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      Balloon sinuplasty, an initial assessment: 10 cases, results and follow-up

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          Abstract

          Abstract

          Introduction and aims: Balloon sinuplasty has been the object of recent discussions and papers. It is believed that the use of these tools can bring benefits, when compared with traditional endoscopic sinus surgery. Although there already are papers on the efficacy of this new instrument in the literature, there is no study in our country with a series of cases and follow-up of patients undergoing sinuplasty. Our study aims to review the information of 10 patients who underwent balloon sinuplasty, alone or in combination, discussing the indications, complementary therapy and follow up evaluation.

          Method

          retrospective study.

          Results

          Of 10 patients, 6 were males and 4 females. Their ages ranged from 7 to 58 years. All patients had chronic rhinosinusitis without nasal polyps, of which 8 are associated with allergic disease. 3 patients underwent sinuplasty only, and 7 had other procedures done during the same procedure. Follow-up ranged from 2 to 7 months. Of the 10 patients, 9 showed symptoms improvement in imaging studies.

          Conclusion

          sinuplasty was successfully performed in all patients, without major technical difficulties or complications. This instrument can become an alternative surgical treatment for some groups of patients.

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          Most cited references19

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          Pre- and postoperative sinus penetration of nasal irrigation.

          Endoscopic sinus surgery is an accepted treatment for medically recalcitrant chronic rhinosinusitis. Effective saline douching may improve long-term outcomes of chronic rhinosinusitis but is often impaired by postoperative ostial stenosis. The aim of this study is to determine a critical ostial size at which douching solution reliably enters the sinus cavities. Prospective study of consecutive patient cohort. Seventeen preoperative or well-healed postoperative endoscopic sinus surgery patients were irrigated with 5 mL blue food coloring mixed with 200 mL buffered saline from a squeeze bottle. The degree of sinus penetration, sinus ostial patency, and ostial size were endoscopically determined. Sinuses penetrated by blue dye had a significantly larger minimal ostial dimension (7.31 mm; 95% confidence interval 5.54-9.08) than those that had no blue dye penetration (1.26 mm; 95% confidence interval 0.86-1.66) as determined by Student t test. Chi-square analysis showed that operated sinuses were more likely to be penetrated than nonoperated sinuses (P = .0016) and obstructed sinuses (P = .0325). Logistic regression showed a 95% probability of penetration when the minimum ostial dimension is 3.95 mm or greater. Unoperated sinuses or cases with gross sinus ostial obstruction will not be reliably penetrated by sinus irrigant. A 3.95-mm ostial diameter seems to be the minimum size to guarantee penetration in paranasal sinuses to maximize the potential for topical sinus treatment.
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            Safety and outcomes of balloon catheter sinusotomy: a multicenter 24-week analysis in 115 patients.

            The aim of this study was to further evaluate the safety and effectiveness of balloon catheter devices to dilate obstructed sinus ostia/perform sinusotomy. Through a prospective, multicenter evaluation, safety was assessed by rate of adverse events, patency was determined by endoscopic examination, and sinus symptoms were determined by the Sino-Nasal Outcome Test (SNOT 20). At the conclusion of the 24-week analysis, endoscopy determined that the sinusotomy was patent in 80.5% (247 of 307) sinuses and nonpatent in 1.6% (5 of 307), and could not determine ostial patency status in 17.9% (55 of 307). Of the ostia visualized on endoscopy, 98% were patent (247 of 252), while 2% (5 of 252) were considered nonpatent. SNOT 20 scores showed consistent symptomatic improvement over baseline. Revision treatment was required in 3 sinuses (3 of 307 sinuses, 0.98%) in 3 patients (3 of 109 patients, 2.75%). Balloon catheter technology appears safe and effective in relieving ostial obstruction. Patients were pleased and indicated that they experienced symptomatic improvement.
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              Multicenter registry of balloon catheter sinusotomy outcomes for 1,036 patients.

              This study assesses the safety and effectiveness of balloon catheters used as instruments in sinus surgery in a "real-world" multicenter registry of 1,036 patients across 27 US otolaryngology practices. Data were collected by standardized chart review with centralized database administration for all consecutive functional endoscopic sinus surgeries that included the use of balloon catheters across the 18-month time period from December 2005 to May 2007. Balloon catheters were used in 3,276 peripheral (maxillary, frontal, and sphenoid) sinuses, for an average of 3.2 sinuses per patient. There were no major adverse events related to the use of balloon catheter instruments. The revision rate was 1.3% of sinuses treated with a balloon catheter after an average follow-up of 40.2 weeks. Sinus symptoms were improved in 95.2%, unchanged in 3.8%, and worse in 1.0% of patients. Postoperative sinus infections were significantly less frequent and less severe compared to infections before surgery. The results were consistent across all patient categories, including balloon-only patients and revision patients. Use of balloon catheters as instruments in sinus surgery appears to be relatively safe and effective and to improve the patient's quality of life. The results are consistent and generalizable across a wide range of sinusitis patients and physician practices. The complication rates, revision rates, and patient symptom improvement rates all compare favorably with previously reported results of functional endoscopic sinus surgery.
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                Author and article information

                Contributors
                Journal
                Braz J Otorhinolaryngol
                Braz J Otorhinolaryngol
                Brazilian Journal of Otorhinolaryngology
                Elsevier
                1808-8694
                1808-8686
                22 October 2015
                Sep-Oct 2010
                22 October 2015
                : 76
                : 5
                : 588-595
                Affiliations
                [1 ]ENT Physician
                [2 ]PhD in Otorhinolaryngology, Director of the Otolaryngology and Speech and Hearing Center of São Paulo - Hospital Prof. Edmundo Vasconcelos
                [3 ]PhD in Otorhinolaryngology, Head of the Pediatric Otolaryngology Department of the Otolaryngology and Speech and Hearing Center of São Paulo - Hospital Prof. Edmundo Vasconcelos. Centro de Otorrinolaringologia e Fonoaudiologia de São Paulo - Hospital Professor Edmundo Vasconcelos
                Author notes
                [* ]Send correspondence to: João Flávio Nogueira - Rua Dr. José Furtado 1500 Fortaleza CE Brazil 60822-300. www.sinuscentro.com.br joaoflavioce@ 123456hotmail.com
                Article
                S1808-8694(15)30914-9
                10.1590/S1808-86942010000500009
                9450734
                20963341
                05536843-f2f9-42e4-b044-8aefe97b828e
                .

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Categories
                Original Article

                video-assisted surgery,endoscopy,surgical procedures,minor.

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