Functional endoscopic dilatation of the sinuses (FEDS): Patient selection and surgical technique

Current treatment options for patients with chronic rhinosinusitis, defined by Benninger et al as a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 consecutive weeks’ duration, range from medical therapy to surgical intervention in the form of functional endoscopic sinus surgery (FESS). While the potential causes of chronic rhinosinusitis are diverse, an underlying mechanism is inflammation of the mucosa that leads to edema and occlusion of the sinus ostia, which causes ineffective mucociliary clearance, mucus accumulation, and subsequent infection. Those patients without an anatomic cause for obstruction (such as polyps), who have failed medical therapy, could benefit from a procedure less invasive than FESS. Sinuplasty, a new technique of sinus ostia balloon dilatation, is specifically aimed at restoring ostium patency without removing tissue, and is performed with the patient under local anesthesia, thus decreasing the morbidity associated with FESS. In this article, we present the patient selection criteria and technical aspects of sinuplasty.