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

Chaaban, Mohamad R.; Baillargeon, Jacques; Baillargeon, Gwen; Resto, Vicente A.; Kuo, Yong‐Fang

doi:10.1002/alr.21939

Cited by 34 publications

(53 citation statements)

References 45 publications

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“…Similar to several other studies, we found that epinephrine the auto‐injector was underutilized during clinical visits with initial and recurrent anaphylaxis episodes . This is particularly concerning given that only 6.3% of the patients who presented with recurrent anaphylaxis received an epinephrine injection.…”

Section: Discussionsupporting

confidence: 86%

“…Similar to several other studies, we found that epinephrine the auto-injector was underutilized during clinical visits with initial and recurrent anaphylaxis episodes. 23,24 This is particularly concerning given that only 6.3% of the patients who presented with recurrent anaphylaxis received an epinephrine injection. Patients may have already received an injection before arrival to the ED, but the rate was even lower (3.2%) in patients presenting with their initial event.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent anaphylaxis in the United States: time of onset and risk factors

Chaaban

Stuart

Watley

et al. 2019

Int Forum Allergy Rhinol

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Background Studies have not yet examined the trends and risk factors of biphasic and recurrent anaphylaxis in the United States using International Classification of Diseases, tenth revision (ICD‐10) CM codes. The goal of this study is to examine the trends of biphasic and recurrent anaphylaxis in all patient care settings (inpatient, outpatient, emergency department, and observation). Methods We used the Clinformatics database from 2015 to 2017. Our main outcome measure was recurrent anaphylactic events occurring within 1 year after the initial event. We used Cox proportional hazards modeling to assess the factors associated with recurrent anaphylaxis and the Kaplan‐Meier method to estimate time to recurrence. Results There were a total of 19,039 patients with incident anaphylaxis in 2016 and, of these, 2017 had a recurrent anaphylaxis event in the 12‐month period after the index date (10.6%). The most common trigger for recurrent anaphylaxis is venom followed by food allergens. Pediatric patients aged <18 years were more likely to develop recurrent anaphylaxis compared with patients aged 18 to 64 years (hazard ratio [HR], 1.53). Patients with allergic rhinitis and asthma were more likely to develop recurrent anaphylaxis compared to those without these comorbidities (HR, 1.15 and 1.27, respectively). Conclusion This is the first national study using ICD‐10 CM codes looking at rates of biphasic and recurrent anaphylaxis in all patient care settings. Recurrent anaphylaxis is more common in the first 3 days after the initial event, in younger patients (<18 years), and in patients with allergic rhinitis and/or asthma. Physicians need to prescribe epinephrine auto‐injectors and educate their patients about the risk of recurrence.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Recurrent anaphylaxis in the United States: time of onset and risk factors

Chaaban

Stuart

Watley

et al. 2019

Int Forum Allergy Rhinol

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“…A recent systematic review by the Cochrane group on the efficacy of this technique concluded that it did not demonstrate any superiority over conventional techniques. 7 However, since this review in 2011, the REMODEL trial provided supportive evidence for maxillary sinus balloon sinuplasty 8 with evidence accumulating in other studies 9,10 and an increase in the use of the technique seen especially in the USA as a clinic-based procedure 5 ; it is likely that the technique will continue to be part of established practice for the foreseeable future.…”

Section: Technique Balloon Sinuplastymentioning

confidence: 93%

“…3 Most recently, we have seen the advent of balloon sinuplasty and it has become a commonly available tool for clinic-based procedures, initially to the maxillary sinus, 4 but with a more recent shift toward the frontal sinus. 5 This chapter will explore the range of endoscopic techniques currently in use by otorhinolaryngologists in addressing the maxillary sinus.…”

mentioning

confidence: 99%

Endonasal Approaches to Maxillary Sinus

Philpott¹,

Sama²

2018

International Journal of Head and Neck Surgery

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Operating on the maxillary sinus has been a part of the otorhinolaryngologist's surgical repertoire being perceived as the most accessible sinus. Following the advent of endoscopic sinus surgery and advances in angled endoscopes and surgical instruments, approaches to the maxillary sinus have evolved leaving open approaches largely redundant. This review article will guide the readers through the key anatomical principles and techniques available for endoscopic approaches to the maxillary sinus.

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“…[2][3][4][5] These factors, as well as the addition of balloon-specific common procedural technology (CPT) codes in 2011, contributed to a dramatic increase of stand-alone BSP being utilized in 22.5% of sinus revision procedures from 2011 to 2014. 1 Despite the rise in popularity, there is continued debate about when to utilize BSP or FESS. Both procedures are considered generally safe stand-alone with uncertainty about which is the safer option.…”

Section: Introductionmentioning

confidence: 99%

Exploring Balloon Sinuplasty Adverse Events With the Innovative OpenFDA Database

Wright

Davis

Khan

et al. 2020

Am J Rhinol�Allergy

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Background Balloon sinuplasty (BSP) has become a common, minimally invasive treatment for chronic sinusitis. Like any surgical procedure, there are definite risks when using it as a stand-alone procedure or in conjunction with other revision procedures. Objective To explore the adverse events of BSP using the openFDA cloud with regard to malfunction and injury following surgery. Methods Between January 2015 and December 2018, the Food and Drug Administration’s (FDA) openFDA database was queried for adverse event use. Reports were further categorized by procedure location, injury type, device malfunction, procedure (stand-alone BSP vs hybrid), and source of complication (anatomical or surgeon related). Results Seventy-eight events were reported to the FDA in the study period. Majority of cases consisted of device malfunctions (64.1%), while patient injuries consisted of 43.5%. Frontal sinus procedures had the greatest presence of adverse events (47.4%) with the majority reporting significant cerebrospinal fluid (CSF) leaks ( P < .001) and device retention ( P = .021). Orbital complications ( P = .004) were found to be significantly associated with dilation of the maxillary sinus. Skull-based injuries were the only factor incident in which surgeon-reported anatomical complications were significant ( P = .018). Conclusions As balloon dilation procedure continues to rise in the United States, significant adverse events continue to occur. Frontal sinus BSP leads to the highest number of complications and a 4.75 reported CSF leaks yearly. Based on real data, surgeons performing the procedure should be acquainted with common BSP-related injuries so they can prepare for those circumstances and share informed consent with their patients.

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

Abstract: From 2011 to 2014 there was an increase in the use of balloon sinuplasty and a modest decrease in the use of conventional FESS in the United States. Patients with frontal or sphenoid sinus surgical sites were more likely to have a balloon or hybrid procedure.

Cited by 34 publications

References 45 publications

Recurrent anaphylaxis in the United States: time of onset and risk factors

Recurrent anaphylaxis in the United States: time of onset and risk factors

Endonasal Approaches to Maxillary Sinus

Exploring Balloon Sinuplasty Adverse Events With the Innovative OpenFDA Database

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