Balloon Sinuplasty: Fluoroscopic vs. Illumination Guided

Objective To compare two balloon sinuplasty techniques, fluoroscopic guided and illumination guided, with regards to: 1) Sensitivity and specificity of identifying the sinus; 2) Accuracy of cannulating the natural sinus ostium; 3) Ease of technique and cost. Methods Operative reports of 120 consecutive patients, equally representative of each technique, were analyzed to determine: 1) The success of sinus identification with the technique; 2) Evidence of endoscopic visual conformation of natural ostium dilation. The sensitivity and specificity of each technique in sinus identification was determined. The success of natural ostium cannulation was also determined. A cost analysis of each technique was performed with regards to equipment and time. Results A total of 330 sinuses were reviewed (fluoroscopy, n=171; illuminated guide wire, n=159). Fluoroscopy was 100% sensitive and 100% specific with regards to sinus identification; whereas the illuminated guide wire was 97.9 % sensitive and 85.7% specific. With respect to the cannulzation of the natural sinus ostium, the success rate of fluoroscopy and the illuminated guide wire was 85.9% and 87.5% respectively. These results demonstrated no significant difference between the two techniques. The elimination of fluoroscopy with the illuminated guide wire technique reduced overall cost and operative time significantly. Conclusions 1) Balloon sinuplasty with illuminated guide wire is comparable to fluoroscopic guided with regards to sensitivity and specificity of sinus identification and successful cannulation of the natural sinus ostium. 2) Cost and operative time are reduced with the new technique.