Article preview reprinted from Medtech Insight - November/December 2009
The field of otorhinolaryngology is evolving as physicians turn to less invasive and more precise surgical and nonsurgical approaches to treat a variety of ear, nose, and throat conditions. At this year's meeting of the American Academy of Otorhinolaryngology-Head and Neck Surgery, held in San Diego in October, innovation was on display as researchers discussed a variety of current and emerging technologies for use in sinus and head and neck surgery. Read more...
Device Innovations Target ENT
Article preview reprinted from Medtech Insight - November/December 2009
Like other specialties, the field of otorhinolaryngology is evolving as physicians turn to less invasive and more precise surgical and nonsurgical approaches to treat a variety of ear, nose, and throat (ENT) conditions. At this year's meeting of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS), held in San Diego in October, innovation was on display as researchers discussed a variety of current and emerging technologies for use in sinus and head and neck surgery.
Chronic Rhinosinusitis
Rhinosinusitis is a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses. The Centers for Disease Control & Prevention estimates 37 million people develop rhinosinusitis each year, making it one of the most common health complaints in the US. According to the AAO-HNS, rhinosinusitis disorders account for as many as 22 million office visits and more than 500,000 emergency department visits each year in the US. Although only a fraction of these patients will undergo surgery, this number is on the rise. In fact, the total number of endoscopic and inpatient sinus surgeries in the US is projected to increase from 2.076 million in 2009 to over 2.7 million in 2015.
The overall economic impact is also significant. Some sources estimate that direct medical costs related to treating sinusitis, including physician office visits, diagnostic testing, medication, surgery, hospitalization, and complications range between $5.8 and $7.8 billion per year in the US alone.
Unlike acute sinusitis, which lasts less than 12 weeks, chronic rhinosinusitis (CRS) lasts 12 weeks or longer and can be categorized according to the presence or absence of nasal polyps. Treatments typically include drug therapy and sinus surgery. Sinus procedures were once performed externally through incisions on the face; however, since the introduction of functional endoscopic sinus surgery (FESS) in the 1980s, most sinus surgery today employs endoscopic techniques. But even with an endoscopic approach, the close proximity of major nerves, blood vessels, and the brain during FESS means the procedure has the potential for serious, yet rare complications, including double vision, loss of vision, entrance into the intracranial cavity, spinal fluid leak, infection, and meningitis. Moreover, if bone and tissue are excised, FESS can lead to postoperative pain, scarring, and bleeding. To reduce the risk and discomfort associated with endoscopic sinus surgery, manufacturers have been researching and developing even less invasive technologies. Current and emerging technologies for use in sinus surgery include balloon catheters, a hydrodebrider, and even drug-eluting stents.
Balloon Dilation Technologies
In 2005, Acclarent Inc. introduced balloon catheter dilation technology to the field of otolaryngology as an adjunct to current treatments in selected patients with paranasal sinus disease. Balloon sinus surgery is a novel endoscopic technique in which physicians insert a wire-guided balloon catheter into the sinuses to open blocked nasal passages in a manner similar to how interventional cardiologists open clogged arteries using balloon angioplasty. Not all patients with CRS are candidates for the procedure, and some say it may be best suited for patients with milder problems or for those reluctant to undergo more extensive sinus surgery. According to Acclarent, only 500,000 CRS patients each year end up having FESS while there are an estimated two million CRS patients annually who fail medical management and who are potential candidates for sinus surgery.
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Companies mentioned in this article:
Acclarent Inc.
Centers for Disease Control & Prevention
Entellus Medical Inc.
Intuitive Surgical Inc.
Loyola University Medical Center
Medtronic Inc.
National Institutes of Health
Sinexus Inc.
University of North Carolina
University of Texas
University of Texas Southwestern Medical Center
University of Wisconsin
University of Wisconsin, Madison
About Medtech Insight
Medtech Insight newsletter provides insights into the technology and market developments (devices, instrumentation, biomaterials, gene therapy, tissue engineering, etc.) impacting a wide range of surgical and non-surgical clinical practices.
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