Pediatric Balloon Sinuplasty
Pediatric rhinosinusitis is common but sometimes overlooked. Pediatric patients are often subject to other disease entities which may have a significant overlap with symptoms associated with pediatric Chronic Rhinosinusitis (CRS).1-3
Symptom overlap examples include1-3:
- Allergic rhinitis
- Recurrent viral URI
- Chronic adenoiditis
- ET dysfunction
Currently there is a lack of evidence for antibiotic efficacy in chronic sinusitis.4 Adenoidectomy failure rate is 40-60% when used as a sole Chronic Rhinosinusitis (CRS) surgical treatment.5-6
The result is a considerable loss of school time and/or accumulation of medical expenses, affecting children and their parents.7
Balloon Sinuplasty, Safe and Effective for Children Suffering from Chronic Sinusitis
Adenoidectomy with Balloon Sinuplasty and lavage of the maxillary sinus may be an appropriate surgical therapy for children deemed to have failed medical treatment.1,8,9
Multiple studies have demonstrated long-term success of 80-87% with adenoidectomy or after failed adenoidectomy.8-11*
In one study, a higher percentage of children’s SN-5 sinonasal symptoms were improved at 12 months, in the Balloon Sinuplasty and adenoidectomy group (80%) compared to the group that underwent adenoidectomy alone (53%).9*
*Patients were not randomized between the Balloon Sinuplasty and adenoidectomy group and the adenoidectomy alone group. Therefore, the results may be due to different patient characteristics rather than the procedure performed.
Acclarent's Balloon Sinuplasty Systems (RELIEVA® SPIN and ULTIRRA®) are indicated for children aged 17 and under and are intended to dilate sinus ostia and spaces associated with the maxillary sinus for diagnostic and therapeutic procedures.
Balloon Sinuplasty is an Effective Option After Failed Adenoidectomy
In a tertiary care, university affiliated pediatric institution, a side-by-side post-operative comparison of patients who underwent Balloon Sinuplasty with ethmoidectomy or ESS after failed adenoidectomy was conducted. Although the difference was not statistically significant, 62.3% of ESS patients and 80% of Balloon Sinuplasty patients reported improvement in their overall sinus symptoms post-operatively.10**
**Patients were not randomized between the Balloon Sinuplasty and ESS group. Therefore, the results may be due to different patient characteristics rather than the procedure performed.
1 Rizzi MD, Kazahaya K. Pediatric chronic rhinosinusitis: when should we operate? Curr Opin Otolaryngol Head Neck Surg 2014, Feb; 22(1): 27-33. doi: 10.1097/MOO.18
2 Shin. KS et al. The role of adenoids in pediatric rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2008 Nov; 72 ( 11):1643-50
3 Bhattacharyya N, Jones DT, Hill M, Shapiro NL. The diagnostic accuracy of computed tomography in pediatric chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg 2004;130:1029.
4 Mandal R, Patel N, Ferguson BJ. Role of antibiotics in sinusitis. Curr Opin Infect Dis 2012; 25:183-192. (11):1363-8.
5 Vandenberg, SJ, Heatley DG. Efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children. Arch Otolaryngol Head Neck Surg 1997;123:675-8.
6 Ramadan HH, Tiu J. Failures of Adenoidectomy for Chroinc Rhinosinusitis in Children: For Whom and When Do they Fail? The Laryngoscope 2007 June;117 (6):1080-1083
7 Kay DJ, Rosenfeld RM. Quality of life for children with persistent sinonasal symptoms. Otolaryngol Head Neck Surg 2003; 128:17-26
8 Ramadan HH, McLaughlin K et al. Balloon Catheter Sinuplasty in Young Children. American Journal of Rhinology and Allergy, 2010;24(1):e54-e56
9 Ramadan HH, Terrell AM. Balloon catheter sinuplasty and adenoidectomy in children with chronis rhinosinusitis. Annals of Otology, Rhinology & Laryngology, 2010; 119 (9):578-582.
10 Thottam PJ, Haupert M et al. Functional endoscopic sinus surgery (ESS) alone versus balloon catheter sinuplasty (BCS) and ethmoidectomy: A comparative outcome analysis in pediatric chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 76 (2012) 1355-1360
11 Ramadan HH, Bueller H et al. Sinus Balloon Catheter Dilation After Adenoidectomy Failure for Children with Chronic Rhinosinusitis. Arch Otolaryngol Head Neck Surg 2012; 138, 635-637