title: In-office stand-alone balloon dilation of maxillary sinus ostia and ethmoid infundibula in adults with chronic or recurrent acute rhinosinusitis: a prospective, multi-institutional study with-1-year follow-up.
abstract: OBJECTIVE
  This study evaluated in-office balloon dilation of maxillary sinus ostia and ethmoid infundibula to treat chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS).
  
  
  METHODS
  Seventy-four patients with disease in the maxillary and anterior ethmoid sinuses on computed tomography were prospectively enrolled across 12 study centers. All procedures were performed in the office. The primary outcomes were clinical effectiveness and health-care utilization at 1 year, measured by the validated surveys Sino-Nasal Outcome Test (SNOT-20) and Rhinosinusitis Symptom Inventory (RSI).
  
  
  RESULTS
  Dilation was successful in 69 patients (93.2%), and the average periprocedural pain level was 3.2 (scale of 0 to 10). The mean improvement on the SNOT-20 at 1 year was clinically and statistically significant (p < 0.0001), with no significant difference between the CRS and RARS patient outcomes. The treatment effect was the same in the CRS and RARS subgroups and was either "moderate" or "large" for 10 of 12 symptoms. The mean numbers of antibiotic courses (p < or = 0.001), sinus-related physician visits (p < 0.0001), and number of acute sinus infections (p < 0.001) decreased significantly in both subgroups. There were no serious device-related adverse events, and the rate of revision surgery was 5.8%.
  
  
  CONCLUSIONS
  Stand-alone balloon dilation of the maxillary sinus ostia and ethmoid infundibula performed in the office is well tolerated and effectively treats both CRS and RARS.
authors.affiliation: Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA. slevine@entallergymd.com
authors.forename: Steven B
authors.initials: SB
authors.lastname: Levine
authors.affiliation: St Cloud Ear, Nose and Throat, St Cloud, Minnesota, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: Truitt
authors.affiliation: Ear, Nose and Throat Associates of South Florida, West Palm Beach, Florida, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Schwartz
authors.affiliation: Texas Sinus Center, San Antonio, Texas, USA.
authors.forename: James
authors.initials: J
authors.lastname: Atkins
mesh_terms: D000208:Acute Disease; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D002908:Chronic Disease; D004106:Dilatation / Q000379:methods*; D005005:Ethmoid Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012220:Rhinitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome