Balloon catheter technology (BCT) for management of paranasal sinus inflammatory disease was introduced to otolaryngology in 2005. Since its introduction, BCT has been a subject of considerable controversy with proponents for and against adoption of the technology. Balloon procedures have been promoted as a less invasive alternative to endoscopic sinus surgery that results in reduced pain and quicker recovery. The technology and its promotion have generated significant press coverage and interest by the lay public looking for new solutions for sinonasal problems. Over time, alternate balloon devices have been advocated for operating room and office-based sinus ostia dilatation. This contemporary review will evaluate the existing evidence on the available balloon devices. The frank strengths and weaknesses of the peer-reviewed literature will be highlighted. The potential complications unique to balloon catheters and radiation exposure from fluoroscopy will also be discussed.
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