Photo by Ash Daniel
Armstrong offers balloon sinuplasty in the comfort of his own office.
EDITOR'S NOTE: The print version of this story, which appeared in our December 2014 magazine, noted that Dr. Michael Armstrong is possibly the only Richmond-area specialist performing balloon sinuplasty in an office environment. This version of the article has been updated to clarify that multiple otolaryngologists do, in fact, offer the procedure as an outpatient service in their practices.
If the latest seasonal weather shift brings aching sinuses, scratchy throats and maybe a cough waiting in the wings, most of us tend to pop an allergy pill, grab an ibuprofen and hope that the sinuses clear until next season.
For chronic sinusitis sufferers who find themselves on multiple courses of antibiotics, more aggressive techniques are often needed to deal with repeat infections. Typically, in the past, this meant invasive procedures to clear sinus obstructions, removing bone and scraping away tissue. Recovery time took days, and the procedures could be very painful. As Dr. Michael Armstrong of Richmond ENT in Stony Point describes the procedure, it was much like a root canal for your sinuses, and it needed to be done in a hospital.
In the mid-’90s, Armstrong says, he was among other otolaryngologists seeking less-invasive alternatives that could also be performed in an office environment, and by 2005, the U.S. Food and Drug Administration cleared balloon sinuplasty for use. Much as an angioplasty has become a common procedure for clearing arterial blockage, balloon sinuplasty provides a less invasive, less painful procedure for opening chronically clogged sinuses. A balloon is inserted into the sinus cavity and inflated, moving the small bones and tissue out and allowing the sinuses to drain normally. While past methods meant several days of recovery time, the ability to do the procedure in-office and without surgical complications means most patients return to normal activities and work in 24 hours.
Considering sinusitis typically affects 37 million people a year and is the fifth most common reason for antibiotic prescriptions, this is big news.
Jill, who prefers not to give her last name, says, “I had suffered with chronic sinus infections and pain for years, with the past year nearly debilitating me. I was constantly on antibiotics and various medications as well as under a chiropractor’s care, but nothing worked.” Armstrong reviewed her case and suggested sinuplasty. “The Friday before school started, I found myself having it done,” the local teacher says. “I woke up afterwards, took a breath and felt air going to places that had not seen oxygen for years.” She adds that she found sleeping easier, too. “And the best part was I was back to my normal routine two days after surgery, ready for school on Tuesday.”
In a typical week, Armstrong performs three to four procedures in the office. In a blind clinical trial two years ago, he and nine other specialists around the country tested the efficacy and response to the procedure compared to invasive hospital-based procedures. While both were effective, the recovery time for balloon sinuplasty was a third of the time required for surgical procedures, was more cost-effective, and required significantly less pain medication afterward. Typically, he says, “most patients are back at work the next day. Occasionally, we schedule morning appointments, and they’re back at work that afternoon.”
In addition to Armstrong's practice, a number of Richmond-area otolaryngologists offer the service in an outpatient, office environment, including Commonwealth Ear Nose and Throat Specialists; Commonwealth Facial Plastic Surgery; and Virginia Ear, Nose and Throat Associates.
“It’s a much more pleasant experience to do this in the office rather than going through everything that’s involved with a hospital procedure,” Armstrong says. “Patients really seem to prefer [it], which is why we started doing it six years ago.”
So which types of patients benefit most from balloon sinuplasty? Armstrong points out these aren’t typical allergy sufferers. Instead, a typical candidate is a patient who goes through multiple rounds of antibiotics that don’t solve chronic sinus infections.
That said, the procedure is effective enough that people will travel the distance for it. Bob, another patient who declines to give his last name, traveled from Colorado for it after his son had the treatment with Armstrong. “After 30 years of sinus infections and ENT doctors, I flew to Richmond for balloon sinuplasty with Dr. Armstrong,” he says. “It did not hurt at all.”