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Related Experiment Video

Updated: Jan 6, 2026

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Preoperative Computed Tomography Utilization in Patients Undergoing Balloon Sinus Dilation.

Alexander A Romashko1, Nyssa Fox Farrell2, Dorina Kallogjeri3,4

  • 1Department of Otolaryngology and Communication Sciences; Medical College of Wisconsin, Milwaukee.

JAMA Otolaryngology-- Head & Neck Surgery
|November 13, 2025
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Summary

Computed tomography (CT) scans are crucial before balloon sinus dilation (BSD) surgery. While many surgeons adhere to guidelines, a significant number do not obtain necessary CT imaging, indicating a need for better practice monitoring.

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Area of Science:

  • Otolaryngology
  • Medical Imaging
  • Health Policy

Background:

  • Computed tomography (CT) imaging is a standard prerequisite for sinus surgery, including balloon sinus dilation (BSD).
  • Adherence to practice guidelines ensures optimal patient care and surgical outcomes.
  • Variations in adherence can impact the quality of care and necessitate further investigation.

Purpose of the Study:

  • To evaluate the adherence of otolaryngologists to practice guidelines regarding the use of CT imaging prior to balloon sinus dilation (BSD) procedures.
  • To identify the prevalence of non-adherence and explore potential factors associated with it.

Main Methods:

  • A cross-sectional study utilizing Medicare claims data from January 1, 2022, to December 31, 2023.
  • Identified otolaryngologists performing at least 11 BSD procedures annually.
  • Analyzed the availability of preprocedure CT imaging within one year of BSD and identified outlier physicians.

Main Results:

  • The study analyzed 19,692 BSD procedures performed by 490 otolaryngologists.
  • Preprocedure CT imaging was unavailable within one year for 15% of patients (2905/19692).
  • 31.8% of otolaryngologists (156/490) were identified as outliers, with a subset accounting for a disproportionate number of cases lacking CT imaging.

Conclusions:

  • Most otolaryngologists adhere to guidelines by obtaining pre-BSD CT imaging.
  • A substantial minority of physicians do not consistently obtain necessary CT imaging, failing to meet standard practice guidelines.
  • Improved monitoring systems are needed to ensure consistent adherence to CT imaging standards before BSD.