February 1, 2006 Recovering from sinus surgery is notoriously painful and uncomfortable -- especially when doctors need to remove a packing they placed inside the sinus cavity during the procedure to reduce bleeding. A less-painful packing uses a new kind of gel instead, one that forms directly in the patient's sinus cavity and is later reabsorbed by the body.
CHICAGO--Sinus surgery may have you breathing easier after it's over, but recovery can be a painful process and scares many people away. Now, a new technique cuts down on the pain and has people breathing better!
Marty Dwan is busy -- he is a husband, father and runs his own company and somehow manages to do it all while suffering from sinus problems. He dreaded the surgery and even worse the recovery because after sinus surgery, patients have to deal with uncomfortable nose packing. "You have to go in a day or two later, have the packing removed, and that is the absolute worst pain in the world," he says.
Now, Dwan doesn't have to deal with the painful packing -- commonly used for plastic surgery. Ear, nose and throat doctor Jay Dutton, an otolaryngologist at Rush University Medical Center in Chicago, uses a revolutionary gel to stop bleeding after sinus surgeries. "It forms sort of a super-clot in the sinuses, for lack of better words," Dr. Dutton tells DBIS.
The gel is made from the patient's own blood. Plasma, or red and white blood cells and platelets, is combined with thrombin, a cow hormone that helps blood clot fast. This mixture is sprayed into the sinus cavities. Dr. Dutton says, "As soon as it hits the sinuses, within 30 seconds it forms a gel the consistency of Jell-O."
"It was nice that I didn't even have a bandage or anything on the nose," Dwan says.
After surgery, the gel is eventually absorbed into the sinus cavity so it never needs to be removed.
BACKGROUND: A gel made from a patient's own blood reduces pain and may improve the rate of wound healing following sinus surgery. The study compared 16 patients who received platelet gel after surgery with a control group who received traditional post-surgery packing material. Those patients reported less pain and an easier recovery than the control group, with no adverse reactions to the gel.
HOW IT WORKS: A small amount of the patient's blood is drawn and placed into a centrifuge machine to separate out the platelet-rich plasma -- a process similar to the way a salad spinner removes water droplets off fresh lettuce. This gel is then sprayed into the sinus cavity after surgery. The gel contains platelets for clotting, growth hormones for healing, and white blood cells to fight infection, and there is no risk of diseases because it is made from the patient's own blood. It replaces temporary sponges or sterile packing in the nasal cavity, which can be uncomfortable, painful, and may restrict breathing. Unlike the traditional material, which must be removed after a few days, the plasma gel is absorbed into the sinus cavity.
ABOUT SINUSITIS: Four pairs of air-filled spaces in the head make up the sinus cavity. The sinuses moisten and warm the air we breathe, and filter out particles like dust, spores, and bacteria. Each sinus is lined with tissue or mucous membrane that produces a fluid to keep the sinuses moist and clean, and drains naturally through the nose. Colds or allergies may cause the membrane to become inflamed, the blockage can lead to bacterial growth and sinus infection. Symptoms include headaches, nasal congestion, post-nasal drip and facial pressure. In more severe cases, the inflammation can cause polyps to form, which must be surgically removed. Over 30 million people, or 14 percent of the U.S. population, suffer from chronic sinusitis; nearly a quarter of those develop polyps.
ABOUT ENDOSCOPIC SURGERY: Endoscopic sinus surgery (ESS) is performed using instruments inserted through the nose to remove thickened and diseased tissue, while disturbing as little healthy tissue as possible. The endoscope is like a mini-telescope, giving the surgeon a better view of the sinus cavity. ESS is typically performed as an outpatient procedure under general anesthesia.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.