Balloon Sinus Ostial Dilation
What Is Balloon Sinus Ostial Dilation?
气球窦开口病变扩张(BSOD)是一个procedure during which a slender balloon device is placed across a narrowed sinus ostium and then inflated. The technique is similar to balloon angioplasty, a procedure intended to open narrowed blood vessels that supply blood to the heat.
How Is Balloon Sinus Ostial Dilation An Alternative To Conventional Sinus Surgery?
当首次引入气球窦鼻膨胀（BSOD）时，一些ENT外科医生认为这是常规内窥镜鼻窦手术的替代方法。如今，大多数ENT外科医生认为BSOD是一种手术技术，而不是替代程序。
因此，对于某些患者，BSOD可以使用常规仪器进行内窥镜窦手术的一部分。在其他患者中，BSOD可以作为独立手术进行。使用BSOD技术的决定是基于许多因素，包括炎症性疾病，患者解剖结构和患者偏好的类型和程度。
球囊窦性膨胀如何进行？
球囊鼻窦膨胀（BSOD）是一个相对直接的过程。在内窥镜可视化下，鼻窦气球装置被放入鼻腔，并引导到阻塞的窦。一旦确认定位，气球就会充气然后放气。然后卸下设备。必须执行整个过程，重点是最大程度地减少对窦衬里细腻的组织的创伤。
有两种类型的窦气球设备。一个人使用灵活的导线来找到窦出口道。另一个使用可延展的轨道，用于找到鼻窦流出道。当然，每个设备都有优势和缺点。每位外科医生将选择他或她认为最适合特定手术目标的设备。
在额窦，BSOD是一个四步骤：
1. A guide wire is placed across the block frontal sinus outflow tract.
2.然后在导丝上引入气球并充气。Then the balloon is removed.
3.窦是灌溉的。（这是一个可选步骤。）
4. The device is removed from the sinus and the opening is inspected via direct visualization.
在上颌窦，BSOD也是一个四步骤的过程：
1. A guidewire is placed across the blocked maxillary sinus outflow tract.
2.然后在导丝上引入气球并充气。
3. The balloon has been removed and then an irrigation catheter is placed over the guide wire. Saline irrigation then flushes debris (mucus and pus) from the maxillary sinus.
4. The device is removed from the sinus and the opening may be inspected via direct visualization. The maxillary sinus outflow tract has been enlarged. Debris (mucus and pus) is no longer in the maxillary sinus.
成功的BSOD取决于气球在阻塞的Sinus流出轨道上的精确放置。最初，X射线用于设备放置；但是，今天很少做。对于额叶和上颌BSOD，通过透射确认正确的放置；也就是说，明亮的光被传递到靶窦，当在额头中看到光（对于额窦）或脸颊（对于上颌窦）设备的位置时。
最近，可以通过技术来确定位置的微传感器，因为手术导航已被用于确认设备放置。
Where Is Balloon Sinus Ostial Dilation Performed?
可以在手术室或办公室环境中执行气球鼻窦骨扩张（BSOD）。设置的选择是基于许多因素。通常，尽管技术和仪器的最新进展已将其中一些程序移至办公室环境，但将在手术室中执行更广泛或复杂的程序。
当手术室执行手术时，可以在医院门诊部或专门的手术中心进行。最常见的是，该过程将在这些位置的全身麻醉下进行。有时，手术仅通过静脉镇静进行。
In the office setting, the BSOD may be combined with conventional endoscopic sinus surgery techniques, or BSOD alone may be performed. Regardless, procedures in the office are performed without general anesthesia. Topical medications and local anesthesia provide sufficient comfort for successful procedure in the office. The main advantages of performing the procedure in the office is a rapid return to normal activity—patients may resume normal activity on the same day in most instances. In addition, scheduling is easier in the office and overall costs are much less.
谁是气球鼻窦膨胀的候选者？
慢性鼻孔炎的初始治疗几乎总是医学的。该规则的例外包括并发症的真菌鼻鼻涕或鼻孔炎。
当药物治疗失败时，患者将成为鼻窦手术的候选者。特定技术的选择取决于许多因素，并且没有指导此过程的“艰难和快速”规则。
The ideal candidate for balloon sinus ostial dilation (BSOD) only procedure has inflammatory disease only in the sinuses that can be addressed with this technique. Thus, patients with sinusitis predominantly in the ethmoid sinuses would not be ideal candidates for a BSOD only procedure. In contrast, patients with sinusitis limited to the frontal, maxillary and/or sphenoid sinuses may be good candidates for BSOD only procedures, especially in the absence of polyps and/or fungal sinusitis.
BSOD may be combined with conventional endoscopic sinus surgery techniques in so-called “hybrid” procedures. This combination is ideally suited for those patients with significant inflammation in the ethmoid sinuses as well as the other sinuses.
The selection of BSOD is a complicated decision. Patients are encouraged to discuss this option with their surgeons so that the right selection is made for each patient.
What Are The Risks Of Balloon Sinus Ostial Dilation?
Balloon sinus ostial dilation (BSOD) is considered a safe procedure. In fact, many surgeons believe that the risks directly related to BSOD are probably less than conventional techniques. (It must be emphasized that conventional endoscopic sinus surgery has also been deemed a “safe” procedure.)
In general, the risks related to BSOD are similar to the risks of conventional endoscopic sinus surgery. Some of these risks are intrinsic to any surgical procedure; there are always concerns about anesthesia reactions, bleeding, scarring and infection. Other risks are related to the location of the sinuses; because the sinuses located next to the orbits and beneath the brain, the risk of brain or eye injury is always present. Fortunately, the rate of major complications from any sinus procedure are quite low.
气球鼻窦膨胀能够治愈我的鼻窦问题吗？
Reported outcomes from balloon sinus ostial dilation (BSOD) are quite good—comparable in many ways to conventional endoscopic sinus surgery. Most patients report dramatic reductions (or even resolution) of their nasal and sinus symptoms after BSOD.
必须记住的是，BSD的主要指示是慢性鼻孔炎 - 鼻衬的炎症状况。由于没有外科手术可以改变患者的生物化学，因此某些患者需要进行一些持续的医疗服务。因此，任何手术程序（无论是BSOD还是常规内窥镜鼻窦手术）（或将BSOD与标准内窥镜技术纳入BSOD的混合程序） - 应视为减少鼻窦炎症的全面策略的一部分（尽管是重要的部分）。
