Balloon Catheter Sinuplasty in Young Children

Abstract

Background Balloon catheter sinuplasty (BCS) for chronic rhinosinusitis (CRS) was found to be successful in adults. The safety and feasibility of BCS in children has been recently established. The purpose of this study was to study the outcome of this technology in CRS in children. Methods A prospective, multicenter, nonrandomized evaluation was performed on patients with CRS. Thirty-two children between the ages of 2 and 11 years were enrolled. Safety was assessed by rate of adverse events. Effectiveness was assessed using the Sino-Nasal (SN)-5 quality-of-life questionnaire for children with CRS at 52 weeks follow-up. Results Thirty-two children were enrolled of which 24 completed their 52 weeks follow-up. No adverse events were reported because of the procedure. SN-5 score improved from a mean of 4.9 at baseline to a mean of 2.95 at 52 weeks (p < 0.0001). Twelve (50%) children had a significant improvement of their SN-5 (> – 1.5), 7 (29%) had moderate improvement (> –1.0 and < –1.5), 2 (8%) had mild improvement (> –0.5 and < –1.0), 1 (4%) remained the same, and 2 (8%) had worsening scores. Conclusions Balloon catheter dilation of the sinus ostia in children was safe and a significant number showed improvement of their SN-5 at 1 year follow-up. Additional studies comparing balloon sinuplasty to other modalities of treatment in children are needed to determine its efficacy in the treatment of CRS in children.

Use of balloon sinuplasty in patients with chronic rhinosinusitis in the United States

“…It is considered a minimally invasive surgical approach to the sinuses that avoids distortion of the original sinonasal anatomy with minimal mucosal damage . The use of this technology for the management of patients with CRS has been reported in the literature in multiple nonrandomized retrospective comparative trials, including its use in the outpatient setting, pediatrics, and in patients with limited disease . In a systematic review by Ahmed et al .…”

“…However, there are only a few comparative studies in the literature and hence the role of BCT in the management of CRS has yet to be established. BCT has been used for medically refractory CRS in adult and pediatric patients, in patients with limited disease, in the frontal sinus, and for delivery of surgical therapy in the clinic setting . Since its introduction in 2005, this technology has not been shown to contribute substantially to the overall frequency of ESS .…”

Adenoidectomy With Balloon Catheter Sinuplasty: A Randomized Trial for Pediatric Rhinosinusitis

“…An additional limitation noted early on was the inability for BCS to achieve success in six of 10 hypoplastic maxillary sinuses. 22,23 Based on the current reports in the literature, it appears that BCS does lead to improvement in sinonasal symptoms of children with CRS. However, it is uncertain as to whether or not it is better than the traditional maxillary sinus puncture/irrigation which, as noted above, improves QOL scores from 60.7% (adenoidectomy alone) to 87.5% (adenoidectomy with antral irrigation).…”

Balloon dilation for management of choanal atresia and stenosis

“…Balloon dilation has proven a useful tool in the management of subglottic stenosis [4]. More recently, balloon dilators have been used in endoscopic surgery of the maxillary, frontal, and sphenoid sinuses [3,5,6]. Balloon dilation applies a steady, radial force for dilation, avoiding the shearing forces associated with other dilating techniques (e.g.…”

“…Recently balloons have gained popularity for their use in balloon sinuplasty [5,6]. The advantage of balloon dilation is the application of a stable, radial force as compared to rigid dilation which exerts shearing, linear forces.…”