Evaluation of Practice Patterns for 6-Sinus Balloon Sinus Dilation

Area of Science:

• Otolaryngology
• Medical device utilization
• Healthcare policy

Background:

• Balloon sinus dilation (BSD) is a key treatment for chronic and recurrent acute rhinosinusitis.
• Increased BSD use raises concerns about potential misuse, with expert consensus suggesting not all patients require six-sinus dilation.
• Understanding current practice patterns is crucial for optimizing BSD's value.

Purpose of the Study:

• To determine the percentage of patients undergoing six-sinus BSD.
• To evaluate factors associated with the practice of six-sinus BSD.
• To explore outlier practice patterns in six-sinus BSD procedures.

Main Methods:

• A retrospective cross-sectional review of Medicare claims data from January 2022 to December 2023.
• Included otolaryngologists performing at least 11 BSD procedures annually (high-volume clinicians).
• Analyzed 21,290 unique BSD procedures performed by 522 otolaryngologists.

Main Results:

• Sixty percent (12,799/21,290) of BSD procedures involved all six sinuses.
• Eight percent of otolaryngologists performed six-sinus BSD in 100% of their cases.
• A small group of physicians (2%) accounted for 10% of all six-sinus BSD procedures.

Conclusions:

• The high volume of six-sinus BSD suggests potential overuse.
• Significant practice variations underscore the need for clear guidelines for multisinus BSD.
• Optimizing BSD utilization and value requires defined indications for comprehensive procedures.