The use of ballooning in medicine is very common. "Ballooning" is used in other medical specialities such as cardiology and interventional radiology. In ENT, this has allowed the introduction of a minimally invasive technique for the surgical treatment of the paranasal sinuses (maxillary, frontal and wedge sinuses). This method is gaining more and more supporters, both among doctors and patients. As the treatment method is based on the use of microsurgery and an endoscope, it is very safe and has a low incidence of post-operative complications. It has also been successfully used in children with recurrent inflammation. During the procedure, no incisions are made in the skin of the nose or inside the nasal cavity, so the recovery time and tissue healing are maximally reduced. No intra-nasal or extra-nasal dressings are required after surgery. Often the procedure is performed as a same-day procedure, which means that a few hours after the surgery, the patient can leave the clinic and go home. It is also possible to return to work and daily activities a few days after the procedure.

Method description:

• This method is one of the minimally invasive procedures (micro-tools are used during the procedure to reach hard-to-reach areas in the nasal cavity and sinuses),
• The first stage of the procedure involves inserting a small catheter through the front nostrils ("nasal holes"), into the natural sinus mouth, which is fitted at the end with a very strong balloon made of special material,
• The surgeon controls the position of the catheter using an endoscope - a device that is equipped with a light source and special optical fibres that allow visualisation of the inside of the nose (the surgeon can see the walls of the nasal cavity and the sinus cavity on a monitor, under considerable magnification),
• The balloon is then inflated with fluid at a pressure of several to several atmospheres, which allows the inflamed sinus mouths to be effectively unblocked, enabling them to be unblocked,
• During this stage, the sinuses are flushed of inflammatory and purulent secretions, thus restoring their normal function,
• Once the sinus outlet has been unblocked, all the instruments (balloon, catheter and guidewire) are removed,
• The use of delicate and flexible instruments has made the procedure safer and less invasive than classic surgery. By avoiding surgical removal of tissue, the possible violation of blood vessels and nerves can be reduced.

How is the procedure performed?

Before the procedure, it is necessary to carry out laboratory tests such as blood count, determination of blood clotting time, blood group and virological tests. The procedure is carried out under general anaesthesia. The length of the procedure depends on whether other additional procedures are performed during the operation, such as septoplasty (correction of the nasal septum), conchoplasty (correction of the nasal conchae).

It usually takes approximately 1-3 hours. An examination to be carried out before the procedure is a sinus CT scan to assess changes in the sinuses and inside the nose. An anaesthetic consultation (to assess the surgical risks) and an ECG test (to assess the heart function) are also necessary. This procedure is intended for people who have been suffering from recurrent sinusitis for many years and previous treatments (mainly pharmacological) have not been successful. It should be emphasised that this technique can only be used by specially trained otolaryngologists who are certified to participate in the Endoscopic Sinus Catheterisation (CEZ),(Balloon Sinuplasty) training course.