Office-Based Sinus Surgery - 09/05/19

Doi : 10.1016/j.otc.2019.02.003

Alok T. Saini, MD ^a, Martin J. Citardi, MD ^b, William C. Yao, MD ^b, Amber U. Luong, MD, PhD ^b,^⁎
^a Department of Otorhinolaryngology–Head and Neck Surgery, University of Kentucky College of Medicine, 740 S. Limestone, E300E, Lexington, KY 40536, USA
^b Department of Otorhinolaryngology–Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA

^∗Corresponding author. 6431 Fannin Street, MSB 5.036, Houston, TX 77030.6431 Fannin StreetMSB 5.036HoustonTX77030

Résumé

Office-based rhinologic procedures have seen a dramatic rise in incidence over the last decade. It is crucial to select appropriate patients and understand which pathologies may be amenable to in-office procedures. It behooves the otolaryngologist to be familiar with the array of technologic advances that are expanding the limits of office-based rhinology and to have a solid understanding of the technical nuances of using these technologies in the clinic. This article highlights the issues associated with some of the more common office-based sinus procedures, and provides practical information on set-up and reimbursement.

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Keywords : Office-based surgery, Balloon catheter dilation, Sinus surgery, Steroid-eluting implant, Cryotherapy

Plan

Key points

Introduction

Room set-up, instrumentation, and supplies

Patient selection and expectations

Management of anxiety and pain

Common sinus procedures

Balloon Catheter Dilation

Traditional Sinus Surgery Including Polypectomies

Endoscopic Placement of Drug Delivery Implants

Cryotherapy of Nasal Tissue

Complications

Coding, billing, and reimbursement

Summary

Disclosure Statement: Dr A.U. Luong is a consultant to 480 Biomedical, Aerin Medical, ENTvantage, and Medtronic. She is on the speaker’s bureau for Intersect ENT and Stryker. Dr M.J. Citardi serves as a consultant for Acclarent, Arrinex, Biosense Webster, Factory CRO, Intersect ENT, Medical Metrics, Medtronic, and Stryker. Drs W.C. Yao and A.U. Luong are Assistant and Associate Professors at the McGovern Medical School Department of Otorhinolaryngology, which receives industry research funding from Genetech and AstraZeneca.