Using balloon sinuplasty to treat chronic forehead sinusitis

Seattle Nasal and Sinus Surgeon, Thomas Lamperti, MD, narrates an intraoperative video that shows how balloon sinuplasty (or sinus-plasty) can be used to dilate the forehead or frontal sinus to treat chronic sinusitis. This can help with chronic sinus infection, recurrent sinus infection or problems with frequent pressure sinus headaches. You can watch a schematic animation of frontal sinus balloon sinuplasty here.

Video Transcript:

"This is Seattle facial plastic surgeon, Dr. Thomas Lamperti. Today I'm going to show you how to dilate a narrowed forehead or frontal sinus.

We’ll start on the right side of the nose. We’re looking upward with an angled endoscope — the small telescope nasal surgeons use to examine and operate inside the nose. The plastic  tube that looks like a straw is the tip of the balloon sinuplasty instrument. The blue soft rubber tip allows us to manipulate the sinus tissues with minimal trauma.

To identify the proper sinus opening up into the frontal sinus I’ll be using a very thin lighted guide wire. The tip of the wire has a bright light that when placed into the forehead sinus will illuminate the sinus through the skin such that we can confirm the proper wire position visually by looking at the patient’s forehead.

Now that I’ve confirmed the guide wire position I’ll now advance the balloon forward along the wire so that it rests within the nasal outflow tract of the frontal sinus. You can see me advancing the balloon slowly throughout he narrowed outflow tract in this instance. I’ll then have my assistant gradually increase the pressure within the balloon using pressurized water. The balloon doesn’t get very big but it is very strong and when inflated is able to create small micro-fractures in the bones of the frontal sinus.    The end result is a widened pathway up to the sinus that is much less likely to become closed off. This can help improve chronic sinus infections and also can help people who get frequent forehead pressure headaches related to improper pressurization of the forehead sinuses.

I’m now withdrawing the balloon now that it is deflated. You can see what the balloon looks like. And along with this I’ll also take out the guide wire as well. We’ll now move on to the left side of the nose to dilate the left forehead sinus.

Now I’ll try once again to find the forehead sinus on the left side. There are several potential openings and a few of them are actually dead ends but once we do find the proper opening I’ll advance the balloon and then inflate it to dilate the outflow tract. I normally dilate the forehead sinus outflow tract in several different sections or segments. This is actually a fairly long distance and I do it in this manner in order to make sure that the entire length of the outflow tract is dilated.

Once I’m happy with the dilation in the most distant segment I’ll withdraw the balloon leaving the guide wire in place and then inflate it again at least 1 or 2 more times.

Well, thanks for watching. Please check out the rest of my YouTube channel to learn more about nose and sinus surgery."