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How-to: Frontal Access & Dilation

Suggested Tools

Procedure Steps

PREPARE PATH WITH PATH ASSIST LIGHT SEEKER

1. Use a 30⁰ scope as a scouting tool to thoroughly explore the frontal recess area
2. Use the PathAssist Light Seeker to locate the treatment area

  • Combines transcutaneous light confirmation with tactile feedback
  • Smaller 1.5mm profile may assist in finding frontal sinus pathways

ACCESS AND DILATE WITH XPRESS

3. Follow Light Seeker path with XprESS LoProfile
4. When the XprESS LoProfile device advances smoothly without significant resistance to the 2cm marker, you are likely in the frontal sinus

  • Review CT scan prior to treatment to identify any other anatomical path or small frontal sinus
  • If Light Seeker or XprESS LoProfile is only able to be advanced 0.5 to 1cm into a path that is believed to be frontal recess, this is likely not the frontal recess

5. Use transcutaneous light confirmation with integrated PathAssist LED Light Fiber to confirm tip placement

6. Advance balloon and inflate

  • With a tight anatomical space, pre-dilation of the inferior portion of the frontal recess may allow for subsequent advancement of XprESS LoProfile in a step-wise fashion

REMOVE AND VISUALIZE

7. Deflate balloon and remove device

8. When possible, use scope to visualize dilation

Frontal Procedure Pearls

  • To help orient the angle of the frontal recess, review the CT scan (sagittal view is required). Establish the presence and shape of any agger nasi and frontal cells.
  • Adjust bend of the XprESS LoProfile to easily negotiate the patient's unique anatomy
  • Begin the case with the PathAssist Light Seeker to provide additional tactile and visual assistance in locating the frontal recess


IFUs

XprESS

XprESS Indications for Use: To access and treat the frontal recesses, sphenoid sinus ostia, and maxillary sinus ostia/ethmoid infundibula in adults using a trans-nasal approach. The bony sinus outflow tracts are remodeled by balloon displacement of adjacent bone and paranasal sinus structures. Please see the Instructions for Use below for a complete listing of contraindications, warnings, precautions and adverse events.

LED Light Fiber

LED Light Fiber Indications for Use: To locate, illuminate within, and transilluminate across nasal and sinus structures in patients aged 18 and over. Please see Instructions For Use for a complete listing of contraindications, warnings, precautions, and adverse events.

Light Seeker

PathAssist Light Seeker Indications for Use: The PathAssist Light Seeker is intended to locate, illuminate within, and transilluminate across nasal and sinus structures, including the frontal, ethmoid and maxillary sinuses, in patients aged 18 and over. Please review the Instructions for Use for a complete listing of contraindications, warnings, precautions and adverse events. Refer to PathAssist Light Seeker Instructions for Use below for complete instructions.