What are the geographic and temporal trends in sinus surgery and frontal sinus surgery in the United States?
Bottom Line: Endoscopic sinus surgery (ESS) has increased dramatically since 2000, with the greatest changes seen in frontal sinus surgery. Marked variation is seen among geographic regions, with the highest rates in the East South Central states when controlling for population. Presence of fellowship-trained rhinologists inversely correlates to the numbers of frontal sinus surgeries performed in a region.
Explore this issue:September 2016
Background: The last 30 years have seen a dramatic change in the frequency and types of surgery performed for chronic rhinosinusitis. While introduction of endoscopic techniques in the 1980s led to a marked decline in open procedures and increase in endoscopic approaches, the impact on treatment patterns of similar introductions of new technology, including balloon catheter dilation in the early 2000s, is unclear.
Study design: Retrospective review of a nationwide database of ESS procedures drawn from the Medicare Part B data files from 2000 to 2011 using current procedural terminology (CPT) codes and geographic data. In addition, 2010 U.S. census data was analyzed to determine populations of patients older than 65 in different states, while surgical society websites were analyzed to determine the number of practicing otolaryngologists and rhinologists in different areas.