title: Transantral balloon dilation plus posterior ethmoidectomy.
abstract: OBJECTIVE
  Transantral endoscopic balloon dilatation (TABD) was recently introduced for the management of limited mild maxillary and ethmoid disease. An expanded approach by inserting surgical tools into the antrum via a second port, directed toward the maxillary ostium, ethmoid infundibulum, and posterior ethmoids will allow for the treatment of moderate disease as well.
  
  
  METHODS
  Retrospective data review.
  
  
  METHODS
  A study including all TABD procedures performed between January and December 2009 was performed. Sublabial approach with two working channels, one for the endoscope and a second port for balloon dilatation or other surgical instrumentation, was devised. Both channels were created via mini-trephine aimed toward the osteo-meatal complex (OMC) with different angulations. The same approach was used for transantral posterior ethmoidectomy (TAPE). Data collected included demographics, Sino-Nasal Outcome Test (SNOT) scores, Lund-Mackay score, and complications.
  
  
  RESULTS
  Thirty-five patients with 64 dilated sinuses and 10 TAPE procedures were enrolled. All SNOT scores showed statistically significant improvement decreasing from 1.77 to 0.83. Complication rate was minimal. Only a small number of procedures were converted to standard endoscopic septoplasty (ESS) owing to severity of OMC disease. TAPE proved to be a minimally invasive procedure.
  
  
  CONCLUSIONS
  Two trocars inserted through the canine fossa can achieve a successful result in moderate antral disease for TABD and allow TAPE to be performed, thus creating a bridge between mild disease and one requiring standard full ESS. The minimally invasive approach proved to be particularly useful.
authors.affiliation: St. Luke's Roosevelt Hospital, New York, New York, USA. vkizhner@gmail.com
authors.forename: Victor
authors.initials: V
authors.lastname: Kizhner
authors.forename: Michael
authors.initials: M
authors.lastname: Setzen
authors.forename: Yosef P
authors.initials: YP
authors.lastname: Krespi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D002648:Child; D002908:Chronic Disease; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D055815:Young Adult