title: Unsuccessful frontal balloon sinuplasty for recurrent sinus barotrauma.
abstract: The standard of care treatment for diffuse recurrent sinus barotrauma (RSB) is an endoscopic sphenoethmoidectomy with a complete frontal dissection. Successful healing leaves the RSB patient with no ethmoid sinuses and endoscopically patent frontal, sphenoid, and maxillary ostia. In persistent cases, patients with small frontal ostia will go on to require a frontal drillout. Patients presenting for surgical management of RSB generally have minimal sinus disease despite significant symptoms during flight and the prospect of extensive surgical management can be unappealing. With the advent of balloon sinuplasty, military otolaryngologists anticipated this technology would permit therapeutic dilation of sinus ostia without the extensive surgical dissection and prolonged recovery typical for standard of care management. This case report is a cautionary note to the wider flight community to recognize a mechanism for recurrence of the underlying pathology when balloon sinuplasty is used that is not possible after properly performed standard of care sinus surgery for RSB.
authors.affiliation: Department of Otolaryngology, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), 2200 Bergquist Dr., Ste. 1, Lackland AFB, TX 78236, USA. s7jandrews@gmail.com
authors.forename: Jamie N
authors.initials: JN
authors.lastname: Andrews
authors.forename: Erik K
authors.initials: EK
authors.lastname: Weitzel
authors.forename: Robert
authors.initials: R
authors.lastname: Eller
authors.forename: Christopher K
authors.initials: CK
authors.lastname: McMains
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D001469:Barotrauma / Q000601:surgery / Q000628:therapy*; D002404:Catheterization; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000601:surgery; D005260:Female; D006801:Humans; D008889:Military Personnel; D010254:Paranasal Sinus Diseases / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D013101:Sphenoid Sinus / Q000601:surgery; D017211:Treatment Failure; D014481:United States