Paranasal Sinus Balloon Catheter Dilation for Treatment of Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

Otolaryngol Head Neck Surg. 2016 Jan;154(1):33-40. doi: 10.1177/0194599815613087. Epub 2015 Oct 30.

Abstract

Objective: Paranasal sinus balloon catheter dilation (BCD) represents a commonly used tool in the management of chronic rhinosinusitis (CRS) for which the indications, utilization, and outcomes have not been well established. A systematic review and meta-analysis were undertaken to evaluate change in quality of life and sinus opacification following paranasal sinus BCD in the treatment of CRS.

Data sources: MEDLINE and EMBASE databases.

Review methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilized to identify English-language studies reporting patient outcomes following BCD for CRS. Primary outcomes included the impact of BCD on validated measures of quality of life and sinonasal opacification.

Results: Systematic review identified 17 studies for qualitative analysis. Studies generally included cases with limited disease based on radiographic opacification. Five studies contained extractable data for change in 20-Item Sinonasal Outcome Test (SNOT-20) 1 year following BCD, with significant improvement in self-reported quality of life (P = .04). Five studies reported a significant change in paranasal sinus opacification following BCD (P < .001). Two studies directly compared change in SNOT-20 between BCD and endoscopic sinus surgery, without demonstration of significant difference in outcome (P = .07). Subgroup analysis found that change in SNOT-20 score was greater after BCD in the operating room than in the office (P = .004).

Conclusion: Current evidence supporting the role of BCD in CRS remains incomplete. Long-term within-group improvements in quality-of-life and sinus opacification scores are demonstrated among a restricted adult population with CRS. Additional study is needed to further evaluate the role for BCD in specific settings and patient subgroups.

Keywords: ESS; balloon dilation; chronic rhinosinusitis; endoscopic sinus surgery; quality of life; sinus surgery.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Catheters*
  • Chronic Disease
  • Dilatation / instrumentation
  • Equipment Design
  • Humans
  • Paranasal Sinuses*
  • Rhinitis / complications
  • Rhinitis / therapy*
  • Sinusitis / complications
  • Sinusitis / therapy*