Objective: Paranasal sinus balloon catheter dilation (BCD) represents a commonly used tool in the management of chronic rhinosinusitis (CRS) for which the indications, utilization, and outcomes have not been well established. A systematic review and meta‐analysis were undertaken to evaluate change in quality of life and sinus opacification following paranasal sinus BCD in the treatment of CRS.Data Sources: MEDLINE and EMBASE databases.Review Methods: Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines were utilized to identify English‐language studies reporting patient outcomes following BCD for CRS. Primary outcomes included the impact of BCD on validated measures of quality of life and sinonasal opacification.Results: Systematic review identified 17 studies for qualitative analysis. Studies generally included cases with limited disease based on radiographic opacification. Five studies contained extractable data for change in 20‐Item Sinonasal Outcome Test (SNOT‐20) 1 year following BCD, with significant improvement in self‐reported quality of life (P =. 04). Five studies reported a significant change in paranasal sinus opacification following BCD (P <. 001). Two studies directly compared change in SNOT‐20 between BCD and endoscopic sinus surgery, without demonstration of significant difference in outcome (P =. 07). Subgroup analysis found that change in SNOT‐20 score was greater after BCD in the operating room than in the office (P =. 004).Conclusion: Current evidence supporting the role of BCD in CRS remains incomplete. Long‐term within‐group improvements in quality‐of‐life and sinus opacification scores are demonstrated among a restricted adult population with CRS. Additional study is needed to further evaluate the role for BCD in specific settings and patient subgroups.

Background: Ear symptoms are common among patients presenting to a rhinology clinic. Validated inventories are available for patient quality‐of‐life in sinonasal disease and Eustachian tube dysfunction (ETD). This study sought to determine the extent of ETD symptoms, using validated metrics, in a large population of patients presenting to a tertiary rhinology clinic.Methods: Seven‐item Eustachian Tube Dysfunction Questionnaires (ETDQ‐7) and 22‐item Sino‐Nasal Outcome Tests (SNOT‐22) were prospectively collected from 492 patients treated in a tertiary rhinology clinic. Patient diagnoses were retrospectively determined from the medical record. Correlation between reported SNOT‐22 and ETDQ‐7 scores were analyzed, in addition to the number of patients meeting the criterion score for ETD.Results: A total of 213 patients reported mean ETDQ‐7 scores >2.1, consistent with a diagnosis of ETD. Overall SNOT‐22 scores were strongly correlated with ETDQ‐7 scores (r = 0.679, p < 0.001). The SNOT‐22 ear subdomain was very strongly correlated with the ETDQ‐7 score (r = 0.847, p < 0.001), while there was a moderate correlation with the SNOT‐22 rhinologic subdomain (r = 0.486, p < 0.001). Patients with allergic fungal sinusitis had decreased ETDQ‐7 scores compared to patients with other rhinologic diagnoses (p = 0.010).Conclusion: Symptoms of ETD are common in patients treated in a rhinology clinic, with 43.3% of patients reporting symptom scores consistent with a formal diagnosis of ETD. Increased SNOT‐22 scores are correlated with increased ETDQ‐7 scores, even when only the SNOT‐22 rhinologic subdomain is considered. Patients presenting for treatment of rhinologic symptoms likely have an increased prevalence of otologic symptoms and ETD.

Objectives: Structured histopathology reporting has been recently described for detailing immunopathological characteristics of chronic rhinosinusitis (CRS), and can be utilized for subtyping CRS and personalizing management. This study scrutinized elements of structured histopathology to identify characteristics that prognosticate outcomes following endoscopic sinus surgery (ESS) for CRS patients with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP).Methods: Outcomes following ESS were measured using the patient‐reported 22‐item sinonasal outcome test (SNOT‐22). Changes in total SNOT‐22 scores at 6 and 12 months postoperatively were analyzed. Thirteen parameters reported in structured histopathology of sinus surgical tissue were studied for association with outcomes postsurgery. The overall cohort of all CRS patients was studied, along with subgroup analyses of CRSwNP and CRSsNP patients.Results: In the entire CRS cohort (n = 171), eosinophil count >10 per high power field (HPF) was associated with greater improvement in SNOT‐22 scores at 6 months post‐ESS (P = .039). At 12 months follow‐up, no histopathological characteristic was associated with change in total SNOT‐22 score. In the CRSwNP (n = 66) subgroup, the presence of fibrosis (P = .006) and eosinophil count ≤10 per HPF (P = .025) were associated with less favorable changes in SNOT‐22 scores at 12 months follow‐up. Fibrosis remained statistically significant in multivariable analysis (P = .007).Conclusions: At 6 months post‐ESS, tissue eosinophilia is associated with significantly higher improvement in SNOT‐22 scores, but this difference is diluted by 12 months. Fibrosis was associated with less favorable outcomes in SNOT‐22 scores for CRSwNP patients at 12 months and may be a prognosticator for poorer long‐term outcomes.Level of Evidence: 4