title: In-office balloon catheter dilation: analysis of 628 patients from an administrative claims database.
abstract: OBJECTIVE
  Balloon catheter dilation (BCD) of the paranasal sinuses is increasingly described as a standalone procedure in the office for minimally invasive treatment of patients with chronic rhinosinusitis (CRS). This study evaluates CRS-related healthcare utilization before and after in-office treatment as performed by otolaryngologists within the United States in an all-comer population.
  
  
  METHODS
  Retrospective claims database analysis.
  
  
  METHODS
  The MarketScan database was queried for patients undergoing BCD (Current Procedural Terminology [CPT] 31295-31297) for CRS (International Classification of Diseases Ninth Edition [ICD-9] 473.x) since 2011 in the office (place of service: 11). Exclusion criteria included < 1 year preoperative enrollment, < 6 months postoperative history, and concurrent (± 30 days) endoscopic sinus surgery (CPT 31254-31288). A cohort of 628 patients was identified. Analyses included preoperative comorbidities and CRS-related healthcare use.
  
  
  RESULTS
  Preoperative comorbidities included asthma (29.0%), polyps (11.5%), and aspirin sensitivity (9.9%). An average of 3.0 sinuses (95% confidence interval: 2.91-3.17) were dilated at index. Maxillary, frontal, and sphenoid dilations were performed in 88.9%, 74.5%, and 33.8% of cases, respectively. There were two orbital complications and seven cases of hemorrhage potentially associated with the procedure, but no postoperative cerebrospinal fluid leaks. No blood transfusion, lateral canthotomy, or canthoplasty were reported. CRS-related postoperative healthcare use declined rapidly from the immediate preoperative state. Twenty-one patients underwent revisions, with one patient undergoing two surgeries for a total of 22 reoperations (3.5%).
  
  
  CONCLUSIONS
  In-office BCD is associated with low risks of complications and revisions. Whereas not significant for patients with polyps, decreases in healthcare utilization pre- to postsurgery were significant for patients without polyps.
authors.affiliation: Alabama Nasal Sinus Center, Birmingham, Alabama.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sillers
authors.forename: Kristopher F
authors.initials: KF
authors.lastname: Lay
authors.forename: Chantal E
authors.initials: CE
authors.lastname: Holy
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000379:methods; D015897:Comorbidity; D004106:Dilatation / Q000379:methods*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D014481:United States
keywords: MarketScan; Sinusitis; balloon dilatation; chronic rhinosinusitis; claims database; clinical; minimally invasive surgical procedures; office-based procedure; paranasal sinuses; retrospective study; surgical endoscopy