Mapping Your Unique Sinus Anatomy
Every patient's nasal and sinus structure is as unique as a fingerprint. When you consult an ENT specialist, the first step in deciding on a procedure is understanding your specific anatomical landscape. Factors such as the size of your sinus openings, the presence of a deviated septum, or the thickness of the mucosal lining play a critical role. Specialists look for physical obstructions like nasal polyps or enlarged turbinates that may be hindering natural drainage. By assessing these physical traits, your doctor can determine if a targeted, tissue-preserving approach is possible or if a more comprehensive structural correction is required to provide long-term relief from chronic symptoms.2,3
The Diagnostic Power of CT Imaging
To see beyond what a physical exam or nasal endoscopy allows, specialists utilize Computed Tomography (CT) scans. This imaging acts as a blueprint for your procedure. Medtronic provides advanced software that allows doctors to upload these scans into planning stations, such as the StealthStation™ S8. This technology enables your surgeon to measure distances between critical structures within millimeters, identifying precisely where blockages occur. Whether your disease is localized to the maxillary sinuses behind your cheeks or deeper in the ethmoid cells between your eyes, the CT scan ensures the surgical plan is tailored specifically to your internal 'map' before you even enter the treatment room.3,8
Selecting Minimally Invasive Balloon Sinuplasty
For patients with moderate disease and no significant structural abnormalities like polyps, balloon sinuplasty is often the procedure of choice. This minimally invasive option, often performed in a comfortable office setting, uses the Medtronic NuVent™ EM Balloon Sinus Dilation System. During this procedure, a small, flexible balloon is inserted into the blocked sinus opening and gently inflated. This reshapes the anatomy by widening the natural drainage pathway without removing bone or tissue. Because it preserves the delicate mucosal lining, patients typically experience less bleeding and a significantly faster recovery compared to traditional surgery, making it an ideal choice for localized anatomical blockages.4,7
Addressing Complex Structures with FESS
When the sinus anatomy is more complex—such as in cases of extensive nasal polyposis, a severely deviated septum, or chronic inflammation that has scarred the passages—Functional Endoscopic Sinus Surgery (FESS) may be necessary. Unlike balloon dilation, FESS allows the surgeon to physically remove obstructive tissue and bone to restore airflow. Medtronic powered instruments, such as microdebriders, are used to precisely clear diseased tissue while protecting healthy surrounding areas. This approach is highly effective for patients whose anatomy requires a more thorough reconstruction to ensure the sinuses can drain and ventilate properly for the long term.1,5
Navigating Safely with Image Guidance Technology
Safety is paramount when operating near the eyes and brain. To navigate your unique anatomy with the highest precision, many specialists use the Medtronic StealthStation™ ENT navigation system. Think of this technology as a GPS for the human body; it provides real-time 3D tracking of surgical instruments relative to your pre-operative CT scan. This is especially vital for 'revision' surgeries where previous procedures may have altered your original anatomy. By using electromagnetic sensors, the system gives your surgeon an added level of confidence, ensuring they can be thorough in removing disease while avoiding critical anatomical boundaries.6,8
Integrating Post-Operative Healing Solutions
The decision-making process doesn't end when the procedure is finished; it includes planning for the healing phase. To prevent the anatomy from scarring or closing back up, specialists often utilize drug-eluting technology. Medtronic offers solutions like the SINUVA™ Sinus Implant, which is designed for patients with nasal polyps. These specialized stents are placed directly into the treated sinus cavity, where they slowly release anti-inflammatory medication while providing a physical spacer to keep the newly opened pathways clear. Choosing the right post-operative support is just as important as the surgery itself to ensure that your anatomy remains healthy and functional during the recovery period.
Frequently Asked Questions
The primary difference lies in how the anatomy is altered to improve drainage. Balloon dilation, such as with the Medtronic NuVent™ system, is a tissue-preserving procedure where a small balloon is inflated to widen the natural sinus openings without any cutting. It is typically performed under local anesthesia in an office setting with very fast recovery times. Traditional Functional Endoscopic Sinus Surgery (FESS) involves the removal of bone, diseased tissue, or polyps to create larger drainage pathways. FESS is usually reserved for more severe cases where the anatomy is significantly obstructed or when structural issues like polyps are present, and it is typically performed in an operating room.4,5
Image guidance systems (IGS) function like a GPS for your surgeon, providing a real-time map of your internal anatomy during the operation. By correlating the position of surgical instruments with your pre-operative CT scan, the StealthStation™ ENT system allows the doctor to see exactly where they are within millimeters at all times. This is particularly crucial when working near delicate structures such as the optic nerve, the brain, or major blood vessels. For patients with complex or distorted anatomy from previous surgeries, this technology provides an essential layer of visualization that helps the surgeon be more thorough while significantly reducing the risk of complications.6,8
The recommendation for an in-office procedure is typically based on the severity of your disease and your specific anatomy. If your blockages are localized and you do not have significant complications like large nasal polyps or a severely crooked septum, an in-office procedure using the NuVent™ EM Balloon Sinus Dilation System may be ideal. Benefits of the office setting include the avoidance of general anesthesia, which reduces the risk of post-operative nausea, and a much faster return to normal activities—often within 24 to 48 hours. It is a more streamlined experience for patients whose anatomical needs can be addressed through dilation rather than extensive tissue removal.4,7
Candidates for sinus stents like SINUVA™ typically have an anatomy prone to recurrent nasal polyps or significant post-operative inflammation. After a sinus procedure, the body’s natural healing response can sometimes lead to the growth of new polyps or the formation of scar tissue that re-blocks the sinus openings. A specialist may choose to use a stent if your anatomy shows a high risk of 'closure' during healing. These devices are placed into the ethmoid sinus and serve two purposes: they act as a physical spacer to keep the passage open, and they deliver a controlled dose of steroid medication directly to the tissue to keep inflammation and polyp regrowth at bay.9,10
Important Safety Information
SINUVA™ (mometasone furoate) Sinus Implant
Indication & Important Safety Information
Healthcare Professional Facing Materials
INDICATION
SINUVA™ (mometasone furoate) Sinus Implant is a corticosteroid-eluting implant indicated for the treatment of chronic rhinosinusitis with nasal polyps in adult patients ≥18 years of age who have had ethmoid sinus surgery.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
Patients with known hypersensitivity to mometasone furoate or any of the ingredients of the SINUVA™ Sinus Implant.
WARNINGS AND PRECAUTIONS
Local Nasal Adverse Reactions Monitor nasal mucosa adjacent to the SINUVA™ Sinus Implant for signs of:
- Bleeding (epistaxis)
- Irritation
- Infection
- Perforation
Avoid use in patients with nasal ulcers or trauma.
Glaucoma and Cataracts
Nasal steroids may result in the development of glaucoma and/or cataracts.
These were not observed in patients from one randomized controlled clinical study (N = 53) who underwent bilateral placement of SINUVA™ Sinus Implants. However, close monitoring is warranted in patients with:
- Changes in vision
- History of increased intraocular pressure
- Glaucoma
- Cataracts
Hypersensitivity Reactions
Hypersensitivity reactions including rash, pruritus, and angioedema have been reported with the use of corticosteroids.
Immunosuppression and Risk of Infections
Persons using immunosuppressive drugs, including corticosteroids such as the SINUVA™ Sinus Implant, may be more susceptible to infections.
Safety and effectiveness have not been established in pediatric patients under 18 years of age, and SINUVA™ is not indicated for this population.
Corticosteroids should be used with caution in patients with:
- Active or quiescent tuberculosis infection of the respiratory tract
- Untreated systemic fungal, bacterial, viral, or parasitic infections
- Ocular herpes simplex
Hypercorticism and Adrenal Suppression If corticosteroid effects such as hypercorticism or adrenal suppression occur, consider sinus implant removal.
ADVERSE REACTIONS
The most common adverse reactions observed (>1% of subjects) in clinical studies were:
- Asthma
- Headache
- Epistaxis
- Presyncope
- Bronchitis
- Otitis media
- Nasopharyngitis
POSTMARKETING EXPERIENCE
The following adverse reactions have been identified during post-approval use of the SINUVA™ sinus implant:
- Implant migration
- Lack of efficacy
- Nasal pain
- Headache
- Epistaxis
Rx only.
Please see Full Prescribing Information for SINUVA™ available at SINUVA.com/hcp.
StealthStation™ ENT System
The StealthStation™ ENT system is intended as an aid for precisely locating anatomical structures in either open or percutaneous procedures.
The system hardware and software should be used only by qualified medical professionals who are:
- Trained in performing surgery
- Familiar with image-guided surgery systems
If system navigation appears inaccurate and recommended steps to restore accuracy are not successful, abort use of the system.
NuVent™ EM Balloon Sinus Dilation System
Balloon sinus dilation can cause minor side effects such as:
- Congestion
- Facial numbness
- Headache
- Tenderness
- Sinus pain or pressure
Sinus surgery (FESS & BSS) has associated risks, including:
- Tissue trauma
- Bleeding
- Infection
- Possible ophthalmic injury
Patients should always discuss their individual needs and the potential risks and benefits of any treatment or procedure with their doctor.
Important Safety Information
PROPEL™ mometasone furoate sinus implants
The PROPEL Family of sinus implants are indicated to deliver a steroid drug locally and maintain the sinus opening after sinus surgery in patients 18 years of age or older:
PROPEL in the ethmoid sinus, PROPEL Mini in the ethmoid sinus and frontal sinus opening, and PROPEL Contour in the frontal and maxillary sinus openings. Patients allergic to the drug (mometasone furoate) or ingredients of the implant should not receive PROPEL.
It is not known if the implant is safe and effective in women that are pregnant or nursing.
Common side effects include infection, headache, and nose bleeds.
Risks related to the implant include pain/pressure, movement of the implant (within or out of the sinus) and potential side effects of steroids. For more information on the risks and benefits of PROPEL sinus implants, talk to your doctor or review the FDA approved labeling at www.manuals.medtronic.com. Rx only.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
