Balloon catheter dilation is being used to help improve paranasal sinus ventilation.1,2 Those who teach the technique emphasize the use of the C-arm fluoroscope and the tactile introduction of a sinus guidewire. This is followed by the insertion of the sinus balloon catheter over the sinus guidewire. The balloon is inflated, deflated, and withdrawn. All of this can usually be accomplished without the use of a sinus telescope. However, we have found that the use of a telescope in addition to fluoroscopy is quite helpful.