Sinuplasty Gaining Momentum for Sinus Procedures

When sinus endoscopy is used to create a sinusotomy in the frontal, maxillary of sphenoid sinuses whether using forceps, a microdebrider, a laser, or a balloon catheter, there is displacement of bone and mucosa. These various techniques have some variations in time among themselves and between operators but we feel the work is similar enough to justify existing codes when the following conditions are met:

• A sinus endoscope is used to position the balloon prior to and during the cannulation of the ostia and confirming the dilation with the balloon.
• Bone and mucosa must be moved in such a fashion to significantly enlarge the ostium of the sinus addressed.

Dr. Setzen continued, You can see that when we do use the balloon technology these two criteria are being met, so you can use these codes.

Indications for the Procedure

Dr. Setzen said that fears of an unfavorable backlash against sinuplasty due to an abundance of lay news media publicity has been allayed and may actually prove to be a benefit. Many patients are coming into our offices and are asking, ‘Doctor, can you use this new balloon sinuplasty on my sinuses?’

He said that even though some of these patients may not be candidates for sinuplasty, their presentation in the office will give otolaryngologists the opportunity to discuss other forms of endoscopic sinus surgery with those individuals. It may bring a whole slew of nasal sinus patients back to our offices, he said.

The economics surrounding the use of sinuplasty, however, bothered Donald Lanza, MD, a private practice otolaryngologist in St. Petersburg, FL. My concern is that economic forces-and not necessarily science-are driving this at this time. I think that there has to be a somewhat altruistic way in which we have to search our consciousness as to what the actual indication for sinus surgery are. That’s a bigger question than what the indications are for a device.

Dr. Weiss said he agreed that research is still required in the area.

©2007 The Triological Society