Modified In-Office Maxillary Balloon Sinus Dilation for Post-Procedure Sinus Monitoring and Access
20 April 2016
25 January 2017
27 April 2017 (eFirst)
Introduction As experience grows with in-office balloon sinus dilation (BSD) procedures, technique modifications will evolve to meet specific needs. The major disadvantage with the maxillary BSD procedure is that the intact uncinate process prevents visualization of and instrument access into the maxillary sinus both intraoperatively and postoperatively. Combining a partial or complete uncinectomy procedure with maxillary BSD could be beneficial in selected patients with certain maxillary sinus problems.
Objective The primary objective of this study was to see if, in selected patients, combining an uncinectomy and maxillary sinus BSD together allowed visualization of and access to the maxillary sinus cavity at the time of the procedure and at follow-up visits.
Method A chart review was completed for BSD cases performed from 2013 through mid-2015 identifying patients who underwent partial or complete uncinectomy with in-office maxillary sinus BSD. A total of 14 patients were identified, with 26 sinuses treated. The data collected included: difficulty or problems in performing an uncinectomy with the maxillary sinus BSD; visualization and access to the maxillary sinus cavity both intraoperatively and at follow-up visits; and occurrence of complications or late adverse sequelae. All patients completed a minimum 6-month follow-up.
Results Combined uncinectomy and maxillary sinus BSD procedures were easily completed for all patients without complications, and no late adverse sequelae were encountered. The maxillary sinuses could be visualized and accessed, if needed, intraoperatively and at all follow-up visits.
Conclusions In selected subsets of maxillary sinus conditions this procedure modification can provide significant benefits. A case is presented for illustration.
- 1 Stewart AE, Vaughan WC. Balloon sinuplasty versus surgical management of chronic rhinosinusitis. Curr Allergy Asthma Rep 2010; 10 (03) 181-187
- 2 Karanfilov B, Silvers S, Pasha R, Sikand A, Shikani A, Sillers M. ; ORIOS2 Study Investigators. Office-based balloon sinus dilation: a prospective, multicenter study of 203 patients. Int Forum Allergy Rhinol 2013; 3 (05) 404-411
- 3 Sikand A, Silvers SL, Pasha R. , et al; ORIOS 2 Study Investigators. Office-based sinus dilation: 1-year follow-up of a prospective, multicenter study. Ann Otol Rhinol Laryngol 2015; 124 (08) 630-637
- 4 Atkins J, Truitt T. In-office balloon dilation of the ethmoid infundibulum. Oper Tech Otolaryngol 2010; 21 (02) 102-106
- 5 Gould J, Alexander I, Tomkin E, Brodner D. In-office, multisinus balloon dilation: 1-Year outcomes from a prospective, multicenter, open label trial. Am J Rhinol Allergy 2014; 28 (02) 156-163
- 6 Mirante JP, Munier MA, Christmas Jr DA, Yanagisawa E. Balloon sinus dilation in the office setting. Ear Nose Throat J 2014; 93 (08) 300-301
- 7 Albritton IV FD, Casiano RR, Sillers MJ. Feasibility of in-office endoscopic sinus surgery with balloon sinus dilation. Am J Rhinol Allergy 2012; 26 (03) 243-248
- 8 Eloy JA, Shukla PA, Choudhry OJ, Eloy JD, Langer PD. In-office balloon dilation and drainage of frontal sinus mucocele. Allergy Rhinol (Providence) 2013; 4 (01) e36-e40
- 9 Sillers MJ, Melroy CT. In-office functional endoscopic sinus surgery for chronic rhinosinusitis utilizing balloon catheter dilation technology. Curr Opin Otolaryngol Head Neck Surg 2013; 21 (01) 17-22
- 10 Byun JY, Lee JY. Usefulness of partial uncinectomy in patients with localized maxillary sinus pathology. Am J Otolaryngol 2014; 35 (05) 594-597
- 11 Kennedy JL, Hubbard MA, Huyett P, Patrie JT, Borish L, Payne SC. Sino-nasal outcome test (SNOT-22): a predictor of postsurgical improvement in patients with chronic sinusitis. Ann Allergy Asthma Immunol 2013; 111 (04) 246-251.e2
- 12 Okushi T, Nakayama T, Morimoto S. , et al. A modified Lund-Mackay system for radiological evaluation of chronic rhinosinusitis. Auris Nasus Larynx 2013; 40 (06) 548-553
- 13 Rosenfeld RM, Piccirillo JF, Chandrasekhar SS. , et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152 (2, Suppl) S1-S39
- 14 Donaldson M, Gizzarelli G, Chanpong B. Oral sedation: a primer on anxiolysis for the adult patient. Anesth Prog 2007; 54 (03) 118-128 , quiz 129
- 15 Setliff III RC. Minimally invasive sinus surgery: the rationale and the technique. Otolaryngol Clin North Am 1996; 29 (01) 115-124
- 16 Setliff III RC. The small-hole technique in endoscopic sinus surgery. Otolaryngol Clin North Am 1997; 30 (03) 341-354