Health Problem: Chronic rhinosinusitis (CRS), which is the symptomatic inflammation of sinonasal mucosa, is one of the most prevalent chronic conditions, impacting from 5% to 15% of adults and costing the United States an estimated $6.9 to $9.9 billion per year. Differentiating CRS and recurrent acute rhinosinusitis (RARS) is challenging, so the 2 diseases are often viewed and treated as the same indication, although they are still considered distinct conditions.

Technology Description: Balloon sinuplasty (BS) is a minimally invasive endoscopic procedure in which a balloon is inflated within affected sinus ostia in attempts to widen the ostia and restore proper drainage of the sinus. BS is less invasive and traumatic than the standard functional endoscopic sinus surgery (FESS) and can be performed in-office under local anesthesia.

Controversy: FESS is the standard surgical treatment for recalcitrant CRS and RARS. BS is a less invasive and less traumatic alternative 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 BS relative to alternative treatments has not been well established.

Key Questions:

  • Is BS effective for reducing sinonasal obstruction, relieving symptoms, and improving quality of life in adult patients with CRS or RARS?

  • Is BS safe?

  • Have definitive patient selection criteria for BS been established?

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