Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

Abstract

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

Balloon Sinus Dilation Versus Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: Systematic Review and Meta-Analysis

“…Study and patient characteristics of the selected studies : Study characteristics are presented in Table 1. Of 18 studies included in qualitative review, 9 were RCTs 9,12,16-22 , 9 were cohort 10,13,15,23-28 studies. When multiple articles reported on the same patient cohort, all studies were included in narrative review but only the study with the most complete result reporting was included in quantitative analysis.…”

Safety of day‐case endoscopic sinus surgery in England: An observational study using an administrative dataset

“…37 However, the indications for balloon sinuplasty are more limited than ESS, 38,39 and there is evidence that patients undergoing balloon sinuplasty require revision surgery more frequently than conventional ESS patients. 40 As such it will not fully replace conventional ESS, but may have a more significant role in practice in England if local anaesthetic procedure facilities are improved. Although it is difficult to predict how balloon sinuplasty will affect ESS day-case rates, the future use of balloon sinuplasty and its outcomes should be monitored.…”

“…Balloon sinuplasty is thought to have a complication risk similar to conventional ESS 37 . However, the indications for balloon sinuplasty are more limited than ESS, 38,39 and there is evidence that patients undergoing balloon sinuplasty require revision surgery more frequently than conventional ESS patients 40 . As such it will not fully replace conventional ESS, but may have a more significant role in practice in England if local anaesthetic procedure facilities are improved.…”

Use of balloon-assisted nasal access to augment endoscopic endonasal transsphenoidal approach: illustrative case

“… 8 Endoscopic sinus surgery and septal modification are also effective treatments for chronic rhinosinusitis. 9 Major components of the nasal septum include cartilage, the vomer extending upward from the hard palate, and the perpendicular plate of the ethmoid bone extending downward from the anterior skull base. Septal deviation and individual anatomy can lead to difficulty visualizing operative trajectories in transsphenoidal surgery.…”

“…However, this finding is likely not relevant to surgical access to the sella and skull base region. 9 Melroy et al reported a complication rate of 0.0035% per sinus when reviewing balloon septoplasty for nasal access in an FDA database. 11 Our patient had a successful tumor resection and did not note any postoperative complications.…”