title: Paranasal Sinus Balloon Catheter Dilation for Treatment of Chronic Rhinosinusitis: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  Paranasal sinus balloon catheter dilation (BCD) represents a commonly used tool in the management of chronic rhinosinusitis (CRS) for which the indications, utilization, and outcomes have not been well established. A systematic review and meta-analysis were undertaken to evaluate change in quality of life and sinus opacification following paranasal sinus BCD in the treatment of CRS.
  
  
  METHODS
  MEDLINE and EMBASE databases.
  
  
  METHODS
  Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilized to identify English-language studies reporting patient outcomes following BCD for CRS. Primary outcomes included the impact of BCD on validated measures of quality of life and sinonasal opacification.
  
  
  RESULTS
  Systematic review identified 17 studies for qualitative analysis. Studies generally included cases with limited disease based on radiographic opacification. Five studies contained extractable data for change in 20-Item Sinonasal Outcome Test (SNOT-20) 1 year following BCD, with significant improvement in self-reported quality of life (P = .04). Five studies reported a significant change in paranasal sinus opacification following BCD (P < .001). Two studies directly compared change in SNOT-20 between BCD and endoscopic sinus surgery, without demonstration of significant difference in outcome (P = .07). Subgroup analysis found that change in SNOT-20 score was greater after BCD in the operating room than in the office (P = .004).
  
  
  CONCLUSIONS
  Current evidence supporting the role of BCD in CRS remains incomplete. Long-term within-group improvements in quality-of-life and sinus opacification scores are demonstrated among a restricted adult population with CRS. Additional study is needed to further evaluate the role for BCD in specific settings and patient subgroups.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Levy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Marino
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA Department of Otorhinolaryngology-Head and Neck Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA emccoul@gmail.com.
authors.forename: Edward D
authors.initials: ED
authors.lastname: McCoul
mesh_terms: D057785:Catheters; D002908:Chronic Disease; D004106:Dilatation / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D010256:Paranasal Sinuses; D012220:Rhinitis / Q000150:complications / Q000628:therapy*; D012852:Sinusitis / Q000150:complications / Q000628:therapy*
keywords: ESS; balloon dilation; chronic rhinosinusitis; endoscopic sinus surgery; quality of life; sinus surgery