New innovations in office-based rhinology

Purpose of reviewChronic rhinosinusitis (CRS) affects millions of patients worldwide, with significant health and financial implications. There is an immense utilization of resources involved, including prescription medications and surgical interventions. With increased emphasis on sound resource allocation and patient convenience, recent years have witnessed significant expansion in office-based rhinologic procedures. The purpose of this review is to discuss new technologic innovations designed to facilitate treatment of sinonasal disease in the clinic setting.Recent findingsVacuum-powered polypectomy, in-office navigation, photodynamic therapy, and drug-eluting sinus implants will be specifically addressed. The clinical indications, advantages and disadvantages, as well as accompanying evidence will be elucidated. Thus far, preliminary clinical studies have demonstrated the safety, feasibility, and efficacy of vacuum-powered polypectomy and steroid-eluting implants in select CRS patients with recurrent nasal polyposis. In-vitro studies have also illustrated the antimicrobial and anti-inflammatory effects of photodynamic therapy, but clinical trials evaluating its role in CRS are still ongoing.SummaryThe review discusses novel tools recently developed to expand our in-office armamentarium of rhinologic procedures in management of sinonasal disease. Ultimately, it is at the discretion of individual surgeons to determine how such innovations can be integrated into their clinical practice.