title: Balloon dilation of sinus ostia in the Department of Defense: Diagnoses, actual indications, and outcomes.
abstract: To determine the primary diagnoses for which balloon catheter dilation (BCD) of sinus ostia is being employed in a profit-blind health care system, the Department of Defense.
  
  
  
  Retrospective chart review.
  
  
  
  From January 1, 2011 to December 31, 2013, 319 consecutive patient charts were reviewed for International Classification of Diseases, Ninth Edition (ICD-9) diagnoses, presence of chronic rhinosinusitis (CRS) defined by the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), preoperative Lund-Mackay scores, nasal endoscopy findings, sinuses dilated, postoperative outcomes, and complications.
  
  
  
  Of the 319 patients identified, 217 had sufficient documentation to be included. A CRS ICD-9 code was applied in 182 of 217 (83.9%) and recurrent acute rhinosinusitis in 12 of 217 (5.6%). Only 50.5% of CRS patient charts met criteria using EPOS guidelines. In contrast, 39.6% met the ICD-9 criteria for atypical facial pain. Patients with Lund-Mackay scores ≤ 4 were reviewed for number of sinuses dilated. Eighty-eight of 123 patients (71.5%) had sinuses dilated that were free from opacification/mucosal edema on preoperative imaging.
  
  
  
  Balloon dilation of sinus ostia has an expanding role in treating sinus disease. In the studied population, BCD is often utilized for alternate indications for which there is currently no evidence of efficacy. Future studies are needed to evaluate the efficacy of this technology in treating these alternate indications.
  
  
  
  4. Laryngoscope, 127:544-549, 2017.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Ft. Sam Houston, Texas, U.S.A.
authors.forename: Adrienne M
authors.initials: AM
authors.lastname: Laury
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Ft. Sam Houston, Texas, U.S.A.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Bowe
authors.affiliation: University of South Florida Morsani College of Medicine, Tampa, Florida, U.S.A.
authors.forename: Joshua
authors.initials: J
authors.lastname: Stramiello
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Ft. Sam Houston, Texas, U.S.A.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: McMains
mesh_terms: D000328:Adult; D057785:Catheters; D002908:Chronic Disease; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D004106:Dilatation / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010256:Paranasal Sinuses / Q000503:physiopathology; D012189:Retrospective Studies; D012220:Rhinitis / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D018570:Risk Assessment; D012852:Sinusitis / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States
keywords: Balloon dilation; cost-effectiveness; outcomes; rhinology