The advances in endoscopic sinus technologies in the twentieth and twenty-first centuries have allowed sinus surgeons to skillfully visualize and access all of the paranasal sinuses and generally avoid the need for open surgical sinus procedures [1]. Angled endoscopes of various sizes with large monitor video systems, a plethora of instrumentation choices, powered shavers, and navigation systems that allow those instruments and shavers to be tracked throughout the surgical procedure have become customary in the operating suite [1–3]. As these endoscopic sinus surgery technologies advanced, several factors directed surgeons to bring sinus procedures from the operating room into the office, including economic drivers like lower overall healthcare cost and direct to patient cost, ease and timeliness of procedure scheduling, access to operating room block time, patient preference to avoid general anesthesia and recover/return to work more quickly, surgeon preference, and improved surgical efficiency during and between procedures [2, 4–7].