Image guided dilation of sinus ostium in revision sinus surgery.

Purpose: Assess if a rigid, image-guided balloon could be used effectively and safely in revision sinus surgery.
Materials and Methods: A prospective, non-randomized, single-arm, multicenter study to assess the safety and device performance of the NuVent™ EM Balloon Sinus Dilation System. Adults with CRS in need of revision sinus surgery were enrolled for balloon sinus dilation of a frontal, sphenoid, or maxillary sinus. The primary device performance endpoint was the ability of the device to (1) navigate to; and (2) dilate tissue in subjects with scarred, granulated, or previously surgically-altered tissue (revision). Safety outcomes included the assessment of any operative adverse events (AEs) directly attributable to the device or for which direct cause could not be determined. A follow-up endoscopy was conducted at 14 days post-treatment for assessment of any AEs. Performance outcomes included the surgeon's ability to reach the target sinus (es) and dilate the ostia. Endoscopic photos were captured for each treated sinus pre- and post-dilation.
Results: At 6 US clinical sites, 51 subjects were enrolled; 1 subject withdrew before treatment due to a cardiac complication from anesthesia. 121 sinuses were treated in 50 subjects. The device performed as expected in 100 % of the 121 treated sinuses, with investigators able to navigate to the treatment area and dilate the sinus ostium without difficulty. Ten AEs were seen in 9 subjects, with 0 related to the device.
Conclusion: The targeted frontal, maxillary or sphenoid sinus ostium were safely dilated in every revision subject treated, with no AEs directly attributed to the device.
Competing Interests: Declaration of competing interest Author disclosures/conflicts of interest are: 1) Joseph K. Han works as a consultant for Medtronic Xomed, Inc.; 2) James Nathan Palmer is a consultant for OptiNose, Acclarent, and Medtronic Xomed, Inc.; 3) Nithin Adappa is a consultant for Acclarent and on the Clinical Trial Steering Committee for OptiNose; 4) Rakesh K. Chandra is a consultant for Regeneron, Astra Zeneca and GSK, and on the Clinical Trial Steering Committee for OptiNose; 5) Joseph B. Jacobs has no disclosures to report; 6) Peter Manes received Research and Grant Support from OptiNose; and 7) Karen McKenzie is an employee of Medtronic Xomed, Inc.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)