A RECENT study highlights that a significant number of ENT surgeons are performing balloon sinus dilation (BSD) without obtaining timely preoperative CT scans.
Balloon sinus dilation is a common minimally invasive procedure intended to relieve sinus blockages. But standard clinical guidelines recommend imaging of the sinuses prior to surgery to ensure safety, proper planning, and to confirm eligibility for the procedure.
New Data Reveal Practice Variations in Balloon Sinus Surgery
Researchers analysed Medicare claims data from January 2022 to December 2023 and focused on 490 otolaryngologists who each carried out at least 11 BSD procedures during that window. Across the nearly 20,000 BSD cases included, 15 percent of patients (around 2,900) had no CT imaging of the sinuses recorded within the 12 months before their procedure.
Moreover, nearly a third of the surgeons (32%) were categorised as “outliers,” meaning they failed to adhere to imaging guidelines in more than 10% of their BSD cases. Strikingly, just 8.6% of the surgeons were responsible for almost half of all the patients who went to BSD without the recommended pre-op CT.
Why Preoperative Imaging Still Matters for Patients
The authors suggest these findings call for better monitoring of adherence to imaging practices in sinus surgery. While many clinicians followed the standards, the gap in preoperative scanning raises potential risks, not just for patient safety, but also for surgical planning and outcomes.
In an accompanying commentary, experts argue that routine CT imaging remains a cornerstone for pre-surgical evaluation before BSD. Without it, they warn, surgeons may miss important details about a patient’s sinus anatomy or underlying disease, potentially leading to worse outcomes.
The study clearly underscores both the progress in minimally invasive sinus care and the ongoing need to reinforce established best practices, especially imaging, before intervention.
Reference
Romashko AA et al. Preoperative computed tomography utilization in patients undergoing balloon sinus dilation. JAMA Otolaryngol Head Neck Surg. 2025; doi: 10.1001/jamaoto.2025.4030
