TY - JOUR
T1 - Current utilization of balloon dilation versus endoscopic techniques in pediatric sinus surgery
AU - Ference, Elisabeth H.
AU - Schroeder, James W.
AU - Qureshi, Hannan
AU - Conley, David
AU - Chandra, Rakesh K.
AU - Tan, Bruce K.
AU - Shintani Smith, Stephanie
N1 - Publisher Copyright:
© American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2014/11/8
Y1 - 2014/11/8
N2 - Objectives. To study the utilization of balloon catheter dilation (BCD) compared to traditional endoscopic surgery (ESS) in pediatric patients. Study Design. Cross-sectional analysis. Setting. Hospital and freestanding ambulatory surgery centers in California, Florida, Maryland, and New York Subjects. Patients less than 18 years who underwent BCD(316) or ESS(2346), as identified by CPT codes from the State Ambulatory Surgery Databases 2011. Methods. Patient and facility demographics, mean charges, and operating room time were examined using bivariate and multivariate analyses. Results. A total of 2662 children underwent surgery, with BCD used in 10.6% of maxillary, 8.4% of sphenoid, and 11.8% of frontal procedures. Adjusted analysis found that children with asthma, allergic rhinitis (AR), GERD, or concomitant adenoidectomy were more likely to have BCD compared to patients without these comorbidities, asthma odds ratio (OR) = 1.94 (95% CI, 1.84-3.41), AR OR = 1.77 (95% CI, 1.03-3.07), GERD OR = 2.79 (95% CI, .59-4.90), or without adenoidectomy OR = 2.50 (95% CI, 1.84-3.41). Patients with cystic fibrosis were less likely to have BCD, OR = 0.33 (95% CI, 0.11-0.95). Median charges for patients undergoing maxillary antrostomy alone by BCD (P = .042) or with adenoidectomy (P < .001) were approximately $2100 and $4200 greater than the median of patients undergoing those procedures with ESS. However, operating room time was similar (P = .81) between patients undergoing maxillary antrostomy, regardless of whether BCD was used, but was longer (P<.001) in those undergoing maxillary antrostomy and adenoidectomy when BCD was utilized. Conclusions. BCD was used in 11.9% of pediatric sinus surgery and had higher average charges with no decrease in OR time compared to procedures that only utilized ESS. Future research is necessary to evaluate whether BCD may lead to improved outcomes and eventually decreased operating room time for pediatric patients with chronic rhinosinusitis.
AB - Objectives. To study the utilization of balloon catheter dilation (BCD) compared to traditional endoscopic surgery (ESS) in pediatric patients. Study Design. Cross-sectional analysis. Setting. Hospital and freestanding ambulatory surgery centers in California, Florida, Maryland, and New York Subjects. Patients less than 18 years who underwent BCD(316) or ESS(2346), as identified by CPT codes from the State Ambulatory Surgery Databases 2011. Methods. Patient and facility demographics, mean charges, and operating room time were examined using bivariate and multivariate analyses. Results. A total of 2662 children underwent surgery, with BCD used in 10.6% of maxillary, 8.4% of sphenoid, and 11.8% of frontal procedures. Adjusted analysis found that children with asthma, allergic rhinitis (AR), GERD, or concomitant adenoidectomy were more likely to have BCD compared to patients without these comorbidities, asthma odds ratio (OR) = 1.94 (95% CI, 1.84-3.41), AR OR = 1.77 (95% CI, 1.03-3.07), GERD OR = 2.79 (95% CI, .59-4.90), or without adenoidectomy OR = 2.50 (95% CI, 1.84-3.41). Patients with cystic fibrosis were less likely to have BCD, OR = 0.33 (95% CI, 0.11-0.95). Median charges for patients undergoing maxillary antrostomy alone by BCD (P = .042) or with adenoidectomy (P < .001) were approximately $2100 and $4200 greater than the median of patients undergoing those procedures with ESS. However, operating room time was similar (P = .81) between patients undergoing maxillary antrostomy, regardless of whether BCD was used, but was longer (P<.001) in those undergoing maxillary antrostomy and adenoidectomy when BCD was utilized. Conclusions. BCD was used in 11.9% of pediatric sinus surgery and had higher average charges with no decrease in OR time compared to procedures that only utilized ESS. Future research is necessary to evaluate whether BCD may lead to improved outcomes and eventually decreased operating room time for pediatric patients with chronic rhinosinusitis.
KW - SASD
KW - balloon dilation
KW - cost
KW - pediatric sinus surgery
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U2 - 10.1177/0194599814545442
DO - 10.1177/0194599814545442
M3 - Article
C2 - 25091194
AN - SCOPUS:84908699472
SN - 0194-5998
VL - 151
SP - 852
EP - 860
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 5
ER -