- PathAssist Light Seeker
- XprESS LoProfile
- 30⁰ endoscope / 0⁰ endoscope (2.7 or 3.0mm if available)
- Video system, camera, light source, and light guide
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
About the Presenting Physicians
Dr. Knox practices in Colorado Springs, CO, at Colorado ENT & Allergy.
He is a Center of Excellence Trainer for Entellus Medical, regularly hosts peers to share insights on office-based procedures, and is the author of "Topical and injected lidocaine with epinephrine provides good anesthesia and excellent hemostasis for in-office sinonasal procedures."
Dr. Loughlin practices in Litchfield, CT at Westood ENT.
Dr. Loughlin is an Entellus trainer, and regularly shares his approach to in-office treatment with visitors at his practice in Connecticut.
Dr. Peters practices in Baton Rouge, LA.
He serves as trainer in the Entellus Center of Excellence peer-to-peer education program, and hosts regular visits to his practice to discuss technique best practices.
Dr. Gould is the founder and director of the St. Louis Sinus Center. He is a Center of Excellence trainer for Entellus, and hosts peers to share his best practices on integrating and performing balloon sinus dilation procedures in the office.
Dr. Gould is the lead author of "In-office, multisinus balloon dilation: 1-Year outcomes from a prospective, multicenter, open label trial," published in March/April 2014 issue of the American Journal of Rhinology & Allergy.
Dr. Cutler practices in Denver, CO at the Colorado Sinus Institute and is the lead author of "Standalone balloon dilation versus sinus surgery for chronic rhinosinusitis: A prospective, multicenter, randomized, controlled trial" published in the Journal of Rhinology & Allergy, which features 6 month data from the REMODEL study--the first prospective, multi-center, open-label, randomized, controlled trial with sufficient statistical power to compare standalone balloon sinus dilation to the standard of care, Functional Endoscopic Sinus Surgery (FESS) for the treatment of medically refractory CRS.
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 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.
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.