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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Trends and complications in functional endoscopic sinus surgery and balloon sinuplasty: A TriNetX database analysis
Benjamin F Bitner1, Sina J Torabi1, Theodore V Nguyen1
1Department of Otolaryngology-Head and Neck Surgery University of California Irvine Medical Center Orange California USA.
Objectives:
Balloon sinuplasty (BSP) and functional endoscopic sinus surgery (FESS) have undergone changes in utilization over time. This study investigates national trends in BSP and FESS and postoperative outcomes over the last decade as well as the impact of Corona Virus Disease 2019 (COVID-19) on these trends.
Methods:
The TriNetX database was queried for patients undergoing either FESS or BSP from 1/1/2011 to 5/4/2024. Data were collected on patient demographics, diagnoses, and postoperative outcomes.
Results:
A total of 1738 patients underwent BSP and 90,311 underwent FESS. A greater proportion of FESS patients had diabetes (p = 0.001), hypertension (p < 0.001), and chronic pulmonary disease, p = 0.001) compared to BSP whereas a similar proportion of patients for both cohorts had a history of ischemic heart disease (p = 0.73). Body mass index was higher for patients undergoing FESS (28.6 ± 6.5) compared to BSP (28.1 ± 6.578; p = 0.02). Overall postoperative complications were similar between BSP and FESS (odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.58-1.09) with similar rates of epistaxis (OR = 0.77, 95% CI = 0.53-1.12) and cerebrospinal fluid (CSF) leak (OR = 0.14, 95% CI = 0.01-2.25). Overall revision rate was higher for FESS (OR = 0.34, 95% CI = 0.21-0.57). Thirty-day readmission (OR = 0.44, 95% CI = 0.29-0.66) and Emergency Department visits (OR = 0.51, 95% CI = 0.28-0.92) were less common in patients who received BSP. Surgical volume consistently increased over time for both cohorts but at a more rapid pace for BSP (425.64%) compared to FESS (274.19%) and a dramatic decrease in volume by 44.85% and 22.28%, respectively, at the onset of COVID-19.
Conclusion:
Overall, BSP and FESS surgical volume have steadily increased over time with a drastic reduction following the COVID-19 pandemic. BSP and FESS carry different complication profiles emphasizing the importance of patient selection and preoperative counseling.
Level Of Evidence:
Level 4.
