrueger.com.
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