{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T02:51:57Z","timestamp":1767927117452,"version":"3.49.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"\n Importance<\/jats:title>\n Balloon sinus dilation (BSD) is a tool for treating patients with chronic rhinosinusitis or recurrent acute rhinosinusitis. The use of BSD has increased exponentially since its introduction, with concerns for potential misuse. Expert consensus reports that most patients who are candidates for BSD do not need to have all 6 sinuses dilated (bilateral frontal, maxillary, and sphenoid).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the percentage of patients who are undergoing 6-sinus BSD, evaluate factors associated with this practice, and explore outlier practice patterns when performing 6-sinus BSD.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional, retrospective review of a Medicare claims database from January 2022 to December 2023 included otolaryngologists (US Centers for Medicare &amp;amp; Medicaid Services code 04) who performed at least 11 BSDs during the study period, who were defined as high-volume BSD clinicians (&amp;gt;10 BSDs per year). Data were analyzed in July 2024.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome defined before data collection as the percentage of patients billed for 6-sinus BSD. Physician variables were explored for potential association with 6-sinus BSD.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 522 otolaryngologists (mean [SD] age, 52 [9.3] years), most physicians were male (489 [94%]), practiced in a group setting (428 [82%]), and were in an urban environment (474 [91%]). A total of 21\u202f290 unique BSD procedures were performed, and 12\u202f799 procedures (60%) involved all 6 sinuses. Of the 522 otolaryngologists, 40 (8%) performed 6-sinus BSD in 100% of their BSD procedures, while 54 (10%) performed no 6-sinus BSDs. Practice patterns varied substantially, with 8 physicians (2%) responsible for 10% of 6-sinus BSDs (n\u2009=\u20092152).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this cross-sectional study suggest that the high volume of 6-sinus BSD suggests the potential for overuse of BSD. Substantial variations in care emphasize the need for clear guidelines and indications for multisinus BSD to optimize the utilization and value of BSD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoto.2025.4017","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T16:00:29Z","timestamp":1763049629000},"page":"47","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Practice Patterns for 6-Sinus Balloon Sinus Dilation"],"prefix":"10.1001","volume":"152","author":[{"given":"Kristine A.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nyssa Fox","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Romashko","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorina","family":"Kallogjeri","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri"},{"name":"Statistics Editor, JAMA Otolaryngology\u2013Head & Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"S\u00e1enz","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay F.","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri"},{"name":"Editor, JAMA Otolaryngology\u2013Head & Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"3","key":"ooi250070r1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1001\/jamaoto.2019.4357","article-title":"Medicare reimbursement for balloon catheter dilations among surgeons performing high volumes of the procedures to treat chronic rhinosinusitis.","volume":"146","author":"Kasle","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"9","key":"ooi250070r2","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/alr.21976","article-title":"Industry relationships are associated with performing a greater number of sinus balloon dilation procedures.","volume":"7","author":"Eloy","year":"2017","journal-title":"Int Forum Allergy 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follow-up.","volume":"122","author":"Levine","year":"2013","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"1","key":"ooi250070r14","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/MOO.0b013e32835c05e1","article-title":"In-office functional endoscopic sinus surgery for chronic rhinosinusitis utilizing balloon catheter dilation technology.","volume":"21","author":"Sillers","year":"2013","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"6","key":"ooi250070r15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0235432","article-title":"A new approach to categorization of radiologic inflammation in chronic rhinosinusitis.","volume":"15","author":"Kuiper","year":"2020","journal-title":"PLoS One"},{"issue":"6","key":"ooi250070r16","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.anl.2013.04.010","article-title":"A modified Lund-Mackay system for radiological evaluation of chronic rhinosinusitis.","volume":"40","author":"Okushi","year":"2013","journal-title":"Auris Nasus Larynx"},{"issue":"4","key":"ooi250070r17","first-page":"244","article-title":"Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis.","volume":"32","author":"Fadda","year":"2012","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"ooi250070r18","doi-asserted-by":"crossref","first-page":"40","DOI":"10.11604\/pamj.2014.18.40.2839","article-title":"Chronic rhinosinusitis: correlation of symptoms with computed tomography scan findings.","volume":"18","author":"Amodu","year":"2014","journal-title":"Pan Afr Med J"},{"issue":"33","key":"ooi250070r19","first-page":"33","article-title":"Correlation between the opacification degree of paranasal sinuses on CT, clinical symptoms and anatomical variations of the nose and paranasal sinuses in patients with chronic rhinosinusitis.","volume":"18","author":"Niknami","year":"2021","journal-title":"Front 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