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Balloon Sinus Ostial Dilation for Chronic Rhinosinusitis without Nasal Polyps.

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eMediNexus    05 December 2019

A new study published in The Annals of Otology, Rhinology and Laryngology assessed the clinical experience of balloon sinus ostial dilation (BSD) in chronic rhinosinusitis without nasal polyps (CRSsNP) patients, with concurrent anticoagulant or antiplatelet therapy (AAT). This was a prospective study that conducted a review of clinical data from 2012-2017, which was utilized to perform a cohort study of subjects with CRSsNP, who met criteria for surgical intervention while on AAT. Data were collected on demographics, details of the procedures, type of AAT used, pre- and postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scoresand complications. Overall, 35 patients underwent BSD while on AAT. The mean difference in pre- and postoperative SNOT-22 scores of 9.9, both, statistically significant and exceeded the minimal clinically important difference. Absorbable nasal packing was used for persistent bleeding immediately post-procedure in two patients. Intraoperative bleeding was associated with aspirin 325 mg and warfarin. Meanwhile, functional endoscopic sinus surgery (FESS) was required for further management of chronic sinusitis in four patients after the AAT could be discontinued. There were no systemic complications; no patient experienced significant bleeding events occurred postoperatively. From the results, it was inferred that in-office BSD is a safe alternative to endoscopic sinus surgery in patients who cannot discontinue antiplatelet and anticoagulant therapy.

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