Unexpected consequences of transnasal balloon dilation of the maxillary ostium

Pryor S. Brenner, Wesley M. Abadie, Erik K. Weitzel, Roy F. Thomas, Kevin C. McMains

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background: Nasal irrigations and topical sprays have been demonstrated to have benefit in chronic sinusitis. Increasingly, it is evident that delivery system, patient anatomy, and inflammatory process have significant impacts on irrigant distribution. Methods: Intrasinus endoscopy was performed during sinus irrigation of 5 thawed fresh frozen cadavers (10 sides) before and after transnasal dilation of the maxillary, frontal, and sphenoid ostia with a 5-mm balloon. Results: Guidewire insertion created false passages through maxillary fontanelle on all of 10 attempts; 1 of 10 frontal insertions entered the ostia in a submucosal plane, while all 10 sphenoid attempts were successful without complication (p < 0.0001). Average minimum ostial dimension increased from 1.73 mm to 3.6 mm (p < 0.0001) after dilation. Obtaining an ostial size of 5 mm was associated with significantly improved irrigation penetration relative to a minimum dimension of 4 mm or less (p = 0.019). After balloon dilation of the true ostia, irrigation of the sphenoid increased, irrigations into the frontal sinuses were unchanged, and irrigation into the maxillary sinuses decreased. Conclusion: Guidewire insertion in this study was noted to frequently create a false passage during maxillary sinus ostial dilation. After balloon dilation, irrigant penetration was increased into the sphenoid sinus for heavy and mist irrigators whereas the maxillary sinus had diminished irrigant penetration for heavy and NetiPot irrigators.

Original languageEnglish (US)
Pages (from-to)466-470
Number of pages5
JournalInternational Forum of Allergy and Rhinology
Volume1
Issue number6
DOIs
StatePublished - Nov 1 2011

Keywords

  • Balloon sinuplasty
  • Dilation
  • Endoscopic sinus surgery
  • Irrigation
  • Ostia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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