Limitations of balloon sinuplasty in frontal sinus surgery

Limitations of balloon sinuplasty in frontal sinus surgery
European Archives of Oto-Rhino-Laryngology, 05/16/2011 Clinical Article
Heimgartner S et al. – It is essential to have knowledge of classical functional endoscopic sinus surgery of the frontal recess area. The drawbacks of not including a histopathologic exam should be considered in balloon only procedures.

Methods
The charts of patients who underwent balloon sinuplasty from November 2007 to July 2010 at three different ENT- Centres were retrospectively analysed.
CT-analysis of the patients with failed access was performed.
Of the 104 frontal sinuses, dilation of 12 (12%) sinuses failed.
Results
The anatomy of all failed cases revealed variations in the frontal recess (frontoethmoidal-cell, frontal-bulla-cell or agger-nasi-cell) or osteoneogenesis.
In 1 patient, a lymphoma was overlooked during a balloon only procedure.
The lymphoma was diagnosed 6 months later with a biopsy during functional endoscopic sinus surgery.
In complex anatomical situations of the frontal recess, balloon sinuplasty may be challenging or impossible.