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Stil Kountakis, MD, PhD
Professor and Chief, Division of Rhinology
Medical College of Georgia
of Georgia Regents University
Department of Otolaryngology / Head & Neck Surgery
Office Based Balloon Sinuplasty
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In patients with a history of chronic
recurrent rhinosinusitis, confirmed by
CT and/endoscopy
No improvement despite appropriate
medical therapy
Suspected cause of rhinosinusitis is
ostial obstruction
Can be used alone or in hybrid with
ESS
Indications
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Significant ethmoid disease (hybrid
procedure can be done in the OR)
Primarily mucosal disease : diagnosed
sinonasal polyps, allergic fungal
rhinosinusitis, sinonasal osteoneogenesis,
sinonasal tumors, or obstructive lesions
Severe rhinosinusitis with Lund–McKay
scores above 10 (relative contraindication)
– Can do hybrid procedure in the OR.
Contraindications
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OMC
Obstruction Nasal polyps
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Animation Video
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• In the office setting:
Make the patient comfortable
• Intranasal spray and cotton pledgets –
lidocaine and oxymetazoline
• Injection: 1% lidocaine and 1:100,000
epinephrine
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Case Study - Frontal Sinusitis
Baseline 24-weeks Post-op Images provided by Frederick Kuhn, MD
As reported at the AAO-HNS Annual Meeting 2006
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Case Study - Right Maxillary Sinusitis
Baseline 24-weeks Post-op Images provided by Frederick Kuhn, MD
As reported at the AAO-HNS Annual Meeting 2006
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Procedure video 3 Months Postop
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Patient with bleeding disorder
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• Dedicated Procedure codes:
Maxillary dilation - 31295
Frontal dilation - 31296
Sphenoid dilation - 31297
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• Published papers/studies
44 listed in pubmed
“Balloon sinuplasty”
Tolerated by patients
Safe – scarced complications
Efficacious in selected patients
Can be used in hybrid procedures
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