What’s The Difference Between Balloon Sinuplasty and Endoscopic Sinus Surgery?

Millions of people suffer with chronic sinus problems and experience symptoms that can be crippling to daily life. These symptoms can include nasal obstruction or congestion, headaches, facial pressure, loss of smell, fatigue, and pain or fullness.

With advanced treatments and less-invasive procedures to it’s possible to enjoy relief from chronic sinus pain. If you’re looking for a long-lasting, safe, and effective solution there are a number of options available.

You may be familiar with two top treatments for chronic sinus diseases: Endoscopic Sinus Surgery and Balloon Sinuplasty.

But what are the differences balloon sinuplasty or endoscopic sinus surgery? And which procedure may be right for you?

Ultimately, any recommended treatment options will be based on your individual circumstances and experiences.

Here’s an overview of the different procedures—and their primary differences and similarities—to help provide a greater understanding.

Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery (FESS)  is a medical procedure that utilizes particular, advanced techniques to eliminate blockages in the sinuses and help treat chronic sinus conditions. 

Due to these blockages, patients may experience symptoms in the form if facial pain, facial pressure, headaches, drainage problems, recurrent nasal infections, breathing difficulties, and loss of smell.

The most common reason for performing endoscopic sinus surgery is chronic sinusitis. It is generally recommended for patients who have failed to respond to medical therapies for their chronic sinus conditions.

Less commonly, it is also performed to remove blockages caused by other factors such as nasal polyps, nasal congestions, nasal obstruction, or nasal tumors. 

About the Procedure

Sinus surgery was once performed through external incisions (such as on the face and in the mouth), required extensive nasal packing, caused significant pain and discomfort, and often followed by a long recovery period.  So called “traditional sinus surgery” is a term that might conjure dread and fear to those who are familiar or have undergone such past surgeries. Thankfully, endoscopic sinus surgery today is a vastly improved sinus surgery technique and experience.

With recent advances in technology, including the nasal endoscope, sinus surgery is now commonly performed entirely through the nose, without face or mouth incisions.  The nasal endoscope is a small, lighted metal telescope placed into the nostril.  The endoscope allows the surgeon to see inside the nose and sinuses with an attached high resolution camera.  Today, endoscopic sinus surgery is typically done with minimal to no nasal packing, mild pain, and short recovery times.

Endoscopic sinus surgery may be done under local or general anesthesia, and can often be performed on an outpatient basis, depending on the individual patient and the reasons for surgery.  

The majority of sinus surgery is done under general anesthesia. The recovery period will vary depending on the surgery performed and the individual patient but most patients require 1 to 2 weeks off work. The majority of patients who have endoscopic sinus surgery do very well, with significant improvement in their symptoms.

Reasons to Undergo Endoscopic Sinus Surgery

If medical treatments have not been successful in improving your sinus symptoms, endoscopic sinus surgery may be helpful.

The main goal of sinus surgery is to improve the drainage pathway of the sinuses.  By widening the natural drainage pathway of the unhealthy sinuses, sinus infections should be reduced.  One of the most important benefits of surgery is the ability to deliver medications (sprays, rinses, nebulized drugs) to the lining of the sinuses after they have been opened. 

Essentially, sinus surgery is done in addition to—and is not a replacement for—proper medical treatment of the sinuses. It is important to note that if you are one of the patients who have diseased mucous membranes or form nasal polyps, no amount of surgery can change this fact. For many patients, surgery may not be a cure for sinusitis but is one of the many critical steps in managing sinus disease.

Endoscopic sinus surgery generally requires the cutting and removal of bone and tissue in order to clear up your sinus passages, using least-invasive techniques when possible. This removal will allow for better drainage, less blockage, and improved breathing.


The benefits of endoscopic sinus surgery include improved sinus drainage and nasal airflow, reduced amount of sinus infections, improved sense of smell. As mentioned previously, it also helps create better access for delivery of other treatments/medications, thereby improving their efficacy, and making it easier to manage/maintain/reduce symptoms.

For those who suffer from a deviated septum, a septoplasty can sometimes be performed during endoscopic sinus surgery (this is done to straighten the nasal septum, which divides the two sides of the nose).  If the turbinates require surgery, this can also sometimes be accomplished during sinus surgery, as well. 

In some cases, balloons are used as tools to help enlarge the sinus passages, which is a technique known as balloon dilation. Endoscopic sinus surgery can involve or utilize a similar method as that used in a balloon sinuplasty procedure.

Balloon Sinuplasty

Balloon sinuplasty is an alternative to traditional endoscopic sinus surgery. It’s a procedure that is also done to treat chronic sinusitis. It is performed using a small balloon to expand nasal passages, open and flush blocked, inflamed sinuses to help relieve chronic sinusitis. It’s performed in-office, is minimally invasive, safe and provides long-lasting results. It is typically a quick procedure, and patients report minimal discomfort. Recovery time is also fast with little to no downtime, and patients can expect to resume normal activity in 24-48 hours. Many patients begin experiencing the benefits and significant improvement in symptoms virtually immediately.   Typically, balloon sinupalsty is a one-time procedure that offers long-term relief and improvement in quality of life. 

Primary Differences

The primary difference between these two treatment options is the procedure itself and what’s involved. With FESS, or endoscopic sinus surgery, there is cutting and removal of tissue and bone required. With balloon sinuplasty, there is no cutting and removal required. This also means there can be a difference in whether or not general anesthesia is used, how long the treatment takes, and whether or not the treatment can be completed in-office. Of course, balloon sinuplasty is less invasive than FESS. As endoscopic sinus surgery is more invasive, patients will likely experience some discomfort. It also involves more recovery and down time. As mentioned previously, endoscopic sinus surgery doesn’t necessarily cure the problem, but can be significantly bennefical and a major part of a multi-pronged approach to managing chronic and advanced sinus disease. 


Balloon sinuplasty and endoscopic sinus surgery are both safe and effective. With both procedures, the general goal is to open up your sinus passages, so you can breathe better and suffer from fewer sinus complications. Both treatment options also help alleviate chronic sinusitis by working to improve drainage, remove blockage, and better your life. In other words, they treat many of the same problems with different approaches. 

The Right Method For You 

Because balloon sinuplasty is less invasive and requires a shorter recovery time, you may be wondering why anyone would opt for endoscopic sinus surgery? It’s true that balloon sinuplasty can help with a very wide variety of chronic sinus problems and sinus infection related issues, however, in some cases it may not be the appropriate treatment option; the procedure cannot solve every issue, nor benefit every patient. Very severe sinus problems or complicated cases may require a more intensive approach, in which endoscopic sinus surgery can be the best approach. For some, endoscopic sinus surgery may be the better treatment option to fully address underlying problems and bring patients the most benefits and improvement. Although more invasive than balloon sinuplasty, traditional sinus surgeries are still safe and effective treatment options that patients with severe sinus issues may wish to consider. 

 It is important to understand the choice of treatment method depends on each individual patient and your unique situation, after assessing and discussing your situation with your ENT. Whether it’s a endoscopic sinus surgery or a newer surgeries like balloon sinuplasty, there’s a way to get the lasting relief and results that will most benefit you. As the saying goes, the best approach is the one that works for you.

Suffering from ongoing sinus issues and want to learn more about treatment options?

Contact Ohio Sinus Institute today to schedule your appointment. With our vast experience pioneering and the latest technologies and advanced treatment options, we can help you find the right solution to achieve the relief you deserve.

Call today!