Advertisement

Functional Endoscopic Dilatation of the Paranasal Sinuses

  • Demet Yazıcı
  • Osman Kürşat Arıkan
  • Jivianne T. Lee
Chapter

Abstract

As we acquire a better understanding of the pathophysiology of chronic rhinosinusitis (CRS), the requisite for less invasive, mucosal sparing, “functional” surgical approaches has emerged. Recent technologic advances including balloon sinus ostial dilation have provided minimally invasive treatment options for this common disease entity which have optimized tissue preservation. The concept of balloon catheterization has long been applied in urology, cardiology, and gastroenterology. Balloon sinuplasty was adopted from angioplasty to dilate the ostia of the paranasal sinuses by Californian engineers in 2002. This catheter-based technology was first demonstrated at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery in Los Angeles, California, USA, in 2005; and the first publications on the safety and feasibility of this technique appeared in the global literature the following year. Balloon sinuplasty aims to preserve both the function and mucosa of the sinuses through gentle restructuring of the narrowed sinus ostium. Balloon dilatation results in microfractures and bony displacement, causing widening of the natural ostium and subsequent ventilation of the sinus drainage pathways. Tissue resection is averted, thus minimizing postoperative scar formation and adhesions. This procedure is primarily used to treat CRS involving the frontal, sphenoid, or maxillary sinuses without nasal polyposis, with sustained positive clinical outcomes for at least 2 years.

Keywords

Chronic rhinosinusitis Balloon sinuplasty Balloon catheterization Narrowed sinus ostium Minimizing postoperative scar formation Adhesions 

References

  1. 1.
    Brown CL, Bolger WE. Safety and feasibility of balloon catheter dilation of paranasal sinus ostia: a preliminary investigation. Ann Otol Rhinol Laryngol. 2006;115(4):293–9.CrossRefGoogle Scholar
  2. 2.
    Bolger WE, Vaughan WC. Catheter-based dilation of the sinus ostia: initial safety and feasibility analysis in a cadaver model. Am J Rhinol. 2006;20(3):290–4.CrossRefGoogle Scholar
  3. 3.
    Catalano PJ. Balloon dilation technology: let the truth be told. Curr Allergy Asthma Rep. 2013;13(2):250–4.CrossRefGoogle Scholar
  4. 4.
    Bolger WE, Brown CL, Church CA, et al. Safety and outcomes of balloon catheter sinusotomy: a multicenter 24-week analysis in 115 patients. Otolaryngol Head Neck Surg. 2007;137(1):10–20.CrossRefGoogle Scholar
  5. 5.
    Weiss RL, Church CA, Kuhn FA, et al. Long-term outcome analysis of balloon catheter sinusotomy: two-year follow-up. Otolaryngol Head Neck Surg. 2008;139(3 Suppl 3):S38–46.CrossRefGoogle Scholar
  6. 6.
    Xiong GX, Zhan JM, Jiang HY, et al. Computational fluid dynamics simulation of airflow in the normal nasal cavity and paranasal sinuses. Am J Rhinol. 2008;22(5):477–82.CrossRefGoogle Scholar
  7. 7.
    Sanders SP, Proud D, Permutt S. Role of nasal nitric oxide in the resolution of experimental rhinovirus infection. J Allergy Clin Immunol. 2004;113(4):697–702.CrossRefGoogle Scholar
  8. 8.
    Runer T, Lindberg S. Effects of nitric oxide on blood flow and mucociliary activity in the human nose. Ann Otol Rhinol Laryngol. 1998;107(1):40–6.CrossRefGoogle Scholar
  9. 9.
    Moncada S, Higgs A, Furchgott R. International union of pharmacology nomenclature in nitric oxide research. Pharmacol Rev. 1997;49(2):137–42.PubMedGoogle Scholar
  10. 10.
    Lundberg JO. Nitric oxide and the paranasal sinuses. Anat Rec (Hoboken). 2008;291(11):1479–84.CrossRefGoogle Scholar
  11. 11.
    Fang FC. Perspectives series: host/pathogen interactions. Mechanisms of nitric oxide-related antimicrobial activity. J Clin Invest. 1997;99(12):2818–25.CrossRefGoogle Scholar
  12. 12.
    Eloy JA, Friedel ME, Eloy JD, et al. In-office balloon dilation of the failed frontal sinusotomy. Otolaryngol Head Neck Surg. 2012;146(2):320–2.CrossRefGoogle Scholar
  13. 13.
    Eloy JA, Shukla PA, Choudhry OJ, et al. In-office balloon dilation and drainage of frontal sinus mucocele. Allergy Rhinol (Providence). 2013;4(1):e36–40.CrossRefGoogle Scholar
  14. 14.
    Friedman M, Schalch P. Functional endoscopic dilatation of the sinuses (FEDS): patient selection and surgical technique. Oper Tech Otolaryngol Head Neck Surg. 2006;17(2):126–34.  https://doi.org/10.1016/j.otot.2006.03.005.CrossRefGoogle Scholar
  15. 15.
    Stewart AE, Vaughan WC. alloon sinuplasty versus surgical management of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2010;10(3):181–7.CrossRefGoogle Scholar
  16. 16.
    Ikeda K, Ono N, Iizuka T, et al. Bacteriologic evaluation of sinus aspirates taken by balloon catheter devices in chronic rhinosinusitis: preliminary study ORL. J Otorhinolaryngol Relat Spec. 2011;73(5):271–4.CrossRefGoogle Scholar
  17. 17.
    Wittkopf ML, Becker SS, Duncavage JA, et al. Balloon sinuplasty for the surgical management of immunocompromised and critically ill patients with acute rhinosinusitis. Otolaryngol Head Neck Surg. 2009;140(4):596–8.CrossRefGoogle Scholar
  18. 18.
    Ramadan HH. Safety and feasibility of balloon sinuplasty for treatment of chronic rhinosinusitis in children. Ann Otol Rhinol Laryngol. 2009;118(3):161–5.CrossRefGoogle Scholar
  19. 19.
    Ramadan HH, McLaughlin K, Josephson G. Balloon catheter sinuplasty in young children. Am J Rhinol Allergy. 2010;24(1):e54–6.CrossRefGoogle Scholar
  20. 20.
    Mistry S, Kumar B. Balloon sinuplasty for an acute frontal sinus mucocele. J Surg Case Rep. 2011;2011(11):6.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Bozdemir K, Kutluhan A, Yalçıner G, et al. Treatment of Pott’s puffy tumor with balloon sinuplasty: report of three cases. Kulak Burun Bogaz Ihtis Derg. 2012;22(6):342–7.CrossRefGoogle Scholar
  22. 22.
    Bedrosian JC, Garcia-Navarro V, McCoul ED, et al. Endoscopic balloon dilation as an adjunct to extended endoscopic approaches to the skull base. J Neurosurg. 2012;116(6):1215–8.CrossRefGoogle Scholar
  23. 23.
    Kutluhan A, Bozdemir K, Cetin H, et al. Endoscopic balloon dilation sinuplasty including ethmoidal air cells in chronic rhinosinusitis. Ann Otol Rhinol Laryngol. 2009;118(12):881–6.CrossRefGoogle Scholar
  24. 24.
    Hueman K, Eller R. Reduction of anterior frontal sinus fracture involving the frontal outflow tract using balloon sinuplasty. Otolaryngol Head Neck Surg. 2008;139(1):170–1.CrossRefGoogle Scholar
  25. 25.
    Tomazic PV, Stammberger H, Koele W, et al. Ethmoid roof CSF-leak following frontal sinus balloon sinuplasty. Rhinology. 2010;48(2):247–50.PubMedGoogle Scholar
  26. 26.
    Hughes N, Bewick J, Van Der Most R, et al. A previously unreported serious adverse event during balloon sinuplasty. BMJ Case Rep. 2013;28:2013.Google Scholar
  27. 27.
    Özkiriş M, Akin İ, Özkiriş A, et al. Orbital complication of balloon sinuplasty. J Craniofac Surg. 2014;25(2):499–501.CrossRefGoogle Scholar
  28. 28.
    Heimgartner S, Eckardt J, Simmen D, et al. Limitations of balloon sinuplasty in frontal sinus surgery. Eur Arch Otorhinolaryngol. 2011;268(10):1463–7.CrossRefGoogle Scholar
  29. 29.
    Brenner PS, Abadie WM, Weitzel EK, et al. Unexpected consequences of transnasal balloon dilation of the maxillary ostium. Int Forum Allergy Rhinol. 2011;2011(1):466–70.CrossRefGoogle Scholar
  30. 30.
    Tomazic PV, Stammberger H, Braun H, et al. Feasibility of balloon sinuplasty in patients with chronic rhinosinusitis: the Graz experience. Rhinology. 2013;51(2):120–7.CrossRefGoogle Scholar
  31. 31.
    Ramadan HH, Terrell AM. Balloon catheter sinuplasty and adenoidectomy in children with chronic rhinosinusitis. Ann Otol Rhinol Laryngol. 2010;119(9):578–82.CrossRefGoogle Scholar
  32. 32.
    Liu J, Zhao Z, Chen Y, et al. Clinical curative effect and safety of balloon sinuplasty in children with chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2017;100:204–10.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Demet Yazıcı
    • 1
  • Osman Kürşat Arıkan
    • 1
  • Jivianne T. Lee
    • 2
  1. 1.Department of OtorhinolaryngologyUniversity of Health Sciences, Adana Numune Training and Research HospitalAdanaTurkey
  2. 2.Rhinology and Endoscopic Skull Base Surgery, Department of Head and Neck SurgeryUniversity of California Los Angeles School of MedicineLos AngelesUSA

Personalised recommendations