Use of a Foley catheter balloon as a tool during endoscopic frontal sinus surgery in a resource-poor environment

Ann Otol Rhinol Laryngol. 2015 Mar;124(3):194-7. doi: 10.1177/0003489414550242. Epub 2014 Sep 9.

Abstract

Objective: This study aimed to evaluate the non-Food and Drug Administration-approved off-label use of a 10F Foley catheter as a tool during endoscopic frontal sinus surgery.

Method: A cohort of 40 patients with chronic frontal rhinosinusitis was prospectively evaluated using the Sino-Nasal Outcome Test (SNOT-22), computed tomography (CT) imaging, and endoscopic examination. Endoscopic sinus surgery (ESS) was performed in the usual fashion, however, when approaching the frontal sinus, a 10F Foley catheter was inserted and the balloon inflated in the frontal outflow. Patients were assessed postoperatively with SNOT-22, CT imaging, and endoscopic assessment at 6 months.

Results: Successful intraoperative dilation of the frontal recess was achieved in 62 of 69 frontal sinuses (90%). No cerebrospinal fluid leak or orbital entry occurred. Six months postoperative, SNOT-22 scores showed significant improvement, whereas endoscopic assessment revealed patent frontal recess in 55 of 62 (89%) frontal sinuses. Computed tomography imaging was completed in 25 patients comprising 41 operated frontal sinuses with no mucosal thickening seen in 37 of 41 (90%).

Conclusion: The 10F Foley catheter is an effective tool to dilate the frontal recess by compression of edema during ESS. It may be a safe and cost-effective alternative to high-cost commercially available sinus balloons, especially in resource-poor environments.

Keywords: Foley catheter; balloon sinus dilation; chronic frontal sinus; chronic sinusitis.

MeSH terms

  • Adult
  • Catheterization / instrumentation*
  • Chronic Disease
  • Endoscopy / methods*
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Frontal Sinus / surgery*
  • Frontal Sinusitis / diagnosis
  • Frontal Sinusitis / surgery*
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Prospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Urinary Catheters / statistics & numerical data*
  • Young Adult