Operative utilization of balloon versus traditional endoscopic sinus surgery. (2nd September 2014)

• Record Type: Journal Article
• Authors: Ference, Elisabeth H.; Graber, Madeline; Conley, David; Chandra, Rakesh K.; Tan, Bruce K.; Evans, Charlesnika; Pynnonen, Melissa; Smith, Stephanie S.
• Is Part Of: Laryngoscope. Volume 125:Number 1(2015:Jan.)
• Page Start: 49
• Page End: 56
• Publication Date: 2014-09-02
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24901
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24901-sec-0101" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To study the utilization of balloon catheter dilation (BCD) compared to traditional endoscopic sinus surgery (ESS)</p> </sec> <sec id="lary24901-sec-0201" sec-type="section"> <title>Study Design</title> <p>Cross‐sectional analysis</p> </sec> <sec id="lary24901-sec-0001" sec-type="section"> <title>Methods</title> <p>Cases identified by Current Procedural Terminology codes as BCD (2, 717) or traditional ESS (31, 059) were extracted from the State Ambulatory Surgery Databases 2011 for California, Florida, Maryland, and New York. Patient demographics, surgical center and surgeon volume, mean charge, and operating room (OR) time were compared.</p> </sec> <sec id="lary24901-sec-0002" sec-type="section"> <title>Results</title> <p>There were 33, 776 patients who underwent sinus surgery in the included states in 2011. Of these, 4.6% of maxillary, 5.6% of sphenoid, and 13.9% of frontal procedures were performed using BCD. Adjusted analyses found increased use of BCD in patients with chronic diseases(<italic>P</italic> < .001). Patients who had limited sinus surgery were less likely to have BCD compared to patients who had all four sinuses instrumented (<italic>P</italic> < .001). Surgeons who performed a medium (odds ratio 1.38 [1.14–1.65]) or high (odds ratio 1.71 [1.42–2.07]) volume of ESSs were more likely to use BCD compared to those who performed a low volume (<italic>P</italic> < .001). However, among surgeons who utilized BCD, there was a minimal relationship between the percentage of surgeries performed with BCD and the surgeon's total number of cases (<italic>R</italic><sup>2</sup> = 0.055). Compared to traditional ESS, the median charges for maxillary/ethmoid procedures (mini‐ESS) involving BCD were approximately $4, 500 (<italic>P</italic> < .001) and maxillary/ethmoid/sphenoid/frontal procedures (pan‐ESS) were approximately $2, 950 (<italic>P</italic> = .003) greater, whereas the median OR time involving BCD was 8 minutes less for mini‐ESS procedures(<italic>P</italic> = .01) but not statistically different for pan‐ESS procedures (<italic>P</italic> = .58).</p> </sec> <sec id="lary24901-sec-0003" sec-type="section"> <title>Conclusions</title> <p>In the study sample, balloon technology was used in 8.0% of ESS cases in 2011. Procedures using BCD were on average more expensive compared to traditional ESS procedures, with minimal decrease in OR time.</p> </sec> <sec id="lary24901-sec-0004" sec-type="section"> <title>Level of Evidence</title> <p>2c <italic>Laryngoscope</italic>, 125:49–56, 2015</p> </sec> </abstract>