Health Problem: Pediatric chronic rhinosinusitis (PCRS) affects from 1.7 to 4.4 million children in the United States and is associated with an estimated annual expenditure of $1.8 billion. PCRS places a large burden of morbidity on children due to persistent symptoms, impaired sleep, multiple hospital visits, medication usage, and missed school and activities—all of which affect quality of life (QOL).

Technology Description: Balloon sinuplasty (BSP) is a minimally invasive endoscopic procedure in which a balloon is inflated within affected sinus ostia in an attempt to widen the ostia and restore proper drainage of the sinus. BSP is often performed under general anesthesia in pediatric patients but it may be performed under local anesthesia in some circumstances. BSP is a less invasive and traumatic alternative to the more commonly used surgical alternatives, which include adenoidectomy and functional endoscopic sinus surgery (FESS).

Controversy: If adenoidectomy and medical management fail to provide adequate relief, FESS is the standard surgical treatment for recalcitrant PCRS. BSP is a less invasive and less traumatic procedure purported to achieve similar efficacy, with lower rates of treatment-related complications and less scar tissue formation during recovery, which is presumed to decrease the rate of patients who need revision surgery. However, the effectiveness and safety of BSP compared with alternative treatments has not been well established.

Key Questions:

  • Is BSP effective for reducing sinonasal obstruction, relieving symptoms, and improving QOL in patients with PCRS?

  • Is BSP safe for pediatric patients?

  • Have definitive patient selection criteria for BSP been established?

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