Nose & Sinus · In-Office or Operating Room

Balloon Sinuplasty in Fort Worth

When chronic sinus infections, pressure or congestion continue despite appropriate treatment, balloon sinuplasty may offer a less invasive way to reopen selected sinus drainage pathways. It uses a small catheter to widen a narrowed natural opening without removing bone or tissue.

Dr. Fewins has performed hundreds of balloon procedures in the office and operating room. He chooses the procedure and setting around your symptoms, CT findings, anatomy and extent of disease—and will tell you when a balloon is not enough.

Call to Schedule

Balloon sinuplasty — the short version

What it does: Reopens a blocked sinus opening with a small balloon catheter — no cutting, no tissue removed.
Who may benefit: Patients with a CT-confirmed narrowed sinus opening that hasn't responded to medication, and no nasal polyps.
What it will not fix: Nasal polyps, extensive ethmoid disease, allergies, a deviated septum, or an overactive nasal nerve — each needs its own treatment.
Typical recovery: Most patients return to normal activities within 24–48 hours.

What is balloon sinuplasty?

Balloon sinuplasty (also called balloon catheter sinusotomy or balloon dilation) is a minimally invasive procedure that reopens a blocked sinus by gently widening its natural drainage opening — the sinus ostium — with a small, flexible balloon catheter. The goal is simple: restore normal sinus drainage so mucus and infection stop backing up.

The procedure is performed through the nostrils using endoscopic visualization. The setting and any combined treatment depend on the individual case.

How it works

The procedure is done entirely through the nostril, with no incisions on the face:

Using a nasal endoscope for a clear view, a thin guide catheter is passed to the opening of the blocked sinus.
A flexible balloon catheter is advanced and positioned across the narrowed sinus opening.
The balloon is slowly inflated to dilate the sinus ostium and open the sinus cavity, gently restructuring the drainage pathway.
The sinus is irrigated to flush out trapped mucus and debris, then the balloon and instruments are withdrawn.

Dr. Fewins performs balloon sinuplasty both in the office under local anesthesia and in the operating room, matching the setting to your anatomy. He sees patients in Fort Worth and Cleburne, and cares for Spanish-speaking patients directly, in fluent Spanish — no translator needed.

Illustration of balloon sinuplasty: a balloon catheter opening a blocked, infected maxillary sinus, and the same sinus draining afterward — A balloon catheter is guided into a sinus drainage opening, inflated briefly to widen it, then removed. Illustration provided by Dr. Fewins.

When balloon treatment fits—and when it does not

Balloon sinuplasty is widely marketed, but it is not the right answer for everyone with sinus symptoms. The strongest reason to consider it is a documented sinus drainage problem that the procedure can address. Your symptoms, prior treatment, nasal examination and CT findings should point to the same problem.

I have performed hundreds of balloon procedures, so let me be straight with you: balloon sinuplasty is done more often than it should be. It can genuinely help the right patient by reopening natural drainage and sometimes avoiding a larger operation. But when the real problem is deeper disease or nasal polyps, a balloon alone will not fix it. I recommend it when it is the right operation—and when something more thorough is needed, I say so.
Dr. John Fewins

A balloon opens a drainage pathway. It does not remove nasal polyps, straighten a deviated septum, reduce enlarged turbinates, treat an overactive nasal nerve or correct a primary headache disorder. Those problems require their own evaluation and treatment. More extensive disease may need endoscopic sinus surgery.

A shadow on a CT scan is not, by itself, a reason to operate. Mild incidental findings are common, and a respiratory infection can temporarily change how the sinuses look. Dr. Fewins reviews the images alongside your symptoms and examination and compares them with the radiologist’s report.

May help

Selected chronic sinusitis that has not improved with appropriate medical treatment
Recurrent acute sinus infections when the history and evaluation establish that pattern
A narrowed or blocked sinus opening on CT that matches your symptoms and examination

Usually needs another approach

Nasal polyps, fungal sinusitis or extensive ethmoid disease that requires tissue removal
Symptoms driven primarily by allergy, septal deviation, enlarged turbinates or chronic rhinitis
Facial pain or pressure without evidence that a sinus problem is the cause

Some patients need less treatment; others need more. If a previous balloon procedure did not help, the next step is to determine whether the original target was incomplete, the disease has changed or a different diagnosis explains the symptoms.

Explore your symptoms

Find information on congestion, drainage, recurring infections and facial pain. This guide points to educational pages, not a procedure recommendation.

Open the symptom guide ↗

In-office versus operating room

Balloon sinuplasty can be done two ways, and Dr. Fewins matches the setting to your anatomy and your comfort:

In the office under local anesthesia. This may fit selected, limited disease and avoids general anesthesia. Procedure length, transportation, medications and activity instructions are individualized; follow the directions given for your case.
In the operating room, under conscious sedation or general anesthesia. The better choice when several sinuses are involved, when anatomy is complex, or when balloon dilation is combined with another procedure (a hybrid approach). Recovery is still short.

Balloon sinuplasty versus endoscopic sinus surgery

Functional endoscopic sinus surgery (FESS) is the traditional operation for chronic sinusitis. Using an endoscope, the surgeon opens and clears diseased sinuses — and, unlike a balloon, can remove polyps, inflamed tissue, and bone when disease requires it. Balloon sinuplasty is less invasive: it dilates the natural sinus opening without cutting, so there's generally less pain, less bleeding, and a faster return to normal activities.

The honest distinction: a balloon is excellent at reopening a blocked drainage pathway, but it does not address disease inside the sinus.

Balloon sinuplasty may be favored for limited chronic sinusitis or recurrent acute rhinosinusitis where the main issue is a narrowed sinus opening, medications haven't worked, and there are no polyps.
Endoscopic sinus surgery is the better choice when there are nasal polyps, extensive ethmoid disease, fungal sinusitis, or significant structural disease a balloon can't reach.
A hybrid approach — balloon dilation of some sinuses plus targeted endoscopic surgery of others — is sometimes the most efficient way to treat everything that's actually diseased in one setting.

What supports a recommendation

Persistent or recurrent sinus disease must be established first. An appropriate target on CT, the pattern of symptoms, nasal endoscopy and prior medical treatment help determine whether dilation is likely to add benefit. Imaging alone is not enough.

Four reported infections in a year or facial pressure alone do not automatically establish candidacy. Recurrent acute sinusitis and chronic sinusitis each require their own evaluation, and prior sinus or skull-base surgery may change the planning.

Preparing for the procedure

Beforehand, Dr. Fewins obtains a sinus CT scan and notes your baseline symptoms so results can be measured against a real starting point. On the day of an in-office procedure, your nose is prepared with a topical decongestant and numbed with topical and local anesthesia. You'll get simple instructions about which medications to pause and, for cases done under sedation or general anesthesia, about fasting.

There's no single "balloon" and no single right setting. Dr. Fewins selects among several balloon systems — including Acclarent, Medtronic, and VenSure — based on your specific sinus anatomy and whether the frontal, maxillary, or sphenoid sinuses are involved, and decides with you whether the office or the operating room is the safer, more thorough choice.

Recovery time and what to expect

First 24–72 hours

Mild congestion, tenderness, and a little bloody drainage are normal as the sinuses settle. There's no nasal packing and typically no bruising.
First week

Most patients return to work within a day or two. Use saline rinses as directed, keep your head elevated the first night, and avoid strenuous activity or heavy lifting.
Full recovery

Most patients are fully back to normal within one to two weeks. Plan on a follow-up visit so Dr. Fewins can confirm the sinuses are draining well.

Call the office promptly if you have heavy bleeding, a high fever, severe or worsening pain, vision changes, or persistent clear watery drainage — these are uncommon but worth a same-day call.

Risks, complications, and safety

Balloon sinuplasty has a strong safety record. Most side effects are minor and short-lived: temporary congestion, mild pain or pressure, a small amount of bloody drainage, and short-term tenderness. Serious complications — such as bleeding that needs attention or, very rarely, injury near the eye or skull base — are uncommon, and are minimized by careful patient selection and image guidance. The technology has been FDA-cleared since 2005, and its safety has been supported in multicenter studies.

Does balloon sinuplasty work?

For appropriately selected patients, yes — and the improvement lasts. In multicenter studies, patients treated for chronic sinusitis reported meaningful, durable gains in symptoms and quality of life, with high patient-satisfaction rates and long-term outcome analysis showing benefit maintained at two-year follow-up. Symptom improvement is comparable to traditional sinus surgery for the right, limited disease — with less pain and faster recovery. A clinical consensus statement from the American Academy of Otolaryngology–Head and Neck Surgery supports balloon dilation for appropriately selected patients.

The honest caveat, again: this is true for the right patient. Individual results vary, and Dr. Fewins sets realistic expectations with you after your evaluation.

Frequently asked questions

How quickly will I feel better?

Many patients notice easier breathing and less pressure within the first week, with continued improvement over the following weeks as swelling settles and the sinuses drain.

Is it painful, and what about anesthesia?

Your nose is numbed beforehand, so most patients feel pressure rather than pain. In-office procedures use local anesthesia; operating-room cases use conscious sedation or general anesthesia. Any soreness afterward is usually mild and brief.

Do I really need it, or is it being over-recommended?

A fair question — and the right one to ask. Dr. Fewins recommends balloon sinuplasty only when your symptoms, exam, and CT scan agree, and he'll tell you when medication, a different procedure, or more thorough surgery is the better fit.

Is it covered by insurance, and what does it cost?

These procedures are typically covered by insurance, including Medicare, when medical criteria are met. Your out-of-pocket cost depends on your plan and whether the procedure is done in the office or the operating room. Our team will help you navigate your coverage and verify benefits before anything is scheduled.

Is balloon sinuplasty appropriate for children?

Occasionally, in carefully selected cases — and in children it's performed under general anesthesia, not in the office. Many children with sinus symptoms are better helped by other treatments first. Dr. Fewins, who has decades of pediatric ENT experience, will guide the right approach for a child.

Why choose Expert ENT and Sinus Care for sinus care in Fort Worth

Dr. John L. Fewins, MD, FACS — board-certified otolaryngologist with a particular focus on nose and sinus care.
A personalized evaluation with real diagnostic testing — nasal endoscopy and a CT scan reviewed with you, and independently read by a radiologist.
The full range of options — in-office or operating room, balloon, endoscopic surgery, or a hybrid — with the device and setting matched to your anatomy.
Straight talk: he tells you what he'd recommend, even when that means a different treatment or none at all — and second opinions after a failed balloon are welcome.
Convenient care in Fort Worth and Cleburne — and fluent Spanish spoken, so Spanish-speaking patients are cared for directly, not through a translator.