Balloon Dilation of Sinus Ostia in the Department of Defense: Diagnoses, Actual Indications, and Outcomes

Abstract

Introduction: In the past decade, increasing evidence bas supported the use of balloon catheter dilation (BCD) of sinus ostia in the treatment of chronic and recurrent acute rhinosinusitis. However, this technology is often advertised and utilized for off-label indications, which lack evidence-based support. Therefore, we sought to evaluate "actual" indications for BCD in a profit-blind healthcare system - the Department of Defense (DoD). Methods: A retrospective review was performed on 319 consecutive patients who underwent BCD in the DoD from January 1, 2011 - December 31, 2013. All charts were reviewed for ICD-9 diagnoses, presence of chronic rhinosinusitis (CRS) defined by the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), pre-op Lund-Mackay scores, nasal endoscopy findings, sinuses dilated, post-operative outcomes, and complications. Results: Of the 319 patients identified, 217 had sufficient documentation to be included. A CRS ICD-9 code was applied in 182/217 (83.9%) and recurrent acute rhinosinusitis in 12/217 (5.6%). Only 50.5% of CRS patient charts met criteria using EPOS guidelines. In contrast, 39.6% met the ICD-9 criteria for atypical facial pain. Patients with Lund-Mackay scores </= 4 were reviewed for number of sinuses dilated. Eighty-eight of 123 patients (71.5%) had sinuses dilated that were free from opacification/mucosal edema on pre-operative imaging. Conclusion: Balloon dilation of sinus ostia has an expanding role in treating sinus disease. In the studied population, BCD is often utilized for off-label indications for which there is currently no evidence. Future studies are needed to evaluate the efficacy of this technology in treating these alternate indications.

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Document Details

Document Type
Technical Report
Publication Date
May 18, 2016
Accession Number
AD1036175

Entities

People

  • Adrienne M. Laury
  • Joshua Stramiello
  • Kevin C. Mcmains
  • Sarah N. Bowe

Organizations

  • 59th Medical Wing

Tags

DTIC Thesaurus Topics

  • Active Duty
  • Body Regions
  • Clinical Trials
  • Contracts
  • Department Of Defense
  • Electronic Mail
  • Emphysema
  • Health Services
  • Hospitals
  • Institutional Review Board
  • Medical Personnel
  • Nose Diseases
  • Otorhinolaryngology
  • Pain
  • Respiration Disorders
  • Surgery
  • Therapy

Fields of Study

  • Medicine

Readers

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