title: Use of a Foley catheter balloon as a tool during endoscopic frontal sinus surgery in a resource-poor environment.
abstract: OBJECTIVE
  This study aimed to evaluate the non-Food and Drug Administration-approved off-label use of a 10F Foley catheter as a tool during endoscopic frontal sinus surgery.
  
  
  METHODS
  A cohort of 40 patients with chronic frontal rhinosinusitis was prospectively evaluated using the Sino-Nasal Outcome Test (SNOT-22), computed tomography (CT) imaging, and endoscopic examination. Endoscopic sinus surgery (ESS) was performed in the usual fashion, however, when approaching the frontal sinus, a 10F Foley catheter was inserted and the balloon inflated in the frontal outflow. Patients were assessed postoperatively with SNOT-22, CT imaging, and endoscopic assessment at 6 months.
  
  
  RESULTS
  Successful intraoperative dilation of the frontal recess was achieved in 62 of 69 frontal sinuses (90%). No cerebrospinal fluid leak or orbital entry occurred. Six months postoperative, SNOT-22 scores showed significant improvement, whereas endoscopic assessment revealed patent frontal recess in 55 of 62 (89%) frontal sinuses. Computed tomography imaging was completed in 25 patients comprising 41 operated frontal sinuses with no mucosal thickening seen in 37 of 41 (90%).
  
  
  CONCLUSIONS
  The 10F Foley catheter is an effective tool to dilate the frontal recess by compression of edema during ESS. It may be a safe and cost-effective alternative to high-cost commercially available sinus balloons, especially in resource-poor environments.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tanta University, Tanta, Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Askar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tanta University, Tanta, Egypt.
authors.forename: Hossam S
authors.initials: HS
authors.lastname: El-Sherif
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tanta University, Tanta, Egypt Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA mohamedtomoum@yahoo.com.
authors.forename: Mohamed O
authors.initials: MO
authors.lastname: Tomoum
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Senior
mesh_terms: D000328:Adult; D002404:Catheterization / Q000295:instrumentation*; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery*; D015522:Frontal Sinusitis / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D062885:Urinary Catheters / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Foley catheter; balloon sinus dilation; chronic frontal sinus; chronic sinusitis