[The possible failing reasons of balloon catheter dilation procedure in the management of chronic rhinosinusitis].

Objective: To investigate the effectiveness of balloon catheter dilation (BCD) in the treatment of chronic rhinosinusitis, and to analyse the possible factors which lead to BCD failure, as well as to provide basic reference for BCD clinical usage. Method: Forty-six sinuses of 32 patients with chronic rhinosinusitis were underwent "Balloon-only" BCD or "FESS assisted" BCD at our institution between September 2014 and December 2016. By recording details of the operation of all the subjects in this study and following up the clinical symptoms, nasal endoscopy, computed tomography of the sinuses, and postoperative complications six months after operation, to evaluate the difficulty, safety, effectiveness and especially, the failing reasons of BCD. Result: BCD was approached in 46 sinuses (19 maxillary sinus, 22 frontal and 5 sphenoid), and succeeded in 13 maxillary sinuses, 19 frontal sinuses, and 4 sphenoid sinuses. Of the 13 maxillary sinuses, there were 9 sinuses underwent "Balloon-only" procedure, other 4 cases underwent "FESS assisted" procedure. There were 3 cases of frontal sinus failed, because of the frontal recess anatomical complexity and the twisted drainage. Of the 5 sphenoid sinuses, 4 cases succeeded, including fungal sphenoiditis cases, in which the mould was completely cleared through the dilated ostia, and 1 case failed. All the patients were followed up for 1, 3 and 6 months of patient's quality of life, nasal endoscope, computed tomography of the sinuses. The results showed that the SNOT-20 scores of the quality of life in significant relief of symptoms, nasal mucosa status improved significantly compared with the preoperative, dilated ostium remains open, no obvious scar formation, no severe operative complications. Conclusion: Balloon catheter dilation in the treatment of chronic rhinosinusitis is safe and effective. But the operation indications is limited, and many factors influence the success rate of BCD, so, preoperatively gaining the information of nasal cavity and anatomical structure around ostium according to patients' nasal endoscopy and sinus CT is critical to success of BCD.