Sinus irrigation penetration after balloon sinuplasty vs functional endoscopic sinus surgery in a cadaveric model
Oliver Gantz MD Arman Danielian BS Alison Yu BA Elisabeth H. Ference MD, MPH Edward C. Kuan MD, MBA Bozena Wrobel MD
First published: 23 July 2019 https://doi.org/10.1002/alr.22386
Potential conflict of interest: This work was not supported financially by any company or industry partner. The specimens, endoscopes, and imaging equipment were provided by Olympus America, Center Valley, PA, as part of a resident education and dissection course. Olympus America had no part in protocol development, data collection, or creation of the manuscript.
Presented as a poster at the Annual ARS Meeting on October 5‐6, 2018, in Atlanta, GA.
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Abstract
Background
Nasal irrigation is a cornerstone of treatment for chronic rhinosinusitis. The purpose of this study was to quantify irrigation penetration to the sinuses following balloon sinuplasty and functional endoscopic sinus surgery (FESS).
Methods
Balloon sinuplasty followed by FESS was performed on 4 cadaver heads. Using a high‐volume, high‐flow bottle, each head was irrigated with fluorescein‐dyed water prior to and following each procedure, and recorded by rigid endoscopy through trephinations. Three blinded, fellowship‐trained rhinologists reviewed videos and scored the extent of staining (using an accepted scale of 0 to 3) for each site.
Results
The mean score prior to any procedure was maxillary sinus 1.67, frontal sinus 1.29, and nasal cavity 1.71. After balloon sinuplasty the mean was maxillary 2.25, frontal 2.04, and nasal cavity 2.17. After FESS the mean was maxillary 2.75, frontal 2.08, and nasal cavity 2.63. There was a statistically significant increase for both maxillary (p = 0.005) and frontal sinuses (p = 0.006) following balloon sinuplasty. There was a statistically significant increase following FESS compared to balloon for the maxillary sinus (p = 0.003), but not the frontal sinus (p = 0.96). Interrater reliability was good, with Cronbach's alpha of 0.85.
Conclusion
Irrigation improved in all sinuses following balloon sinuplasty and FESS. There was further improvement to the maxillary sinus after FESS; however, there was no difference in irrigation to the frontal sinuses following FESS compared to balloon sinuplasty. Extended frontal sinus approaches such as the Modified Lothrop procedure should be considered if more extensive access for irrigation is required.
Oliver Gantz MD Arman Danielian BS Alison Yu BA Elisabeth H. Ference MD, MPH Edward C. Kuan MD, MBA Bozena Wrobel MD
First published: 23 July 2019 https://doi.org/10.1002/alr.22386
Potential conflict of interest: This work was not supported financially by any company or industry partner. The specimens, endoscopes, and imaging equipment were provided by Olympus America, Center Valley, PA, as part of a resident education and dissection course. Olympus America had no part in protocol development, data collection, or creation of the manuscript.
Presented as a poster at the Annual ARS Meeting on October 5‐6, 2018, in Atlanta, GA.
Read the full text
ePDFPDFTOOLS SHARE
Abstract
Background
Nasal irrigation is a cornerstone of treatment for chronic rhinosinusitis. The purpose of this study was to quantify irrigation penetration to the sinuses following balloon sinuplasty and functional endoscopic sinus surgery (FESS).
Methods
Balloon sinuplasty followed by FESS was performed on 4 cadaver heads. Using a high‐volume, high‐flow bottle, each head was irrigated with fluorescein‐dyed water prior to and following each procedure, and recorded by rigid endoscopy through trephinations. Three blinded, fellowship‐trained rhinologists reviewed videos and scored the extent of staining (using an accepted scale of 0 to 3) for each site.
Results
The mean score prior to any procedure was maxillary sinus 1.67, frontal sinus 1.29, and nasal cavity 1.71. After balloon sinuplasty the mean was maxillary 2.25, frontal 2.04, and nasal cavity 2.17. After FESS the mean was maxillary 2.75, frontal 2.08, and nasal cavity 2.63. There was a statistically significant increase for both maxillary (p = 0.005) and frontal sinuses (p = 0.006) following balloon sinuplasty. There was a statistically significant increase following FESS compared to balloon for the maxillary sinus (p = 0.003), but not the frontal sinus (p = 0.96). Interrater reliability was good, with Cronbach's alpha of 0.85.
Conclusion
Irrigation improved in all sinuses following balloon sinuplasty and FESS. There was further improvement to the maxillary sinus after FESS; however, there was no difference in irrigation to the frontal sinuses following FESS compared to balloon sinuplasty. Extended frontal sinus approaches such as the Modified Lothrop procedure should be considered if more extensive access for irrigation is required.
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