What is Endonasal Balloon Therapy?
Endonasal Balloon Therapy (EBT) goes by various names such as Bilateral Nasal Specific (BNS), Nasal Specific Technique or Cranial Facial Release (CFR). It is a "balloon-assisted" advanced cranial chiropractic adjustment designed to restore cranial mobility and eliminate dural meningeal stress.
Similar to the spinal joints, the cranial joints - referred to as sutures - are prone to restriction and locking, particularly in the sphenobasilar junction, maxillary-zygoma and the deep bones that comprise the endonasal chamber. These restrictions are commonly caused by some form of head trauma, sports related injury, whiplash and/or concussions, often during early childhood or adolescence. In many cases, from as early as the birthing process as the left side of the skull and face compresses during delivery through the birth canal.
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Bilateral Nasal Specific or EBT is an advanced cranial chiropractic technique that requires extensive training, clinical knowledge in cranial joint mechanics, neurology and the dural meningeal system. It is a delicate procedure that is desinged to naturally release restricted cranial sutures and restore full cranial mobility - also known as cranial rhythm. In doing so, it 1) eliminates dural meningeal stress on the brain and central nervous system - including the cranial nerves 2) improves the flow of cerebrospinal fluid (CSF) that bathes the brain and spinal cord, improving overall neural funtion and 3) opens the nasal passages to allow for proper sinus and eustachian tube drainage.
Bilateral Nasal Specific or EBT is a non-invasive holistic procedure, meaning it addresses the cause, not the symptoms. Instead of trying to supress the symptoms, (ie. sinus congestion, TMJ dysfunction, facial pain, chronic headaches, tinnitus, myoclonus, poor cognitive function etc) it aims to restore one thing; Cranial Rhythm. This rhythmic expansion and contraction of the cranial and facial bones determines the level of tension on the dural meningeal system, cranial nerves and CSF flow. When cranial rhythm is restricted or compromised, it results in subtle asymmetry of the head and face, torsion of the facial bones, septum, jaw and cheek bones. It also causes specific tender points along the temples, maxilla, occiput and soft palate that are palpable on examination.
Bilateral Nasal Specfic is a technique developed by Dr. Richard Stober in the 1950's where his practice in Portland, Oregon was geared towards treating thousands of children with disabilities like autism, ADD, ADHD and cerebral palsy using BNS to correct cranial restriction and improve cognitive function.
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More and more research is being done in this field as the benefits of BNS are becoming evident across various disciplines. Functional neurology at the world renowned Carrick Institute is studying and teaching the benefits of advanced Chiropractic techniques like Cranial adjusting for the management of Post Concussion Syndrome (PCS), Craniocervical Instability (CCI) and Vestibular Dysfunction to name a few (1). The in depth lectures of Dr. Richard Stober in the 1980's based on his nearly 30 years of clinical experience working with ADD, Autism and Down Syndrome children. Dr. Stober's profound case studies with Bilateal Nasal Specific is documented extensively by Dr. Andre Saine in his recently published book " The Art, Principles and Practice of Bilateral Nasal Specific - A Practitioner's Manual". Other studies have shown a significant reduction in symptoms of Migraine Headache and improvement in quality of work following EBT procedures (2). A new branch of Dentistry called Functional Dentistry is beginning to understand the Stomatognathic (facial, jaw and endonasal integrity) from a holistic perspective and collaborating with Chiropractors to provide a more comprehensive option for patients suffering from TMJ dysfunction, nasal obstruction and headaches (3). Others have shown significant improvements in balance and vestibular function following EBT therapy (4). This all builds on the foundational work that was done by many researchers, most notably, Dr. John Upledger, a clinical researcher and professor in the 1970’s who demonstrated how stress on the dural meningeal system of the cranium and spine impacted both neurological and physiological function (5). And so the research continues today with each case study to help us better understand the importance of this delicate cranial - dural meningeal - stomatognathic system and its significance to overall health and wellbeing.
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What is involved in an EBT/BNS procedure?
Cranial Facial Release CFR, Functional Cranial Release FCR, Bilateral Nasal Specificn BNS
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During your initial consultation, specific questions will be asked pertaining to your medical history, and current symptomology along with relevant imaging or scans you’ve done recently. The doctor will examine you through a set of palpatory tests to detect if any restrictions are present in the cranial and/or facial plates. Often times with head trauma, one side of the head and face will exhibit restriction in joint mobility compared to the other side along with visible torsion of the skull in severe and chronic cases. Based on your history and exam findings, the doctor will determine If you are deemed a candidate for the EBT procedure.
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The procedure involves four(4) consecutive days of therapy, each about 30 min in length. It involves the insertion of a small latex balloon through the nostril and positioned adjacent to one of the turbinates. The patient is asked to continue normal breathing through the mouth as the balloon is slowly inflated. The reason for the consecutive days is due to the delicate nature of the procedure; each session slowly expands and pushes outward on the cranial plates and stretching open the soft tissue lining of the airway. The delicate nature of the area demands a slow and steady pace otherwise it would be too painful and cause inadvertent injury. By the 3rd session, the nasal cavity is much more maleable and expansive to allow the cranial sutures to begin to move and mobilize with minimal pressure. As adhesions within the sutures are released, cranial-sacral rhythm is gradually restored leading to a return to optimal flow of cerebral spinal fluid to nourish the brain and spinal cord. When structure is restored, function is restored.
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Top 5 conditions that benefit from EBT
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Sports related head trauma (MMA, Hockey, Football, Lacrosse and Rugby)
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Motor vehicle accident related head trauma
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Childhood and adolescent head impact injuries from falls, fights and/or sports
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Eustachian Tube blockages from chronic and severe colds/flus
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Chronic Migraine Headaches, Sinusitis, Deviated Septum, Nasal Blockages
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Is EBT/BNS covered by my insurance?
Yes, this procedure falls under the scope of Chiropractic care and is billed as a Chiropractic visit. Most private insurance carriers also have a health spending or flex account that can be used to help cover the cost of the procedure. Dr. Filo combines EBT therapy with cranial sacral, upper cervical and other advanced Chiropractic techniques to ensure all areas of the head and spine are structurally balanced.
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A licensed Chiropractor practicing in Ontario is bound by the Regulated Health Professions Act or RHPA and licensed by the College of Chiropractors of Ontario (CCO). As per the RHPA, the Authorized Act of ‘moving the joints of the spine beyond a person’s usual physiological range of motion using a fast, low amplitude thrust’ (ie. joint manipulation) is within the scope of practice for all licensed Chiropractors practicing in Ontario.
Furthermore, the latex cot/balloon used as part of the EBT procedure by Dr. John Filo, is NOT placed beyond the nasal conchae or meatus (narrowest part of the nasal passage) as per RHPA section 27(2).(6)
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Is EBT a safe procedure?
Absolutely. It is a holistic Chiropractic procedure designed to correct the root cause and restore cranial mobility naturally and efficiently. No drugs or surgery is needed. In very rare instances, patients may experience mild nose bleeding or spotting immediately after the procedure. This is due to the stretching of the soft tissue lining inside the nasal cavity. Individuals on blood thinner medication may be prone to a longer period of nose bleeding following the procedure. Please discuss this with the doctor during your initial consultation.
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Do I need a medical referral?
No, a referral is not required to see a Chiropractor. If any prior imaging (x-ray or CT/MRI ) have been done for your condition, please bring a copy of the report(s) with you to your initial consultation. The doctor will review your results during your exam.
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Is EBT/BNS painful?
Some patients have described it as a feeling of expansion or pressure inside the nasal cavity. Other patients have described it as a feeling of ” unlocking” or “opening” followed by a sense of immediate relief. It is common to hear popping or cracking noises during the procedure as blockages are released and facial bones re-align. The first thing many patients will report is a sudden increase in breathing capacity through the nose and less pressure in the sinuses and ears.
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How many sessions will I need?
This is entirely dependent on the chronicity of your condition – the length of time you have been suffering from the symptoms – and other underlying factors. One EBT procedure involves four (4) consecutive sessions. If more than 4 are required, additional sessions will be scheduled the following week up to a maximum of 6 total. Other underlying factors include; increased levels of stress, chronic inflammatory conditions due to diet and sensitivities or pre-existing structural limitations (severe deviated septum, cranial deformity, congenital defects etc. ).
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Chronic cases may require more frequent follow ups and maintenance to ensure cranial alignment and suture mobility is fully restored. The frequency of follow ups will be determined by the doctor and based on your specific level of response from the treatments.
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Out of town patients typically fly in on a Sunday and start the EBT procedure on the Monday and fly out on Thursday or Friday following the last procedure. For accommodations, the Novotel Toronto North York on Yonge St (North York Station) has reasonable rates, subway access and is within walking distance to the clinic.
What is the cost of the procedure?
The fee for the initial EBT consultation is $120. The complete procedure which includes 4 consecutive sessions is $2000.
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