ARS Position Statement: Criteria for Sinus-ostial Dilation

January 28, 2023

The American Rhinologic Society (ARS) supports the use of sinus ostial dilation (e.g. balloon ostial dilation) as a therapeutic option for selected patients with chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS) who have failed appropriate medical therapy. Support of this treatment strategy is based on clinical consensus statements and primary research evidence.

Balloon sinus ostial dilation has been FDA-approved for the treatment of paranasal sinus disease since 2005. Prior to considering the use of balloon sinus dilation, clinical diagnosis of CRS and RARS should be based on symptoms of sinusitis and supported by objective evidence, including nasal endoscopy documenting sinonasal abnormality or mucosal thickening on computed tomography of the paranasal sinuses. This approach may be used alone or in conjunction with traditional endoscopic sinus surgery. Balloon dilation has been shown to have similar post-operative outcomes to functional endoscopic sinus surgery for selected patients.

The final decision regarding use of techniques or instrumentation for sinus surgery is the responsibility of the attending surgeon. The use of balloon sinus dilation should remain an option for surgical treatment of paranasal sinus disease.

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