Medical therapy versus sinus surgery by using balloon sinus dilation technology: A prospective multicenter study.

Background: Although previous studies of sinus surgery that used balloon catheter dilation technology for the paranasal sinuses (balloon sinus dilation [BSD]) demonstrated safety and efficacy, data that compare BSD with continued medical management (MM) are lacking.

Objective: To evaluate the outcomes of sinus surgery when using BSD instruments versus MM for patients with chronic rhinosinusitis for whom MM failed.

Methods: Adult patients with chronic rhinosinusitis for whom a minimum of 3 weeks of oral antibiotics, 4 weeks of daily saline solution therapy, and 4 weeks of daily nasal corticosteroids failed were included.

In-office functional endoscopic sinus surgery for chronic rhinosinusitis utilizing balloon catheter dilation technology.

Purpose Of Review: Balloon catheter dilation (BCD) technology was introduced in 2005 as a device employed to dilate maxillary, sphenoid, and frontal sinus outflow tracts in patients with chronic sinus disease. With the evolution of the technology, BCD has been utilized in the office setting. The purpose of this review is to discuss the safety, tolerability, and technical success of this change of venue and to consider the possible significant cost savings in the current healthcare environment.

Safety of ethmoid sinus drug-eluting catheter insertion.

Objectives: We sought to evaluate an instrument that allows a drug-eluting catheter to be inserted into the ethmoid sinuses and to demonstrate its safety and reproducibility in a cadaver model.

Methods: A drug-eluting catheter was placed into 12 cadaveric anterior and posterior ethmoid sinuses by use of a trocar-based insertion device. The device's position was analyzed with computed tomographic scans, and postprocedural dissection was performed.

Long-term frontal sinus patency after endoscopic frontal sinusotomy.

Background: The frontal recess is the drainage pathway that connects the frontal sinus to the anterior ethmoid sinus. Mechanical obstruction is the primary cause of chronic frontal sinusitis with or without a secondary inflammatory process. Eosinophilic inflammation is one of the underlying causes for chronic rhinosinusitis.

The balloon dilating catheter as an instrument in sinus surgery.

The use of the balloon dilating catheter has been a divisive topic in the rhinology community. This commentary addresses shortcomings that are commonly remarked upon by opponents of this technology and reviews the clinical history of the device as detailed in the literature. The reported orbital and cranial complications are described, and the major complication rate per sinus is calculated at 0.

Radiographic resolution of chronic rhinosinusitis without polyposis after 6 weeks vs 3 weeks of oral antibiotics.

Background: Maximal medical therapy is poorly defined in chronic sinusitis treatment.

Objective: To objectively evaluate the radiographic response of chronic rhinosinusitis without polyposis after 3 and 6 weeks of oral antibiotics.

Methods: Thirty-five patients with confirmed chronic sinusitis without polyposis (disease apparent on initial computed tomography [CT] with appropriate symptom duration) were prescribed 6 weeks of antibiotics.

Benign sinonasal neoplasms: a focus on inverting papilloma.

Benign sinonasal neoplasms are a pathologic and clinically varied group of tumors. Inverting papilloma is a notable member of this group, and it is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This article aimed to familiarize the clinician with all the practical aspects of inverting papilloma and its management.

Analysis of methods to assess frontal sinus extent in osteoplastic flap surgery: transillumination versus 6-ft Caldwell versus image guidance.

Background: The aim of this study was to compare three common methods (transillumination, plain radiographs, and computerized tomography [CT] image guidance) for estimating the position and extent of pneumatization of the frontal sinus in osteoplastic flap surgery.

Methods: Axial CT scans and 6-ft Caldwell radiographs were performed on 10 cadaver heads. For each head, soft tissue overlying the frontal bone was raised and the anticipated position and extent of the frontal sinus at four points was marked using three common methods.

Endoscopically guided aerobic cultures in postsurgical patients with chronic rhinosinusitis.

Background: There is considerable amount of debate in the literature regarding the microbial flora of normal, acutely infected, and chronically infected paranasal sinuses. Few studies have specifically looked at the microbial flora of healthy and infected sinus cavities after functional endoscopic sinus surgery.

Methods: One hundred thirty-four cultures were studied.

A comparison of computer-aided surgery registration methods for endoscopic sinus surgery.

Background: Stereotactic computer-aided surgery has provided the surgeon with a means to navigate more safely through diseased or surgically altered sinus anatomy. Accurate registration is vital to successful image-guided surgery. This study compared the accuracy and performance of three registration methods: fiducial, anatomic landmarks, and surface registration.

Concordance of middle meatal swab and maxillary sinus aspirate in acute and chronic sinusitis: a meta-analysis.

Background: The medical management of acute and chronic sinusitis is a therapeutic challenge. The use of endoscopic middle meatal cultures as a noninvasive method to determine the bacteriology of the maxillary sinus has not accurately been established. The aim of this study was to review the literature that compares cultures obtained by endoscopic middle meatal swabs with those obtained from maxillary sinus aspirates (MSAs).

Staged endoscopic and combined open/endoscopic approach in the management of inverted papilloma of the frontal sinus.

Background: The endoscopic management of inverted papilloma has gained increasing popularity over the last 10 years. Although early concerns over an increased risk of recurrence seem to have been allayed, the appropriate management of lesions involving the frontal sinus and frontal recess still has to be determined.

Methods: We performed a retrospective review of the results of all patients with inverted papilloma from 2000 to 2004.

Increased role of the otolaryngologist in endoscopic pituitary surgery: endoscopic hydroscopy of the sella.

Background: The aim of this study was to discuss the use of nasal irrigation and suction systems in endoscopic pituitary surgery to examine the sella and facilitate tumor removal. We describe a new technique of sellar exploration.

Methods: Following the endoscopic approach to the pituitary by the otolaryngology team, pituitary masses are resected.

Multi-use Venturi nasal atomizer contamination in a clinical rhinologic practice.

Introduction: Cross-contamination of Venturi atomizers has been reported.

Methods: In phase I, 16 atomizers were sterilized and refilled with either 1% lidocaine or 0.1% Tyzine (day 0).