In Office Balloon Dilation of the Sinuses with Image Guidance
Faculty:
Kevin Welch, MD
Steven Pletcher, MD
David Poetker, MD
Credits
CME:1.5, MOC:1.5
Description
Since its first feasibility report in 2006, the use of balloon catheter dilation (BCD) for the treatment of chronic rhinosinusitis (CRS) has grown in popularity and controversy. Over the past decade, numerous case reports and single arm studies have suggested that BCD is safe and effective for the treatment of patients with CRS, and more recently a prospective randomized trial comparing BCD to traditional endoscopic sinus surgery has shown similar results over a 6-month follow-up period. This procedure has evolved from one performed in the operating room under general anesthesia to one performed primarily in the office under local anesthesia. When performed, balloon catheters are placed into the maxillary, frontal or sphenoid sinuses before being dilated with the endpoint of widening the natural ostia of these sinuses and, thereby, improving outflow in an obstructed sinus. Confirmation of balloon catheter placement was originally performed with fluoroscopic guidance and later by the passage of lighted guidewire. Recently, the ability to use image-guided surgery (IGS) platforms to facilitate placement of the balloon catheters has emerged. This patient management perspective reviews the indications for treatment of CRS by use of BCD and IGS.
