Treatment of chronic rhinosinusitis with functional endoscopic balloon dilatation of sinus ostia©

Treatment of chronic rhinosinusitis with functional endoscopic balloon dilatation of sinus ostia©

Treatment of chronic rhinosinusitis with functional endoscopic balloon dilatation of sinus ostia©

 

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Kotsis Georgios MD, PhD, Otorhinolaryngologist, Senior Registrar Helpis General Hospital Athens

 The medical management of chronic rhinosinusitis  is usually  successful; however, when medical management fails, surgery may be indicated.. Research of the last years has suggested that optimal medical treatment is as effective as surgery in patients with chronic rhinosinusitis at the end of 1 year [1].


Surgery for chronic rhinosinusitis is not standardized and there is not a consensus on both the extent of surgery required and the manner in which it is performed.

In the past 25 years, schools of curative thought have arisen to help guide the surgical treatment of chronic rhinosinusitis.


1. Functional endoscopic sinus surgery. This surgical treatment  treats problematic areas by ventilating the sinuses through the natural ostia and addressing all diseased sinuses when necessary. The technic of the procedure is not standardized and the final result it depends on  patient and surgeon competence.

2. The minimally invasive sinus technique. This technique has been proposed as a method whereby each surgical procedure is standardized regardless of disease severity.

3. The balloon catheter dilatation of the sinus ostia, which by itself is not truly a procedure, is also discussed as a separate technique since these specific tools used during endoscopic sinus surgery have quickly energized the sinus community [2].


Balloon Sinuplasty (Acclarent, Inc., CA, USA) is a technique in the management of sinusitis and is a hotly debated topic. It is a delicate, minimally invasive tool, and early research demonstrates promising outcomes in terms of safety and effectiveness. This technique has been approved by the US FDA [1].


At present there is no convincing evidence supporting the use of endoscopic balloon sinus ostial dilation compared to conventional surgical modalities in the management of CRS refractory to medical treatment. With the escalating use of balloon sinuplasty, there is an urgent need for more randomised controlled trials to determine its efficacy over conventional surgical treatment modalities [ 3, 4, 5].


References

1. Taghi AS, Khalil SS, Mace AD, Saleh HA. Balloon Sinuplasty: balloon-catheter dilation of paranasal sinus ostia for chronic rhinosinusitis. Expert Rev Med Devices. 2009 Jul;6(4):377-82.

2. Welch KC, Stankiewicz JA. A contemporary review of endoscopic sinus surgery: techniques, tools, and outcomes. . Laryngoscope. 2009 Nov;119(11):2258-68.

3. Ahmed J, Pal S, Hopkins C, Jayaraj S. Functional endoscopic balloon dilation of sinus ostia for chronic rhinosinusitis. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD008515.

4. Burton MJ, Bhattacharyya N, Rosenfeld RM. Extracts from the Cochrane Library: functional endoscopic balloon dilation of sinus ostia for chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2011 Sep;145(3):371-4. Epub 2011 Aug 11.

5. Ahmed J, Pal S, Hopkins C, Jayaraj S. Functional endoscopic balloon dilation of sinus ostia for chronic rhinosinusitis. Clin Otolaryngol. 2012 Jun;37(3):221.

Το παρόν άρθρο προστατεύεται από το Νόμο 2121/1993 και 4481/2017 για την πνευματική ιδιοκτησία. Η ολική ή μερική αντιγραφή του παρόντος επιστημονικού άρθρου χωρίς τη γραπτή έγκριση του Δρ Δημητρίου Ν. Γκέλη θεωρείται κλοπή πνευματικής ιδιοκτησίας και διώκεται βάσει της νομοθεσίας.


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