A cadaveric model for balloon-assisted endoscopic paranasal sinus dissection without fluoroscopy

Area of Science:

• Otolaryngology
• Minimally Invasive Surgery
• Medical Device Technology

Background:

• Balloon catheter (BC) dilatation is a novel technique for opening paranasal sinus ostia.
• Concerns exist regarding BCs' inability to remove tissue and bone, particularly in sinonasal polyposis.
• This study aimed to integrate BC technology into functional endoscopic sinus surgery (FESS).

Purpose of the Study:

• To evaluate the feasibility of using lacrimal duct balloon catheters (BCs) as adjunctive tools in endoscopic sinus dissection without fluoroscopy.
• To assess the efficacy of BCs in dilating sinus ostia and their safety during cadaveric dissection.

Main Methods:

• Three human cadaveric heads underwent endoscopic sinus dissection using conventional instruments alongside lacrimal duct BCs.
• Dissections were performed without fluoroscopic guidance and videotaped for review.
• BCs were inflated to 8 atm for 30 seconds in the frontal recess and sphenoid ostia.

Main Results:

• BCs were successfully used to dilate frontal recess partitions and sphenoid ostia under endoscopic visualization.
• The approach facilitated the removal of fractured frontal recess partitions with conventional instruments.
• No orbital or skull base injuries were observed, and BCs could not be reliably passed through the maxillary ostium.

Conclusions:

• Balloon catheters can serve as effective adjunctive instruments for endoscopic sinus dissection, even without fluoroscopy.
• This technique shows promise for enhancing FESS procedures.
• Further technical and clinical development is warranted to optimize this strategy.