If you're undergoing a balloon sinuplasty, you can expect to first come into the office and we begin the numbing process first. This involves first spraying your nose with some topicalizing anesthetics. After adequate time for the anesthetics to take effect, we then place long strips of cotton that are soaked in anesthetic into your nose for some more time. After possibly 20 to 30 minutes, the anesthetic will soak into the tissues and the nasal cavity, which will provide a very good numbing effect. On top of this, I also inject patients with lidocaine and sometimes with a little adrenaline to not only numb the tissue even more, but also provide a what's called a vasoconstrictive effect, which limits the bleeding during the procedure. Once I have you nice and numb, that's when we can begin the procedure. The first step is to obtain a tracing of the patient's forehead and face. And this essentially uses a computerized system to sync up the tracing with a reconstructed 3D image of the patient's head, and it provides us a GPS-like navigation system to use during the procedure. So this, in effect, allows us to guide the balloon directly into the perfect spot so we can dilate the openings of the sinuses perfectly. So, once the nasal sinuses and the nasal passages are all numb and I've got the GPS system all set up, we start dilating the sinuses. And typically if I'm dilating the frontal maxillary and sphenoid sinuses, I'll start with the frontal sinuses up in the forehead, will slowly guide the catheter right into the opening of the sinus, and once I confirm that it's in the right spot, I'll ask my assistant to go ahead and inflate the balloon. And what happens is when the catheter is just in the right spot and the balloon inflates, it widens that pathway, thus allowing all the contents of the sinus to escape and it provides for better ventilation in the sinus. People often ask me, is this permanent? Well, yeah, it should be. And that's because the sinus openings are surrounded by very thin bone. When we inflate the balloon, patients will often hear a very disconcerting crackling noise. And don't worry, you get used to it, but that's the little tiny bones in the area being pushed aside. And what happens is those bones heal in those positions and leave you with a permanently more open drainage pathway to the sinuses. And so we go on doing the remaining sinuses one sinus at a time. If there's mucus trapped in the sinuses, we'll often suction the mucus and evacuate the contents. And once we've dilated all the sinuses, you're left with wider openings to the sinuses, and you're able to go home the same day without a problem, right from the office. Most patients will experience some bleeding for the first 24, maybe 48 hours. But the recovery time is typically very manageable. There's very little in the way of packing that we often leave in the nose. We often don't pack at all. And patients often tell me that the experience was very tolerable and they had minimal if any pain at all.
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