Balloon Sinus Surgery Does Not Reduce Postoperative Emergency Room Visits in Patients With Chronic Rhinosinusitis

By Andrew John, MD /alert Contributor
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Although ambulatory balloon sinuplasty appeared to be a safe alternative to traditional sinus surgeries, the operation did not result in fewer emergency room visits in the month following surgery, according to findings presented at the AAO-HNSF 2021 Annual Meeting & OTO Experience.

“Balloon sinuplasty has been more widely adopted in recent years for the treatment of chronic rhinosinusitis, yet there is a paucity of literature that compares the revisit rate after balloon vs traditional sinus surgery,” Allison Yu MD, and colleagues wrote in an abstract.

The researchers compared rates of patients who made a “revisit,” or visit to an emergency department, within 30 days of receiving either ambulatory balloon sinuplasty or traditional endoscopic sinus surgery. Yu and colleagues reviewed the state of California’s State Ambulatory Surgery Database to identify both balloon sinuplasty and traditional surgeries for the year 2011. Then, they linked this data to information from the California State Emergency Department Database, identifying emergency room visits related to a sinus surgery performed in the previous 30 days.

All patients in the study were adults with chronic rhinosinusitis with or without nasal polyps. A total of 8,879 patients were included in the analysis. Yu and colleagues considered patients to have undergone “mini-ESS” if they received ethmoidectomy with maxillary antrostomy; patients were considered to receive “pan-ESS” if they received ethmoidectomy plus frontal maxillary and sphenoid sinus surgery. These designations applied whether doctors carried out the procedure with a balloon or traditional surgery.

Overall, 4.3% of patients made emergency room visits in the 30 days following surgery, the researchers reported. Just 1.3% of all patients who underwent mini-ESS and 7.7% of those who underwent pan-ESS received a balloon sinuplasty.

Among those who underwent mini-ESS, Yu and colleagues wrote, 4.3% of those who had traditional surgery visited an emergency department, compared with 9.7% of those who had balloon sinuplasty or combined balloon and traditional surgery. However, the researchers added that when they conducted a multivariate analysis controlling for “patient-related factors,” this difference in ER visits was no longer significant (P = .13).

The revisit rates in patients who had pan-ESS rates were very similar: 4.4% for traditional surgery and 5.6% for balloon or combined procedures, the researchers wrote.

Most patients visited emergency departments because of bleeding, Yu and colleagues reported: 33.8% of those who had traditional surgery and 42.9% of those who had balloon or combined surgery. Neurological causes were the second most common, occurring in 20% of traditional surgeries and 28.6% in balloon or combined surgeries.

“There was no significant difference in the 30-day postoperative revisit between traditional and balloon/combined sinus surgery, suggesting that balloon sinuplasty is a safe option in the ambulatory surgical setting but does not decrease the rate of revisit compared to traditional techniques,” the researchers wrote in their abstract.


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