Cleveland Nasal Sinus and Sleep Center, Associate Staff, Head and Neck Institute, Cleveland Clinic, Cleveland, OH 44124, USA.
Postgrad Med. 2011 Mar;123(2):112-8. doi: 10.3810/pgm.2011.03.2269.
Rhinosinusitis affects ~37 million people in the United States and accounts for almost 2% of all primary care office visits. Chronic rhinosinusitis (CRS) is often successfully managed in the primary care setting using antibiotics, topical or oral steroids, and saline nasal irrigation. Surgery is an option when medical management fails. Balloon sinuplasty is a minimally invasive endoscopic treatment, which is often used in combination with surgery. It aims to restore ostial patency with minimal mucosal damage, and it is indicated for dilatation of the paranasal sinuses for diagnostic and therapeutic purposes. The technology gently displaces, microfractures, and molds the bone surrounding the sinus outflow and may be used alone or in combination with conventional endoscopic surgery. Recent uncontrolled retrospective and prospective studies have reported the effectiveness and safety of balloon sinuplasty, including radiographic evidence of sinus patency and improved sinus-related quality of life scores for up to 2 years after balloon dilation. An examination of adverse events during a postmarketing assessment of balloon sinuplasty identified a total of 3 major complications among 28 500 patients, with a total of > 85 000 treated sinuses. While randomized controlled trials comparing balloon sinuplasty with conventional functional endoscopic sinus surgery have not been conducted, existing prospective and retrospective assessments suggest that balloon sinuplasty is a viable option for sinus intervention, either alone or in combination with conventional surgical treatment.
变应性鼻炎在美国影响约 3700 万人，占所有初级保健门诊就诊人数的近 2%。慢性鼻-鼻窦炎（CRS）常可通过初级保健管理成功治疗，包括抗生素、局部或口服皮质类固醇和盐水鼻腔冲洗。如果药物治疗失败，手术是一种选择。球囊扩张术是一种微创内镜治疗方法，通常与手术联合使用。它旨在通过最小化粘膜损伤来恢复窦口通畅，用于诊断和治疗目的扩张副鼻窦。该技术可轻柔地移位、微骨折和塑造窦腔流出道周围的骨组织，可单独使用或与传统内镜手术联合使用。最近的非对照回顾性和前瞻性研究报告了球囊扩张术的有效性和安全性，包括窦口通畅的放射学证据以及在球囊扩张后长达 2 年的与窦相关的生活质量评分改善。对球囊扩张术上市后评估期间不良事件的检查确定了在 28500 例患者中总共 3 例主要并发症，总共治疗了 >85000 个鼻窦。虽然尚未进行比较球囊扩张术与传统功能性内镜鼻窦手术的随机对照试验，但现有的前瞻性和回顾性评估表明，球囊扩张术是一种可行的鼻窦介入治疗选择，可单独使用或与传统手术治疗联合使用。
