Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

Svider, Peter F.; Darlin, Spencer; Bobian, Michael; Sekhsaria, Vibhav; Harvey, Richard J.; Gray, Stacey T.; Baredes, Soly; Folbe, Adam J.; Eloy, Jean Anderson

doi:10.1002/lary.26941

Cited by 28 publications

(54 citation statements)

References 14 publications

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“…The most recent available data, as of November 2017, was retrieved from the Centers for Medicare and Medicaid Services (CMS) online site. Statistics provided by CMS have been used in numerous previous studies to characterize national trends . Temporal trends were determined through utilization of Medicare Part B National files for years 2007 through 2015.…”

Section: Methodsmentioning

confidence: 99%

Evolving patterns in the diagnosis and management of allergy‐mediated disorders

Arianpour

Svider

Yuhan

et al. 2018

Int Forum Allergy Rhinol

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Physicians have been more aggressive in the workup of allergy-mediated disorders in recent years. Although differences in allergen load exist, there is tremendous geographic variation in the ratio of testing to immunotherapy. While the role otolaryngologists play in immunotherapy remains stable, allergists manage the majority of patients, reinforcing the importance of interdisciplinary cooperation and outreach. SLIT does not appear to play a significant role in this population.

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Section: Methodsmentioning

confidence: 99%

Evolving patterns in the diagnosis and management of allergy‐mediated disorders

Arianpour

Svider

Yuhan

et al. 2018

Int Forum Allergy Rhinol

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“…There was a 5‐fold increase in BSDs performed nationwide among the Medicare population, increasing from 10% of sinus procedures nationally in 2011 to 35% in 2015. However, the number of traditional ESS procedures did not decrease during the same time frame …”

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confidence: 87%

“…Moreover, the technology offers possible cost‐saving opportunities as it can be performed in the office under local anesthesia . One potential downside of BSD is the increased cost associated with use of disposable sinus dilation instruments . When performed in the OR, BSD is associated with a 37.3% increase in OR supply costs while showing no difference in operative time .…”

mentioning

confidence: 99%

“…Use of BSD has rapidly increased in the continental US. Recent studies compared BSD with traditional sinus surgery and showed a large increase in its use since the introduction of balloon‐specific codes, especially in southern states where balloons were used in 42% of sinus procedures in 2015 . There was a 5‐fold increase in BSDs performed nationwide among the Medicare population, increasing from 10% of sinus procedures nationally in 2011 to 35% in 2015.…”

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confidence: 99%

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The intraoperative accuracy of maxillary balloon dilation: a blinded trial

Jensen¹,

Holbrook

Chen

et al. 2019

Int Forum Allergy Rhinol

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Background: Balloon sinus dilation (BSD) is a commonly performed sinus procedure in the United States. Several cadaveric studies have evaluated BSD accuracy and the maxillary sinus has consistently been shown to be the most challenging to cannulate. We designed an independent study to evaluate the intraoperative accuracy of maxillary sinus BSD. Methods:A prospective, single-blinded trial evaluating the accuracy of maxillary sinus BSD was performed using 2 commercially available BSD systems (guidewire-and probebased systems) randomly assigned to patients undergoing endoscopic surgery for chronic rhinosinusitus without nasal polyps (CRSsNP) or a skullbase approach in patients without sinus disease. All patients underwent maxillary BSD followed by uncinectomy to reveal dilation of the natural maxillary sinus ostia. The recorded procedures were reviewed by 3 fellowship-trained rhinologists from different institutions blinded to the BSD system utilized. The primary endpoint compared accuracy of maxillary BSD a empts. The secondary endpoint compared accuracy between the 2 systems.Results: Twenty-nine maxillary BSD procedures were performed in 18 patients (age range, 20-79 years; mean, 51 years) without nasal polyposis undergoing maxillary antrostomy as part of a more extensive procedure. BSD was successful in 18 of 29 (62%) a empts and unsuccessful in 9 of 29 (31%) a empts, with statistically "almost perfect" interrater agreement (kappa = 0.86). There was no statistical difference between the 2 BSD systems (p = 0.81). Conclusion:Maxillary BSD appeared to be less accurate in living patients when compared with findings from previously published cadaver studies. There were no differences in accuracy between the probe-and guidewire-based systems. This is the first non-industry-sponsored study evaluating maxillary sinus BSD in living patients. Further studies are needed to investigate the clinical implications of our findings. C 2019 ARS-AAOA, LLC.

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“…The rhinologic landscape is characterized by increasing employment of minimally invasive approaches . To our knowledge, there have been no population‐based analyses evaluating trends in the endonasal performance of orbital surgery.…”

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confidence: 99%

Endoscopic and external approaches for orbital decompression: an analysis of trends from a U.S. perspective

Svider

Arianpour

Nguyen

et al. 2018

Int Forum Allergy Rhinol.

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There has not been a clear movement toward the endoscopic approach for orbital decompression, with modest growth when compared with external approaches. Potential explanations include the specialty-exclusive nature of approaches, as well as a lack of consensus; the latter idea is further reinforced by geographic variation. High-quality prospective trials may clarify the role of endoscopic approaches in these patients.

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Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

Abstract: NA. Laryngoscope, 128:1299-1303, 2018.

Cited by 28 publications

References 14 publications

Evolving patterns in the diagnosis and management of allergy‐mediated disorders

Evolving patterns in the diagnosis and management of allergy‐mediated disorders

The intraoperative accuracy of maxillary balloon dilation: a blinded trial

Endoscopic and external approaches for orbital decompression: an analysis of trends from a U.S. perspective

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