Balloon sinuplasty and diving

[lttleldydver]

I've had issues with my sinuses for years and have been to many doctors. Years of clogged ears, ear pain, ringing ears, full sinuses. I had given up because most ENTs either drugged me or wanted to put tubes in my ears.

In terms of diving, my biggest issue has always been clearing my ears. However, after days of repetitive diving my sinuses also feel like they are going to explode. I had one very scary incident with a reverse block and learned to use Afrin sparingly. I've tried just about everything but full blown surgery. Recently I had a consult with an ENT here in San Diego that specializes in balloon sinuplasty. His record checks out and his references (including professional swimmers, water polo, etc..) are stellar. I'm seriously thinking of having this surgery. What I can't find is any information on impact on diving. This doctor reassures me that this minimally invasive surgery will only make my diving more comfortable (drained sinus). Recovery time is but a few days.

I guess my main question is, has anyone had this surgery? Have you been diving since?

Secondarily, there is a new balloon procedure currently passing through the FDA for the ears (Eustachian tubes). I know it is a long shot, but has anyone had experience with this?

I'd love to hear what you all have to say. Thanks!

 

[lttleldydver]

Hmmm, nothing? Am I in the wrong forum?

 

[TSandM]

No, you're in the right forum. I just don't know anything about the procedure you mentioned. We have one ENT doc who posts here fairly often, but he is a pediatric ENT guy and I don't know if he does sinuplasties or not.

 

[raftingtigger]

I don't know anything about the ballonsinuplasty, but I do have personal experience with functional endoscopic sinus surgery (aka roto-rooter of the sinus ostia).

I am both a diver and a former commercial airline pilot. For as long as I can remember I have had sinus issues - constantly breathing through my mouth, frequent sinus headaches, colds that last for weeks. It was 'normal' for me. I learned to dive with this - just found free diving too stressful on my sinuses (not ears - they always can clear). Later I took up flying and again dealt with the issues. I went to multiple doctors and ENTs. Finally in 1997 at the age of 37 I had the above surgery. WOW, I can actually breathe with my mouth closed. My colds are less frequent, and actually generally clear without antibiotics.

As I have returned - full speed - to diving this year I have gone a step further. I have an aggressive sinus routine that is working better than anything else in my life. I use a nasal steroid daily (Veramyst works best for me), and right before diving I use Afrin. Of course I am careful to equalized often (clear, clear, breathe, clear, clear, breathe,....) Additionally I have had MUCH fewer colds since taking Vit D 5000 IU daily (Vitamin D Council > Information on Vitamin D, Vitamin D Deficiency and Vitamin D Toxicity) for the last 1-1/2 years. As an Urgent Care physician assistant I'm exposed to just about everything. Lastly a NetiPot is great. Clears the gunk out so it can drain, but with my current routine I rarely need to use it anymore.

 

[DocVikingo]

Indeed they have, lttleldydver. E.g., Hawkeye's Balloon Sinuplasty Surgery Of course, YMMV.

For a quick and simple video for the lay person, see --> Balloon Sinuplasty Video

For a detailed and more medical review of the procedure in general, see --> Balloon Sinuplasty: Literature Review http://www.arquivosdeorl.org.br/conteudo/pdfForl/572_eng.pdf see

Best of luck.

Regards,

DocVikingo

 

[DandyDon]

Interesting article on this today: sinus SOLUTION | Oregon Life | The Register-Guard | Eugene, Oregon

 

[lttleldydver]

Thank you for the links. I actually had the surgery last fall, so I suppose I should report back! I had the surgery on a Thursday in September. I also had a rather severe deviated septum corrected. The recovery from the surgery itself was a little longer and harder than I anticipated. It took about a week to feel back to myself versus a day or so like you hear about. But, that was because of the work done on the deviated septum (slight moving of the cartilage - but no broken bones). The net effect is that my sinuses drained and have been really clear. As of now, no more chronic sinusitis. Not perfect, but the pressure has really lessened. I went diving in Bonaire over Thanksgiving and i was able to easily clear my ears! That was tha primary reason for me willing to try this surgery. A huge bonus for me that it appears to have worked. In the past it would take me a long time to equalize my ears. Sometimes I had to abort the dive because I couldn't descend. After many repetitive dives in Bonaire, I had no problems!

To be honest, the surgery didn't solve all my problems. My ears are still clogged on a daily basis. We had hoped that clearing the nasal passages would also help the ears, but no such luck. My Eustachian tubes are just abnormally small. To bad I didn't get tubes as a kid! There is a similar surgery for the ears, it is just waiting for FDA approval. My ENT is one of the surgeons doing this type of surgery (he has done hundreds), so I might go ahead and do it instead of waiting for insurance.

Anyway, my two cents. The surgery was well worth it for me because it cleared my sinuses and resulted in me having hardly any sinusitis, headaches, etc.. Plus, while my ears aren't clear on a daily basis, they equalize for diving! I would do it again in a heartbeat.

My doctor is Dr. Brian Weeks. I know he did an ear procedure live on "The Doctors". I just thought I'd mention it in case anyone else is having the same issues I did. If you google his name, you'll find a lot of information on both the balloon procedure for both the sinus and the ears.

 

[Mark Derail]

I've had the surgery, when I was 25 (I'm 43 now). Greatest thing ever. I don't think I could have dived at all without it.

I'm not perfect - I take twice as long to get down & equalize, and I often take longer on the way back up to make sure I don't have reverse block. I'm an expert on yawning.

Previous to the operation, I had suffered, to that point, all my life with chronic sinus & lung infections, constantly rotating with different antibiotics. Over 20 years now, not a single use, not once, of an antibiotic. I was able to "beat off" those yearly colds naturally.

I also suffer from seasonal allergies - this lessens over the years.

The doctor performed the surgery in his office, a specialist. In & out within a couple of hours. Yep, you get to swallow anesthesia, boy does it taste bad.
I won't spoil the fun with more spoilers...

 

[afdgf]

I have had a lot of problems with ear clearing and have learned that it is better to sit out a dive to avoid yet another trip to the ENT doc. Every time I go there, the receptionist knows that it is for ear barotitis media and she asks me where I went diving to screw up my ears this time. I have had to take prednisone, pseudophed, and afrin to have any success at ear clearing. I finally made contact with the Dr. Brian Weeks referred to in this thread. He himself is a diver and when I got into his exam room, one whole magazine rack was filled with dive magazines. They first examined me and the Nurse Practitioner (NP) said "no wonder you cannot clear your left ear, you have an enormous bone spurr going all the way from front to back, in addition to the Mother of all deviated septum." (She did not exactly say that but you get the idea). On September 10 I had the following procedures: 1. septoplasty for deviated septum, 2. bone spur removal bilateral, 3. reduction of inferior turbinates, and 4. balloon dilation of eustachian tubes bilateral. It has been over a week and now I understand why my trainer kept wanting me to breath through my nose after each set. Now it is actually possible for me to do that for the first time in my life. We are planning our deep diver course in October which will allow for full healing from the surgery. I hope it works. The experience of the recovery from the surgery was pretty close to what Dr. Weeks said it would be. I only needed three pain pills the night after surgery and the bleeding eventually stopped. I had to come back in a week for the NP to "pick my nose" literally. They put me on methlyprednisolone because there was too much inflammation in the left, but I think I am OK now. The ability to breath through my nose has already been amazing. I am looking forward to testing my ability to clear my ears in October. The balloon dilation procedure is off label so you will need to pay for that entirely on your own. All of the rest was within plan for my health insurance. I will try to update the board after our deep diver experience.

 

[lttleldydver]

Afdgf - thank you for reporting back! While I was completely ecstatic with the sinus dilation, I've been holding off on the ear balloon dilation for FDA approval. I was hoping to avoid out of pocket costs. I can't believe it still hasn't been approved. However, after reading your post, I think I'm going to make another appointment with Dr. Weeks. While my ears are 75% better, still not as good as I know they can be. My understanding was that insurance would cover a lot of the surgery, just not the actual "balloon". Certainly worth another visit to see. Glad your breathing well!!