Intersect ENT (XENT) 10-Q 10 May 21 2021 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2021	May 03, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
Document Transition Report	false
Entity File Number	001-36545
Entity Registrant Name	INTERSECT ENT, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-0280837
Entity Address, Address Line One	1555 Adams Drive
Entity Address, City or Town	Menlo Park
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94025
City Area Code	650
Local Phone Number	641-2100
Title of 12(b) Security	Common Stock, 0.001 par value
Trading Symbol	XENT
Security Exchange Name	NASDAQ
Entity Interactive Data Current	Yes
Entity Current Reporting Status	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		33,140,573
Amendment Flag	false
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001271214
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands		Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents		$ 14,365	$ 13,521	[1]
Short-term investments		56,159	74,506	[1]
Accounts receivable, net		14,581	14,592	[1]
Inventories, net		13,217	12,054	[1]
Prepaid expenses and other current assets		3,965	3,494	[1]
Total current assets		102,287	118,167	[1]
Property and equipment, net		5,242	5,624	[1]
Operating lease right-of-use assets		16,813	17,151	[1]
Intangible assets, net		20,312	21,193	[1]
Goodwill		46,639	46,639	[1]
Restricted cash		18,345	17,500	[1]
Other non-current assets		801	1,107	[1]
Total assets		210,439	227,381	[1]
Current liabilities:
Accounts payable		6,943	6,042	[1]
Accrued compensation		10,917	13,559	[1]
Deferred acquisition related consideration, current	[1]	20,149	21,071
Other current liabilities		5,529	3,575	[1]
Total current liabilities		43,538	44,247	[1]
Operating lease liabilities		15,913	17,736	[1]
Convertible notes, net		64,216	63,650	[1]
Deferred acquisition related consideration, non-current		32,206	33,167	[1]
Deferred tax liability		1,367	1,569	[1]
Other non-current liabilities		942	0	[1]
Total liabilities		158,182	160,369	[1]
Commitments and contingencies (note 10)				[1]
Stockholders’ equity:
Preferred stock		0	0	[1]
Common stock, $0.001 par value; Authorized shares: 150,000 at June 30, 2020 and December 31, 2019; Issued and outstanding shares: 32,645 at June 30, 2020 and 32,235 at December 31, 2019		33	33	[1]
Additional paid-in capital		375,315	370,053	[1]
Accumulated other comprehensive income		15	1	[1]
Accumulated deficit		(323,106)	(303,075)	[1]
Total stockholders’ equity		52,257	67,012	[1]
Total liabilities and stockholders’ equity		$ 210,439	$ 227,381	[1]
Preferred stock, shares authorized (in shares)		9,994,000	9,994,000
Series DF-1 Convertible Preferred Stock
Stockholders’ equity:
Preferred stock		$ 0	$ 0	[1]
Preferred stock, shares authorized (in shares)		6,310	6,000
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
Stockholders’ equity:
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	9,994,000	9,994,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares issued (in shares)	33,136,000	32,936,000
Common stock, shares outstanding (in shares)	33,136,000	32,936,000
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Series DF-1 Convertible Preferred Stock
Stockholders’ equity:
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	6,310	6,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Revenue	$ 24,328	$ 19,826
Cost of sales	8,455	6,410
Gross profit	15,873	13,416
Operating expenses:
Selling, general and administrative	28,077	26,200
Research and development	6,370	5,146
Total operating expenses	34,447	31,346
Loss from operations	(18,574)	(17,930)
Interest expense	(1,375)	0
Other income (expense), net	(504)	397
Loss before income taxes	(20,453)	(17,533)
Provision for income tax (benefit)	(422)	0
Net loss	(20,031)	(17,533)
Other comprehensive income (loss):
Unrealized gain (loss) on short-term investments, net	14	(19)
Comprehensive loss	$ (20,017)	$ (17,552)
Net loss per share, basic and diluted (in usd per share)	$ (0.61)	$ (0.54)
Weighted average common shares used to compute net loss per share, basic and diluted (in usd per share)	33,022	32,365

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholder's Equity - USD ($) $ in Thousands	Total		Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Balance at beginning of period (in shares) at Dec. 31, 2019			32,235,000
Balance at beginning of period at Dec. 31, 2019	$ 118,058		$ 32	$ 348,729	$ 53	$ (230,756)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock and exercise of stock options (in shares)			302,000
Issuance of common stock and exercise of stock options	3,101		$ 1	3,100
Stock-based compensation expense	4,253			4,253
Unrealized gain (loss) on short-term investments	(19)				(19)
Net loss	(17,533)					(17,533)
Balance at end of period (in shares) at Mar. 31, 2020			32,537,000
Balance at end of period at Mar. 31, 2020	107,860		$ 33	356,082	34	(248,289)
Balance at beginning of period (in shares) at Dec. 31, 2020			32,936,000
Balance at beginning of period at Dec. 31, 2020	67,012	[1]	$ 33	370,053	1	(303,075)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock and exercise of stock options (in shares)			200,000
Issuance of common stock and exercise of stock options	1,121			1,121
Stock-based compensation expense	4,141			4,141
Unrealized gain (loss) on short-term investments	14				14
Net loss	(20,031)					(20,031)
Balance at end of period (in shares) at Mar. 31, 2021			33,136,000
Balance at end of period at Mar. 31, 2021	$ 52,257		$ 33	$ 375,315	$ 15	$ (323,106)
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Operating activities:
Net loss	$ (20,031)	$ (17,533)
Adjustments to reconcile net loss to cash used in operating activities:
Depreciation and amortization	1,202	496
Non-cash lease expense	481	538
Stock-based compensation expense	4,061	4,356
Amortization of net investment premium (discount)	265	(83)
Amortization of debt transaction costs and accretion of debt discount	220	0
Impairment of property, equipment, and intangible assets	575	0
Interest expense on deferred acquisition related costs	504	0
Loss on foreign currency forward contracts	2,287	0
Foreign currency remeasurement gain	(1,973)	0
Change in fair value of embedded derivatives	346	0
Provision for income tax benefit	(422)	0
Changes in operating assets and liabilities:
Accounts receivable, net	(172)	8,807
Inventories, net	(1,083)	(151)
Prepaid expenses and other assets	(1,167)	(368)
Accounts payable	1,070	634
Accrued compensation	(2,614)	(2,327)
Other liabilities	(321)	(325)
Net cash used in operating activities	(16,772)	(5,956)
Investing activities:
Purchases of short-term investments	0	(7,339)
Maturities of short-term investments	18,096	23,872
Purchases of property and equipment	(467)	(137)
Net cash provided by investing activities	17,629	16,396
Financing activities:
Proceeds from issuance of common stock and exercise of stock options	1,121	3,101
Net cash provided by financing activities	1,121	3,101
Effect of exchange rates on cash, cash equivalents, and restricted cash	(196)	0
Net increase in cash, cash equivalents, and restricted cash	1,782	13,541
Cash, cash equivalents, and restricted cash:
Beginning of the period	31,021	20,652
End of the period	32,803	34,193
Non-cash investing activities:
Right-of-use asset obtained in exchange for lease obligations	144	0
Property and equipment included in accounts payable	55	321
Lessor funded building improvements	$ 46	$ 0

Organization

Organization	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	Organization Description of Business Intersect ENT, Inc. (the “Company”) is incorporated in the state of Delaware and is headquartered in Menlo Park, California. The Company is a global ear, nose and throat (“ENT”) medical technology leader dedicated to transforming patient care. The Company’s U.S. Food and Drug Administration (“FDA”) approved products are steroid releasing implants designed to treat patients suffering from chronic rhinosinusitis (“CRS”) who are managed by ENT physicians. These products include the PROPEL ® family of products (PROPEL ® , PROPEL ® Mini and PROPEL ® Contour) and the SINUVA ® (mometasone furoate) Sinus Implant. The PROPEL family of products are used in conjunction with sinus surgery primarily in hospitals and ambulatory surgery centers ("ASC") and increasingly in the physician office setting of care in conjunction with balloon dilation and following post-surgical debridement. SINUVA is designed to be used in the physician office setting of care to treat patients who have had ethmoid sinus surgery yet suffer from recurrent sinus obstruction due to polyps. In October 2020, the Company acquired Fiagon AG Medical Technologies (“Fiagon”), a global leader in electromagnetic surgical navigation solutions with an expansive portfolio of ENT product offerings, including the VENSURE sinus dilation balloon (“ VENSURE ”) and CUBE surgical navigation tools (“CUBE”), that complement the Company’s PROPEL and SINUVA sinus implants and extend its geographic reach. The PROPEL family of products are combination products regulated as devices approved under a Premarket Approval (“PMA”) and SINUVA is a combination product regulated as a drug that was approved under a New Drug Application (“NDA”). The VENSURE products received 510(k) clearance in August 2020. In addition, the Company continues to invest in research and development in order to expand its portfolio of products and improve its existing products.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Preparation The condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and pursuant to the rules and regulations of the United States Securities and Exchange Commission (“SEC”). These condensed consolidated financial statements include the accounts of the Company and its consolidated subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. The interim financial data as of March 31, 2021, is unaudited and is not necessarily indicative of the results for the full year. In the opinion of the Company’s management, the interim data includes only normal and recurring adjustments necessary for a fair presentation of the Company’s financial results for the three months ended March 31, 2021 and 2020. Certain information and disclosures normally included in the annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to SEC rules and regulations relating to interim financial statements. The accompanying condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K (“Annual Report”) for the year ended December 31, 2020 filed with the SEC on March 9, 2021. Risks and Uncertainties The Company is subject to risks and uncertainties resulting from the COVID-19 pandemic. The Company cannot predict the extent or duration of the impact of the COVID-19 pandemic on its financial and operating results, as the information regarding the current environment is evolving rapidly. Due to the COVID-19 pandemic, the Company’s business has been and will continue to be impacted by patients’ decisions whether or not to undergo sinus surgeries and, as a result, ENT ASC and office procedure volumes may fluctuate. The Company’s operations may be further impacted by COVID-19 due to changes in its manufacturing operations as a result of the easing of certain restrictions of the shelter-in-place orders issued by local and federal authorities. Furthermore, the COVID-19 pandemic has led to severe disruption and volatility in global capital markets and increased economic uncertainty and instability. The magnitude of the impact of the COVID-19 pandemic on the Company’s business will depend on a number of factors, including, but not limited to: the duration and severity of the pandemic is unknown and could continue longer, and be more severe, than the Company currently expects; the duration, extent and re-occurrence of the shelter-in-place orders impacting its manufacturing operations; the unknown state of the U.S. economy following the pandemic; the level of demand for the Company’s products as the pandemic subsides; and the time it will take for the economy to recover from the pandemic. As of the date of these condensed consolidated financial statements, the extent to which the COVID-19 pandemic may materially adversely impact the Company’s financial results, operating results, or liquidity is uncertain. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts and disclosures reported in the financial statements. Management uses significant judgment when making estimates related to its revenue related allowances, inventory, common stock valuation and related stock-based compensation, leases, business combinations, embedded derivatives, as well as certain accrued liabilities. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates. Accounting Pronouncements Recently Adopted Accounting Standards In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes ("ASU 2019-12"), which is intended to simplify various aspects related to accounting for income taxes. ASU 2019-12 removes certain exceptions to the general principles in Topic 740 and also clarified and amends existing guidance to improve consistent application. ASU 2019-12 became effective for the Company beginning in 2021 . The adoption of the standard did not result in a material impact to the Company’s condensed consolidated financial statements. In October 2020, the FASB issued ASU No. 2020-08, Codification Improvements to Subtopic 310-20, Receivables- Nonrefundable Fees and Other Costs ("ASU 2020-08"). ASU 2020-08 clarifies the accounting for the amortization period for certain purchased callable debt securities held at a premium by giving consideration to securities which have multiple call dates. ASU 2020-08 became effective for the Company beginning in 2021. The adoption of the standard had no impact to the Company’s condensed consolidated financial statements. In August 2020, the FASB issued ASU No. 2020-06, Debt- Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging- Contracts in Entity’s Own Equity (Subtopic 815-40) ("ASU 2020-06") . ASU 2020-06 modifies and simplifies accounting for convertible instruments. The new guidance eliminates certain separation models that require separating embedded conversion features from convertible instruments. ASU 2020-06 also addresses how convertible instruments are accounted for in the diluted earnings per share calculation. The Company early adopted this standard and became effective beginning in 2021. The adoption of the standard had no impact to the Company’s condensed consolidated financial statements. Significant Accounting Policies There have been no significant changes to the accounting policies during the three months ended March 31, 2021, as compared to the significant accounting policies described in Note 2 of the “Notes to Consolidated Financial Statements” in the Company’s audited consolidated financial statements included in its Annual Report on Form 10-K for the year ended December 31, 2020, except as follows: Cost of sales Cost of sales consists primarily of manufacturing overhead costs, material costs, and direct labor. A significant portion of the Company’s cost of sales currently consists of manufacturing overhead costs. These overhead costs include compensation, including stock-based compensation and other operating expenses associated with the cost of quality assurance, material procurement, inventory control, facilities, information technology, equipment and operations supervision and manufacturing and warehouse management. Cost of sales also includes depreciation expense for production equipment, amortization of intangible assets associated with acquired product technologies and processes, maintenance of operational processes, and certain direct costs such as shipping costs. three

Composition of Certain Financia

Composition of Certain Financial Statement Items	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Composition of Certain Financial Statement Items	Composition of Certain Financial Statement Items Accounts receivable, net (in thousands): March 31, December 31, Accounts receivable $ 14,927 $ 15,079 Allowance for doubtful accounts (346) (487) $ 14,581 $ 14,592 Inventories, net (in thousands): March 31, December 31, Raw materials $ 2,922 $ 2,865 Work-in-process 2,908 3,411 Finished goods 7,387 5,778 $ 13,217 $ 12,054 Capitalized stock-based compensation expense of $0.4 million and $0.3 million was included in inventory as of March 31, 2021 and December 31, 2020, respectively. Operating lease liabilities (in thousands): March 31, December 31, Current portion presented in other current liabilities $ 2,238 $ 762 Non-current portion presented in operating lease liabilities 15,913 17,736 $ 18,151 $ 18,498 Revenue (in thousands): Three Months Ended 2021 2020 PROPEL family of products $ 20,442 $ 19,090 SINUVA 2,435 736 VENSURE, CUBE, and accessories 1,451 — $ 24,328 $ 19,826

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company measures certain financial assets and liabilities at fair value on a recurring basis, including cash equivalents, short-term investments, and convertible debt embedded derivatives. Fair value is an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or a liability. A three-tier fair value hierarchy is established as a basis for considering such assumptions and for inputs used in the valuation methodologies in measuring fair value: Level 1 — Observable inputs such as quoted prices (unadjusted) for identical assets or liabilities in active markets. Level 2 — Other inputs that are based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active and model-based valuation techniques for which all significant inputs are observable in the market or can be derived from observable market data. Level 3 — Unobservable inputs that are supported by little or no market activities, which would require the Company to develop its own assumptions. The fair value hierarchy also requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The fair value of marketable securities classified within Level 2 is based upon observable inputs that may include benchmark yields, reported trades, broker/dealer quotes, two-sided markets, benchmark securities, bids, offers and reference data including market research publications. The fair value of debt is based on the amount of future cash flows associated with the instrument discounted using the Company’s estimated market rate as well as a convertible lattice model for the embedded features. As of March 31, 2021, the fair value of the Company’s Convertible Notes (see Note 9) was $101.0 million . Cash, Cash Equivalents, Short-term Investments, and Restricted Cash The following is a summary of cash, cash equivalents, and restricted cash (in thousands): March 31, 2021 March 31, 2020 Cash and cash equivalents $ 14,365 $ 34,193 Restricted cash 18,345 — Restricted cash presented in prepaid and other current assets 93 — Total cash, cash equivalents, and restricted cash shown in the condensed consolidated statement of cash flows $ 32,803 $ 34,193 In association with the acquisition of Fiagon, the Company held $18.3 million and $17.5 million as of March 31, 2021 and December 31, 2020, respectively, with an escrow agent with the seller as beneficiary. These balances are presented as restricted cash on the Company’s condensed consolidated balance sheets. The restricted cash balance presented in prepaid and other current assets at March 31, 2021 represents a rent deposit held in escrow. The following is a summary of the Company’s unrealized gains and losses related to its short-term investments in marketable securities designated available-for-sale (in thousands): Reported as: Amortized Gross Unrealized Estimated Cash and cash Short-term March 31, 2021 Gains Losses Level 1: Cash $ 10,128 $ — $ — $ 10,128 $ 10,128 $ — Money market funds 4,237 — — 4,237 4,237 — 14,365 — — 14,365 14,365 — Level 2: U.S. treasury bills 39,523 10 — 39,533 — 39,533 U.S. government agency bonds 16,621 5 — 16,626 — 16,626 56,144 15 — 56,159 — 56,159 $ 70,509 $ 15 $ — $ 70,524 $ 14,365 $ 56,159 Reported as: Amortized Gross Unrealized Estimated Cash and cash Short-term December 31, 2020 Gains Losses Level 1: Cash $ 9,755 $ — $ — $ 9,755 $ 9,755 $ — Money market funds 2,762 — — 2,762 2,762 — 12,517 — — 12,517 12,517 — Level 2: U.S. treasury bills 49,698 4 (3) 49,699 1,004 48,695 Corporate debt securities 6,307 — (2) 6,305 — 6,305 U.S. government agency bonds 19,504 3 (1) 19,506 — 19,506 75,509 7 (6) 75,510 1,004 74,506 $ 88,026 $ 7 $ (6) $ 88,027 $ 13,521 $ 74,506 There were no transfers in and out of Level 1 and Level 2 during the three months ended March 31, 2021 and year ended December 31, 2020. As of March 31, 2021 and December 31, 2020, the Company had no investments with a remaining maturity of greater than one year. Based on an evaluation of securities that have been in a loss position, the Company did not recognize any other-than-temporary impairment charges during the three months ended March 31, 2021 and year ended December 31, 2020. The Company considered various factors which included a credit and liquidity assessment of the underlying securities and the Company’s intent and ability to hold the underlying securities until the estimated date of recovery of its amortized cost. The Company concluded that any unrealized losses on investments as of March 31, 2021 were not attributed to credit. Convertible Notes Embedded Derivatives The Convertible Notes due in 2025 (see Note 9) have embedded features which were required to be bifurcated upon issuance and then periodically remeasured separately as embedded derivatives. These embedded features include additional make-whole interest payments which may become payable to the lender upon certain events, such as a change in control, upon optional redemption by the Company, or a sale of all or substantially all of the Company’s assets. The embedded features also include additional shares depending on the time to maturity and the stock price which may be added to an early conversion upon certain events. The Company has utilized a convertible lattice model to determine the fair value of the embedded features, which utilizes inputs including the common stock price, volatility of common stock, credit rating, probability of certain triggering events and time to maturity. The fair value measurements of the embedded derivatives are classified as Level 3 financial instruments. At March 31, 2021, the fair value of the embedded features was $3.4 million and has been presented together with the Convertible Notes host instrument on the condensed consolidated balance sheets. Changes in the fair value of the Company’s Level 3 liabilities were as follows: March 31, Balance at December 31, 2020 $ 3,048 Additions — Fair value adjustment 346 Balance at March 31, 2021 $ 3,394 The change in fair value of embedded derivatives for the three months ended March 31, 2021 was a $0.3 million loss, which was recorded in other income (expense), net in the Company's condensed consolidated statements of operations. Derivative Financial Instruments The Company’s deferred purchase consideration related to the Fiagon acquisition exposed it to foreign currency exchange risk between rate fluctuations of the U.S. dollar and the Euro. To manage this risk, the Company entered into a series of foreign currency exchange forward contracts. In general, gains and losses related to these contracts are expected to be substantially offset by corresponding gains and losses on the remeasurement of the deferred purchase consideration each reporting period. The risk of loss in the event of a counterparty default is limited to the amount of any unrealized gains on outstanding contracts (e.g., those contracts that have a positive fair value) at the date of default. The Company does not enter into derivative contracts for trading purposes. The derivative instruments the Company uses to hedge this exposure are not designated as hedges and, as a result, changes in their fair value are recorded in other income (expense), net in its condensed consolidated statements of operations. The derivative assets and liabilities are measured using Level 2 fair value inputs. The Company had gross notional amounts (in EUR) on foreign currency exchange contracts not designated as hedging instruments outstanding as of March 31, 2021 and December 31, 2020 as follows (in thousands): March 31, December 31, Notional amounts: Forward contracts € 45,000 € 45,000 Gross fair value recorded in: Prepaid expenses and other current assets $ — $ 275 Other non-current assets $ — $ 558 Other current liabilities $ 511 $ — Other non-current liabilities $ 942 $ — The following table summarizes the effect of the Company’s foreign currency exchange contracts on its condensed consolidated statements of operations recognized in other income (expense), net (in thousands): Three Months Ended March 31, 2021 Recognized losses $ (2,287) Foreign exchange gain on remeasurement of deferred acquisition related consideration $ 2,384

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2021
Business Combinations [Abstract]
Business Combinations	Business CombinationsOn October 2, 2020, the Company acquired all of the outstanding equity interests of Fiagon and its subsidiaries. Fiagon develops, and commercializes globally, innovative electromagnetic surgical navigation systems and an associated suite of surgical tools and sinus dilation balloons targeted to the ENT surgical space. The transaction increases the Company’s product portfolio as well as its ability to serve customers and patients in the U.S., Europe and elsewhere. Assets and operations acquired included developed technologies, a distribution network, customer relationships, trademarks, certain personnel, and net tangible assets, which collectively met the definition of a business. Under the terms of the Purchase Agreement for the acquisition of Fiagon, the Company made an initial €15.0 million ($17.6 million) payment upon closing in October 2020 and will make €15.0 million annual payments for each of the subsequent three years, plus an estimated €2.2 million purchase price adjustment due in October 2021. The total purchase consideration is denominated in Euros with an equivalent value of $68.9 million which included an upfront cash payment of $17.6 million, and deferred payments of $51.3 million, of which $17.5 million (€15.0 million equivalent) of cash was placed in escrow with the seller as beneficiary. The amount placed in escrow is required to be adjusted to the equivalent of €15.0 million on January 15th and July 15th of each year based on the end of the prior month's five-day trailing exchange rate. The restrictions on cash held in escrow will be released upon payment of the last deferred purchase payment due in October 2023. In addition, the Company entered into agreements to pledge the shares of Fiagon and its intellectual property as security for the deferred payments. The share pledge expires upon payment of the last deferred purchase payment due in October 2023 and the intellectual property pledge expires upon payment of the second installment due in October 2021. The Company recorded $4.6 million of tangible assets, primarily consisting of $2.2 million of inventory, offset by liabilities assumed of $4.2 million, including deferred tax liabilities of $2.2 million. In addition, the Company recorded $21.9 million of intangible assets and $46.6 million in residual goodwill. Goodwill arising from the business combination consists largely of the synergies and economies of scale expected from combining the operations of the Company and Fiagon, as well as the value of Fiagon’s assembled workforce. Intangible assets included patents and developed technology, a distribution network, customer relationships, and trademarks. The Company’s management utilized a specialist to assist in the valuation. Key assumptions included in the valuation were (1) the amount and timing of future revenues, expenses, and other cash flows, and (2) the discount rate used to determine the present value of these cash flows. The goodwill is not amortizable for income tax purposes. The estimated fair value of assets acquired and liabilities assumed are provisional and are based on the information that was available as of the acquisition date. Measurement period adjustments could reflect new information pertaining to the purchase price consideration, deferred tax impacts and goodwill. Purchase price consideration is pending final agreement regarding the purchase price adjustment to be included in the installment payment due in October 2021. Deferred taxes are pending the results of a tax examination of pre-acquisition periods and preparation of 2020 foreign tax returns by the acquired companies. During the three months ended March 31, 2021, the Company recognized impairment expense of $0.2 million, related to the remaining trademarks value as a result of a decision to rebrand the associated products, which was recorded in selling, general and administrative expenses in the condensed consolidated statements of operations.

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2021
Equity [Abstract]
Stockholders' Equity	Stockholders’ Equity Series DF-1 Convertible Preferred Stock The Company’s board of directors has designated 6,310 shares of the authorized 10,000,000 shares of preferred stock, $0.001 par value per share, as Series DF-1 Convertible Preferred Stock (the “Series DF-1 Preferred Stock”). Each share of Series DF-1 Preferred Stock is non-voting and convertible to 1,000 shares of the Company’s Common Stock. There is an aggregate of 6,309,459 shares of common stock issuable upon conversion of the Series DF-1 Preferred Stock. The Series DF-1 Preferred Stock does not have voting rights but is eligible for dividends or distributions on an as-converted basis.

Stock-based Compensation Expens

Stock-based Compensation Expense	3 Months Ended
	Mar. 31, 2021
Share-based Payment Arrangement [Abstract]
Stock-based Compensation Expense	Stock-based Compensation Expense 2014 Equity Incentive Plan In July 2014, the Company’s board of directors approved the 2014 Equity Incentive Plan (the “2014 Plan”). The number of shares of common stock reserved for issuance under the 2014 Plan will automatically increase on January 1 of each year, beginning on January 1, 2015, and continuing through and including January 1, 2024, by 3% of the total number of shares of the Company’s capital stock outstanding on December 31 of the preceding calendar year, or a lesser number of shares determined by the Company’s board of directors. On January 1, 2021, the total number of shares of common stock reserved for issuance increased by 988,070 shares to 10,922,838 shares reserved since the inception of the 2014 Plan. At March 31, 2021, 3,173,483 shares remained available for issuance. A summary of the Company’s stock option activity and related information (options in thousands): Three Months Ended Options Weighted Average Outstanding, beginning of period 3,599 $ 22.01 Granted 691 23.03 Exercised (101) 11.10 Forfeited (104) 27.01 Outstanding, end of period 4,085 22.33 Exercisable 1,666 23.09 As of March 31, 2021, included in the outstanding options was an option subject to both service and market-based vesting conditions to purchase 427,147 shares of the Company’s common stock with an exercise price of $20.44. As of March 31, 2021, these stock options remain unvested. The aggregate pre-tax intrinsic value of options outstanding was $6.9 million and options outstanding and exercisable was $3.9 million, the weighted-average remaining contractual term of options outstanding was 8.0 years and options outstanding and exercisable was 6.5 years. The aggregate pre-tax intrinsic value of options exercised was $1.2 million during each of the three months ended March 31, 2021 and 2020. A summary of the Company’s RSU activity and related information (RSUs in thousands): Three Months Ended RSUs Weighted Average Outstanding, beginning of period 488 $ 23.88 Awarded 277 23.07 Vested (99) 29.98 Forfeited (32) 21.37 Outstanding, end of period 634 22.70 As of March 31, 2021, the aggregate pre-tax intrinsic value of RSUs outstanding was $13.2 million, calculated based on the closing price of the Company’s common stock at the end of the period, and the weighted-average remaining vesting term of RSUs outstanding was 2.3 years. The Company also offers Performance Stock Units (“PSUs”), subject to service, performance, and market-based vesting conditions. A summary of the Company’s PSU activity and related information (PSUs in thousands): Three Months Ended PSUs Weighted Average Outstanding, beginning of period 130 $ 15.94 Awarded 167 25.35 Forfeited (7) 17.28 Outstanding, end of period 290 21.31 As of March 31, 2021, the aggregate pre-tax intrinsic value of PSUs outstanding was $6.1 million, calculated based on the closing price of the Company’s common stock at the end of the period, and the weighted-average remaining vesting term of PSUs outstanding was 2.1 years. Total stock-based compensation expense recognized is as follows (in thousands): Three Months Ended 2021 2020 Cost of sales $ 321 $ 441 Selling, general and administrative 3,091 3,552 Research and development 649 363 $ 4,061 $ 4,356 As of March 31, 2021, the total compensation expense related to unvested stock option, RSU, and PSU grants under the Company’s 2014 plan not yet recognized was $41.5 million and is currently estimated to be expensed through the year 2025. This expense will be amortized on a straight-line basis over a weighted average period of 2.7 years and will be adjusted for subsequent forfeitures. 2014 Employee Stock Purchase Plan In July 2014, the Company’s board of directors approved the 2014 Employee Stock Purchase Plan (“2014 ESPP”). A total of 496,092 shares were initially reserved for issuance under the 2014 ESPP. In June 2018, the Company’s stockholders approved the Amended and Restated 2014 ESPP, increasing the total number of shares of common stock reserved for issuance under the 2014 ESPP by 1,200,000 shares to a total of 1,696,092 shares (the “Amended and Restated 2014 ESPP”) since the inception of the 2014 ESPP. At March 31, 2021, 893,829 shares remained available for issuance and no shares were issued during the three months ended March 31, 2021.

Net Loss per Share

Net Loss per Share	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Net Loss per Share	Net Loss per Share Basic net loss per share is computed by dividing the net loss by the weighted average number of shares of common stock outstanding during the period. Diluted net loss per share is computed by dividing the net loss by the weighted average number of shares of common stock and common stock equivalent shares from dilutive stock options, employee stock purchases and restricted stock units outstanding during the period. Because the Company has reported a net loss for all periods presented, diluted net loss per share is the same as basic net loss per share for those periods as all potentially dilutive securities were antidilutive in those periods. The following potentially dilutive securities outstanding have been excluded from the computations of weighted average shares outstanding because such securities have an antidilutive impact due to losses reported (in common stock equivalent shares, in thousands): Three Months Ended 2021 2020 Common stock options 3,658 3,372 Market-based performance stock options 427 427 Restricted stock units 634 596 Market-based performance stock units 290 192 Employee stock purchase plan shares 63 70 Stock issuable upon conversion of convertible note 6,309 — 11,381 4,657 The Company uses the if-converted method for calculating any potentially dilutive effects of the Convertible Notes. The Company did not adjust the net loss for the three months ended March 31, 2021 to eliminate any interest expense related to the Convertible Notes (see Note 9) in the computation of diluted loss per share, or calculate the potential common shares from conversion, as the effects would have been anti-dilutive. The shares presented above represent the maximum number of convertible shares which can be issued subject to the make-whole increase to the conversion rate upon certain events.

Convertible Notes

Convertible Notes	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Convertible Notes	Convertible Notes On May 11, 2020, in order to finance the Company’s commercial activities as well as for general corporate purposes, the Company entered into a Facility Agreement (the “Facility Agreement”) by and among the Company, as borrower, and Deerfield Partners, L.P. (“Deerfield”), as agent for itself and the lenders, providing for the issuance and sale by the Company to Deerfield of $65.0 million of principal amount of 4.0% unsecured senior convertible notes (the “Convertible Notes”) upon the terms and conditions set forth in the Facility Agreement (the “Deerfield Financing”). The $65.0 million principal amount of the Convertible Notes is not payable until the maturity date of May 9, 2025, unless earlier converted or redeemed. The Convertible Notes are convertible into shares of the Company’s common stock, at a conversion rate of 64.3501 shares per $1,000 principal amount of Convertible Notes, which represents an initial conversion price of $15.54. The net proceeds from the sale of the Convertible Notes were approximately $61.8 million after deducting the expenses payable by the Company. The Convertible Notes bear interest at 4.0% per annum, payable quarterly in arrears on July 1, October 1, January 1 and April 1 of each year, commencing July 1, 2020. The Convertible Notes are convertible at any time at the option of the holders thereof, provided that Deerfield is prohibited from converting the Convertible Notes into shares of common stock if, as a result of such conversion, the converting holder (together with certain affiliates and “group” members) would beneficially own more than 4.985% of the total number of shares of common stock then issued and outstanding (the “Beneficial Ownership Cap”). Pursuant to the Convertible Notes, the holders of the Convertible Notes have the option to demand repayment of all outstanding principal, any unpaid interest accrued thereon, and make-whole interest in connection with a Major Transaction (as defined in the Convertible Notes), which shall include, among others, any acquisition or other change of control of the Company; the sale or transfer of assets of the Company equal to more than 50% of the Enterprise Value (as defined in the Convertible Notes) of the Company; a liquidation, bankruptcy or other dissolution of the Company; or if at any time shares of the Company’s common stock are not listed on an Eligible Market (as defined in the Convertible Notes). The Facility Agreement contains certain specified events of default, the occurrence of which would entitle the holders of the Convertible Notes to immediately demand repayment of all outstanding principal and accrued interest on the Convertible Notes, together with a make-whole payment as determined pursuant to the Facility Agreement. Such events of default include, among others, failure to make any payment under the Convertible Notes when due, failure to observe or perform any covenant under the Facility Agreement or the other transaction documents related thereto (subject in certain cases to specified cure periods), the failure of the Company to be able to pay debts as they come due, the commencement of bankruptcy or insolvency proceedings against the Company, a material judgment levied against the Company and a material default by the Company under other indebtedness. On or after the date that is the second anniversary of the issuance date, the Company may redeem up to $32.5 million of the principal amount of Convertible Notes if: • the volume weighted average price of the common stock on each of any twenty (20) trading days during a period of thirty (30) consecutive trading days ending on the date which an optional redemption notice is delivered; • the volume weighted average price of the common stock on the last trading day of such period; and • the closing price of the common stock on the last trading day of such period, in each case, are greater than 150% of the conversion price. On or after the date that is the third anniversary of the issuance date, the Company may redeem up to the entire $65.0 million original principal amount of Convertible Notes if: • the volume weighted average price of the common stock on each of any twenty (20) trading days during a period of thirty (30) consecutive trading days ending on the date which an optional redemption notice is delivered; • the volume weighted average price of the common stock on the last trading day of such period; and • the closing price of the common stock on the last trading day of such period, in each case, are greater than 200% of the conversion price. The Company is obligated to notify the holders of the Convertible Notes no less than ten trading days nor more than sixty calendar days prior to any such redemption. During the period from the date on which the Company delivers an optional redemption notice until the date the optional redemption price is paid to holders, if a holder elects to convert its Convertible Notes, it will receive the shares otherwise issuable upon conversion of the Convertible Notes, plus an additional number of shares determined in accordance with the Convertible Notes. To the extent the holder would be prohibited due to the Beneficial Ownership Cap to convert its Convertible Notes during such period, such holder would be entitled to convert all or any portion of its Convertible Notes into shares of Series DF-1 Preferred Stock of the Company (such conversion, a “Preferred Stock Conversion”). The number of Series DF-1 Preferred Stock issuable upon a Preferred Stock Conversion shall be determined by dividing the number of shares of common stock of the Company that it would be entitled to receive from such conversion by 1,000. See Note 6 for discussion on the rights and privileges of Series DF-1 Preferred Stock. Upon any conversion of the Convertible Notes in connection with a major transaction, redemption of the Convertible Notes in connection with a major transaction or an optional redemption, holders of the Convertible Notes will also be entitled to a make-whole increase to the conversion rate or make-whole interest provision. The Company is subject to a number of affirmative and restrictive covenants pursuant to the Facility Agreement, including covenants regarding compliance with applicable laws and regulations, maintenance of property, payment of taxes, maintenance of insurance, business combinations, incurrence of additional indebtedness, prepayments of other unsecured indebtedness and transactions with affiliates, among other covenants. The Company is also restricted from paying dividends or making other distributions or payments on its capital stock, subject to limited exceptions. Certain features in the Convertible Notes are accounted for as embedded derivatives bifurcated from the principal balance of the Convertible Notes. See Note 4 for further discussion on the valuation of the embedded derivatives. Upon issuance, the fair value of the embedded derivatives was $1.8 million. A corresponding convertible debt discount and transaction costs of $1.8 million and $3.2 million, respectively were recorded on the issuance date and are netted against the principal amount of the Convertible Notes. Transaction costs related to the issuance of the Convertible Notes primarily comprised of underwriters’, legal, accounting and other professional fees. As of March 31, 2021, the net carrying amount of the Convertible Notes is as follows: March 31, Outstanding principal amount of convertible notes $ 65,000 Unamortized debt discount and transaction costs (4,178) Fair value of embedded derivatives 3,394 Convertible notes, net $ 64,216 The convertible debt discount and transaction costs are being amortized to expense over the term of the Notes. For the three months ended March 31, 2021, the accretion of the convertible debt discount and amortization of debt issuance costs was $0.2 million and was included in interest expense in the condensed consolidated statements of operations. The accrued interest on the outstanding principal of $65.0 million as of March 31, 2021 was $0.6 million and was included in other current liabilities on the condensed consolidated balance sheets.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Litigation The Company may at times be involved in litigation and other legal claims in the ordinary course of business. When appropriate in the Company’s estimation, it may record reserves in its financial statements for pending litigation and other claims. On May 15, 2019, a purported stockholder of the Company, Avi Yaron, filed a putative class action complaint in the United States District Court for the Northern District of California, entitled Yaron v. Intersect ENT, Inc., et al., Case No. 4:19-cv-02647, against the Company and certain individual officers and directors alleging violations of the Securities Exchange Act of 1934. The complaint alleges that the Company and the individual officers made false and/or misleading statements about the Company’s business and seeks unspecified damages and attorney’s fees. The Court appointed the lead plaintiff and set a schedule for initial motions and pleadings. By order dated June 19, 2020, the Court granted the Company’s motion to dismiss the amended complaint with leave to amend. On July 29, 2020, the plaintiff filed a second amended complaint. The Company moved to dismiss the second amended complaint on September 18, 2020. By order dated January 22, 2021, the Court granted the Company’s motion to dismiss the second amended complaint with leave to amend. Although the Company continues to believe this lawsuit is without merit, on March 4, 2021, the Company agreed with the plaintiff to a settlement-in-principle that, if approved, will resolve the litigation in its entirety. The p laintiff’s motion for preliminary approval of the proposed settlement is due on May 11, 2021. As of this filing, the Court has not yet set a date for the preliminary approval hearing. As of March 31, 2021, the Company has accrued anticipated settlement costs associated with this lawsuit of $0.3 million

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes in the periods presented is based upon the loss before income taxes (in thousands): Three Months Ended 2021 2020 Provision for income tax (benefit) $ (422) $ — The Company’s income tax benefit in the three months ended March 31, 2021 was primarily related to the amortization of acquired intangible assets in foreign jurisdictions. Due to historical losses, management believes it is more likely than not that the net deferred tax assets are not recognizable and will not be recognizable until the Company has sufficient taxable income. Accordingly, the net deferred tax assets have been fully offset by a valuation allowance. If management’s assessment of the deferred tax assets of the corresponding valuation allowance were to change, the Company would record the related adjustment to net loss during the period in which management makes the determination.

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2021
Subsequent Events [Abstract]
Subsequent Event	Subsequent EventOn April 26, 2021, the Company was notified by a European Notified Body of deficiencies in certain in-house competencies and training relative to policies and processes after an audit at the Company’s Menlo Park, California facility. As a result of the deficiencies, the Company’s CE Marks for PROPEL and PROPEL Mini have been suspended while it completes necessary remediation activities and submits the response. During the suspension, the Company remains permitted to sell existing inventory located in the European Union. On May 7, 2021, the Company completed its formal response and will be submitting that response in a filing to the Notified Body on May 10, 2021. Prior to that filing, the Company received positive feedback relative to the submission content from the inspector and the Company expects to meet all regulatory filing requirements in a timely manner. While the CE Marks are suspended, the Company believes it remains compliant in all other jurisdictions and no other aspects of the business, including the Fiagon products, have been impacted. For the three months ended March 31, 2021, revenue from PROPEL and PROPEL Mini in Europe was approximately $0.4 million.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Basis of Preparation	Basis of Preparation The condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and pursuant to the rules and regulations of the United States Securities and Exchange Commission (“SEC”). These condensed consolidated financial statements include the accounts of the Company and its consolidated subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. The interim financial data as of March 31, 2021, is unaudited and is not necessarily indicative of the results for the full year. In the opinion of the Company’s management, the interim data includes only normal and recurring adjustments necessary for a fair presentation of the Company’s financial results for the three months ended March 31, 2021 and 2020. Certain information and disclosures normally included in the annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to SEC rules and regulations relating to interim financial statements. The accompanying condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K (“Annual Report”) for the year ended December 31, 2020 filed with the SEC on March 9, 2021.
Risks and Uncertainties	Risks and Uncertainties The Company is subject to risks and uncertainties resulting from the COVID-19 pandemic. The Company cannot predict the extent or duration of the impact of the COVID-19 pandemic on its financial and operating results, as the information regarding the current environment is evolving rapidly. Due to the COVID-19 pandemic, the Company’s business has been and will continue to be impacted by patients’ decisions whether or not to undergo sinus surgeries and, as a result, ENT ASC and office procedure volumes may fluctuate. The Company’s operations may be further impacted by COVID-19 due to changes in its manufacturing operations as a result of the easing of certain restrictions of the shelter-in-place orders issued by local and federal authorities. Furthermore, the COVID-19 pandemic has led to severe disruption and volatility in global capital markets and increased economic uncertainty and instability.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts and disclosures reported in the financial statements. Management uses significant judgment when making estimates related to its revenue related allowances, inventory, common stock valuation and related stock-based compensation, leases, business combinations, embedded derivatives, as well as certain accrued liabilities. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates.
Accounting Pronouncements	Accounting Pronouncements Recently Adopted Accounting Standards In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes ("ASU 2019-12"), which is intended to simplify various aspects related to accounting for income taxes. ASU 2019-12 removes certain exceptions to the general principles in Topic 740 and also clarified and amends existing guidance to improve consistent application. ASU 2019-12 became effective for the Company beginning in 2021 . The adoption of the standard did not result in a material impact to the Company’s condensed consolidated financial statements. In October 2020, the FASB issued ASU No. 2020-08, Codification Improvements to Subtopic 310-20, Receivables- Nonrefundable Fees and Other Costs ("ASU 2020-08"). ASU 2020-08 clarifies the accounting for the amortization period for certain purchased callable debt securities held at a premium by giving consideration to securities which have multiple call dates. ASU 2020-08 became effective for the Company beginning in 2021. The adoption of the standard had no impact to the Company’s condensed consolidated financial statements. In August 2020, the FASB issued ASU No. 2020-06, Debt- Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging- Contracts in Entity’s Own Equity (Subtopic 815-40) ("ASU 2020-06") . ASU 2020-06 modifies and simplifies accounting for convertible instruments. The new guidance eliminates certain separation models that require separating embedded conversion features from convertible instruments. ASU 2020-06 also addresses how convertible instruments are accounted for in the diluted earnings per share calculation. The Company early adopted this standard and became effective beginning in 2021. The adoption of the standard had no impact to the Company’s condensed consolidated financial statements.
Property and Equipment	Property and EquipmentProperty and equipment are stated at cost, less accumulated depreciation and amortization. Depreciation is determined using the straight-line method over the estimated useful lives of the respective assets, generally three
Cost of sales	Cost of sales Cost of sales consists primarily of manufacturing overhead costs, material costs, and direct labor. A significant portion of the Company’s cost of sales currently consists of manufacturing overhead costs. These overhead costs include compensation, including stock-based compensation and other operating expenses associated with the cost of quality assurance, material procurement, inventory control, facilities, information technology, equipment and operations supervision and manufacturing and warehouse management. Cost of sales also includes depreciation expense for production equipment, amortization of intangible assets associated with acquired product technologies and processes, maintenance of operational processes, and certain direct costs such as shipping costs.

Composition of Certain Financ_2

Composition of Certain Financial Statement Items (Tables)	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Accounts Receivable	Accounts receivable, net (in thousands): March 31, December 31, Accounts receivable $ 14,927 $ 15,079 Allowance for doubtful accounts (346) (487) $ 14,581 $ 14,592
Components of Inventory	Inventories, net (in thousands): March 31, December 31, Raw materials $ 2,922 $ 2,865 Work-in-process 2,908 3,411 Finished goods 7,387 5,778 $ 13,217 $ 12,054
Schedule of Operating Leases Liabilities	Operating lease liabilities (in thousands): March 31, December 31, Current portion presented in other current liabilities $ 2,238 $ 762 Non-current portion presented in operating lease liabilities 15,913 17,736 $ 18,151 $ 18,498
Disaggregation of Revenue	Revenue (in thousands): Three Months Ended 2021 2020 PROPEL family of products $ 20,442 $ 19,090 SINUVA 2,435 736 VENSURE, CUBE, and accessories 1,451 — $ 24,328 $ 19,826

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Restrictions on Cash and Cash Equivalents	The following is a summary of cash, cash equivalents, and restricted cash (in thousands): March 31, 2021 March 31, 2020 Cash and cash equivalents $ 14,365 $ 34,193 Restricted cash 18,345 — Restricted cash presented in prepaid and other current assets 93 — Total cash, cash equivalents, and restricted cash shown in the condensed consolidated statement of cash flows $ 32,803 $ 34,193
Schedule of Cash and Cash Equivalents	The following is a summary of cash, cash equivalents, and restricted cash (in thousands): March 31, 2021 March 31, 2020 Cash and cash equivalents $ 14,365 $ 34,193 Restricted cash 18,345 — Restricted cash presented in prepaid and other current assets 93 — Total cash, cash equivalents, and restricted cash shown in the condensed consolidated statement of cash flows $ 32,803 $ 34,193
Summary of Cash, Cash Equivalents and Available-for-Sale Investments Measured at Fair Value on Recurring Basis	The following is a summary of the Company’s unrealized gains and losses related to its short-term investments in marketable securities designated available-for-sale (in thousands): Reported as: Amortized Gross Unrealized Estimated Cash and cash Short-term March 31, 2021 Gains Losses Level 1: Cash $ 10,128 $ — $ — $ 10,128 $ 10,128 $ — Money market funds 4,237 — — 4,237 4,237 — 14,365 — — 14,365 14,365 — Level 2: U.S. treasury bills 39,523 10 — 39,533 — 39,533 U.S. government agency bonds 16,621 5 — 16,626 — 16,626 56,144 15 — 56,159 — 56,159 $ 70,509 $ 15 $ — $ 70,524 $ 14,365 $ 56,159 Reported as: Amortized Gross Unrealized Estimated Cash and cash Short-term December 31, 2020 Gains Losses Level 1: Cash $ 9,755 $ — $ — $ 9,755 $ 9,755 $ — Money market funds 2,762 — — 2,762 2,762 — 12,517 — — 12,517 12,517 — Level 2: U.S. treasury bills 49,698 4 (3) 49,699 1,004 48,695 Corporate debt securities 6,307 — (2) 6,305 — 6,305 U.S. government agency bonds 19,504 3 (1) 19,506 — 19,506 75,509 7 (6) 75,510 1,004 74,506 $ 88,026 $ 7 $ (6) $ 88,027 $ 13,521 $ 74,506
Summary of Changes in the Fair Value of Derivative Liabilities	Changes in the fair value of the Company’s Level 3 liabilities were as follows: March 31, Balance at December 31, 2020 $ 3,048 Additions — Fair value adjustment 346 Balance at March 31, 2021 $ 3,394
Schedule of Derivative Instruments	The Company had gross notional amounts (in EUR) on foreign currency exchange contracts not designated as hedging instruments outstanding as of March 31, 2021 and December 31, 2020 as follows (in thousands): March 31, December 31, Notional amounts: Forward contracts € 45,000 € 45,000 Gross fair value recorded in: Prepaid expenses and other current assets $ — $ 275 Other non-current assets $ — $ 558 Other current liabilities $ 511 $ — Other non-current liabilities $ 942 $ —
Derivatives Not Designated as Hedging Instruments	The following table summarizes the effect of the Company’s foreign currency exchange contracts on its condensed consolidated statements of operations recognized in other income (expense), net (in thousands): Three Months Ended March 31, 2021 Recognized losses $ (2,287) Foreign exchange gain on remeasurement of deferred acquisition related consideration $ 2,384

Stock-based Compensation Expe_2

Stock-based Compensation Expense (Tables)	3 Months Ended
	Mar. 31, 2021
Share-based Payment Arrangement [Abstract]
Summary of Stock Option Activity	A summary of the Company’s stock option activity and related information (options in thousands): Three Months Ended Options Weighted Average Outstanding, beginning of period 3,599 $ 22.01 Granted 691 23.03 Exercised (101) 11.10 Forfeited (104) 27.01 Outstanding, end of period 4,085 22.33 Exercisable 1,666 23.09
Summary of Restricted Stock Units Activity	A summary of the Company’s RSU activity and related information (RSUs in thousands): Three Months Ended RSUs Weighted Average Outstanding, beginning of period 488 $ 23.88 Awarded 277 23.07 Vested (99) 29.98 Forfeited (32) 21.37 Outstanding, end of period 634 22.70
Summary of Performance Stock Units Activity	A summary of the Company’s PSU activity and related information (PSUs in thousands): Three Months Ended PSUs Weighted Average Outstanding, beginning of period 130 $ 15.94 Awarded 167 25.35 Forfeited (7) 17.28 Outstanding, end of period 290 21.31
Summary of Stock Based Compensation Expense	Total stock-based compensation expense recognized is as follows (in thousands): Three Months Ended 2021 2020 Cost of sales $ 321 $ 441 Selling, general and administrative 3,091 3,552 Research and development 649 363 $ 4,061 $ 4,356

Net Loss per Share (Tables)

Net Loss per Share (Tables)	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potentially dilutive securities outstanding have been excluded from the computations of weighted average shares outstanding because such securities have an antidilutive impact due to losses reported (in common stock equivalent shares, in thousands): Three Months Ended 2021 2020 Common stock options 3,658 3,372 Market-based performance stock options 427 427 Restricted stock units 634 596 Market-based performance stock units 290 192 Employee stock purchase plan shares 63 70 Stock issuable upon conversion of convertible note 6,309 — 11,381 4,657

Convertible Notes (Tables)

Convertible Notes (Tables)	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Summary of Net Carrying Amount of the Convertible Notes	As of March 31, 2021, the net carrying amount of the Convertible Notes is as follows: March 31, Outstanding principal amount of convertible notes $ 65,000 Unamortized debt discount and transaction costs (4,178) Fair value of embedded derivatives 3,394 Convertible notes, net $ 64,216

Income Taxes (Tables)

Income Taxes (Tables)	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Schedule of Components of Income Tax Expense (Benefit)	The provision for income taxes in the periods presented is based upon the loss before income taxes (in thousands): Three Months Ended 2021 2020 Provision for income tax (benefit) $ (422) $ —

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Details) $ in Millions	3 Months Ended
	Mar. 31, 2021USD ($)
Property, Plant and Equipment [Line Items]
Impairment of property and equipment	$ 0.4
Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	5 years

Composition of Certain Financ_3

Composition of Certain Financial Statement Items - Accounts Receivable (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accounts receivable	$ 14,927	$ 15,079
Allowance for doubtful accounts	(346)	(487)
Accounts receivable, net	$ 14,581	$ 14,592	[1]
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Composition of Certain Financ_4

Composition of Certain Financial Statement Items - Components of Inventories (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 2,922	$ 2,865
Work-in-process	2,908	3,411
Finished goods	7,387	5,778
Inventory	$ 13,217	$ 12,054	[1]
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Composition of Certain Financ_5

Composition of Certain Financial Statement Items - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Share-based payment arrangement, amount capitalized	$ 0.4	$ 0.3

Composition of Certain Financ_6

Composition of Certain Financial Statement Items - Operating Lease Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Current portion presented in other current liabilities	$ 2,238	$ 762
Non-current portion presented in operating lease liabilities	15,913	17,736	[1]
Total	$ 18,151	$ 18,498
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Composition of Certain Financ_7

Composition of Certain Financial Statement Items - Disaggregation of Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Disaggregation of Revenue [Line Items]
Revenue	$ 24,328	$ 19,826
PROPEL family of products
Disaggregation of Revenue [Line Items]
Revenue	20,442	19,090
SINUVA
Disaggregation of Revenue [Line Items]
Revenue	2,435	736
VENSURE, CUBE, and accessories
Disaggregation of Revenue [Line Items]
Revenue	$ 1,451	$ 0

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020		Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair value of the derivative liabilities	$ 101,000,000
Restricted cash	18,345,000	$ 17,500,000	[1]	$ 0
Investments with a contractual maturity of greater than one year	0	$ 0
Fair value of embedded derivatives	3,400,000
Embedded derivative, loss on embedded derivative	$ 300,000
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020		Mar. 31, 2020	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Cash and cash equivalents	$ 14,365	$ 13,521	[1]	$ 34,193
Restricted cash	18,345	17,500	[1]	0
Prepaid expenses and other current assets	93			0
Total cash, cash equivalents, and restricted cash shown in the condensed consolidated statement of cash flows	$ 32,803	$ 31,021		$ 34,193	$ 20,652
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Fair Value of Financial Instr_5

Fair Value of Financial Instruments - Summary of Cash, Cash Equivalents and Short-Term Investments Available-for-Sale, by Type of Instrument (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020		Mar. 31, 2020
Net Investment Income [Line Items]
Cash and cash equivalents	$ 14,365	$ 13,521	[1]	$ 34,193
Short-term investments	56,159	74,506	[1]
Fair Value, Recurring
Net Investment Income [Line Items]
Cash and cash equivalents	14,365	13,521
Gross Unrealized, Gains	15	7
Gross Unrealized, Losses	0	(6)
Cash and cash equivalents and short-term securities, available for sale, amortized cost	70,509	88,026
Cash and cash equivalents and short-term investments, available for sale	70,524	88,027
Short-term investments	56,159	74,506
Fair Value, Recurring | Level 1:
Net Investment Income [Line Items]
Cash and cash equivalents	14,365	12,517
Fair Value, Recurring | Level 1: | Cash
Net Investment Income [Line Items]
Cash and cash equivalents	10,128	9,755
Fair Value, Recurring | Level 1: | Money market funds
Net Investment Income [Line Items]
Cash and cash equivalents	4,237	2,762
Fair Value, Recurring | Level 2:
Net Investment Income [Line Items]
Cash and cash equivalents		1,004
Amortized Cost	56,144	75,509
Gross Unrealized, Gains	15	7
Gross Unrealized, Losses	0	(6)
Estimated Fair Value	56,159	75,510
Short-term investments	56,159	74,506
U.S. treasury bills | Fair Value, Recurring | Level 2:
Net Investment Income [Line Items]
Cash and cash equivalents		1,004
Amortized Cost	39,523	49,698
Gross Unrealized, Gains	10	4
Gross Unrealized, Losses	0	(3)
Estimated Fair Value	39,533	49,699
Short-term investments	39,533	48,695
Corporate debt securities | Fair Value, Recurring | Level 2:
Net Investment Income [Line Items]
Amortized Cost		6,307
Gross Unrealized, Gains		0
Gross Unrealized, Losses		(2)
Estimated Fair Value		6,305
Short-term investments		6,305
U.S. government agency bonds | Fair Value, Recurring | Level 2:
Net Investment Income [Line Items]
Amortized Cost	16,621	19,504
Gross Unrealized, Gains	5	3
Gross Unrealized, Losses	0	(1)
Estimated Fair Value	16,626	19,506
Short-term investments	$ 16,626	$ 19,506
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Fair Value of Financial Instr_6

Fair Value of Financial Instruments - Summary of changes in the fair value of derivative liabilities (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Embedded Derivative Liability [Roll Forward]
Fair value adjustment	$ 346	$ 0
Ending balance	3,400
Fair Value, Inputs, Level 3
Embedded Derivative Liability [Roll Forward]
Beginning balance	3,048
Additions	0
Fair value adjustment	346
Ending balance	$ 3,394

Fair Value of Financial Instr_7

Fair Value of Financial Instruments - Gross Notional Amounts on Foreign currency Exchange Contracts Not Designated as Hedging Instruments (Details) € in Thousands, $ in Thousands	Mar. 31, 2021USD ($)	Mar. 31, 2021EUR (€)	Dec. 31, 2020USD ($)	Dec. 31, 2020EUR (€)
Derivative [Line Items]
Fair value of the derivative liabilities	$ 101,000
Forward contracts | Not Designated as Hedging Instrument
Derivative [Line Items]
Notional amount | €		€ 45,000		€ 45,000
Forward contracts | Not Designated as Hedging Instrument | Prepaid expenses and other current assets
Derivative [Line Items]
Fair value of derivative assets	0		$ 275
Forward contracts | Not Designated as Hedging Instrument | Other non-current assets
Derivative [Line Items]
Fair value of derivative assets	0		558
Forward contracts | Not Designated as Hedging Instrument | Other current liabilities
Derivative [Line Items]
Fair value of the derivative liabilities	511		0
Forward contracts | Not Designated as Hedging Instrument | Other non-current liabilities
Derivative [Line Items]
Fair value of the derivative liabilities	$ 942		$ 0

Fair Value of Financial Instr_8

Fair Value of Financial Instruments - Effect of Foreign Currency Exchange Contracts (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Derivative [Line Items]
Foreign exchange gain on remeasurement of deferred acquisition related consideration	$ 1,973	$ 0
Forward contracts
Derivative [Line Items]
Recognized losses	(2,287)
Foreign exchange gain on remeasurement of deferred acquisition related consideration	$ 2,384

Business Combinations - Additio

Business Combinations - Additional Information (Details) $ in Thousands, € in Millions	Oct. 02, 2020USD ($)	Oct. 02, 2020EUR (€)	Oct. 31, 2021EUR (€)	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)	[1]	Oct. 02, 2020EUR (€)
Business Acquisition, Contingent Consideration [Line Items]
Goodwill				$ 46,639	$ 46,639
Fiagon AG Medical
Business Acquisition, Contingent Consideration [Line Items]
Payments to acquire businesses, gross	$ 17,600	€ 15
Total purchase consideration	68,900
Deferred purchase consideration for a business combination	51,300
Escrow deposit	17,500						€ 15
Assets	4,600
Inventory assumed	2,200
Liabilities assumed	4,200
Deferred tax liabilities	2,200
Intangible assets	21,900
Goodwill	$ 46,600
Fiagon AG Medical | Trademarks
Business Acquisition, Contingent Consideration [Line Items]
Impairment of intangible assets, finite-lived				$ 200
Fiagon AG Medical | Forecast
Business Acquisition, Contingent Consideration [Line Items]
Purchase price adjustment | €			€ 2.2
[1]	Amounts have been derived from the December 31, 2020 audited consolidated financial statements included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - $ / shares	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020
Class of Stock [Line Items]
Preferred stock, shares authorized (in shares)	9,994,000	9,994,000	10,000,000
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Series DF-1 Convertible Preferred Stock
Class of Stock [Line Items]
Preferred stock, shares authorized (in shares)	6,310	6,000
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Number of common shares issuable per converted share (in shares)	1,000
Conversion of stock, shares issuable (in shares)	6,309,459

Stock-based Compensation Expe_3

Stock-based Compensation Expense - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	Jan. 01, 2020	Jun. 30, 2018	Jul. 31, 2014	Mar. 31, 2021	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shares outstanding			3.00%
Common stock, capital shares reserved for future issuance, increase during period (in shares)	988,070
Shares reserved for issuance (in shares)	10,922,838			3,173,483
Unearned stock-based compensation				$ 41.5
Weighted average period for unearned stock-based compensation to be recognized				2 years 8 months 12 days
Common stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)				691,000
Options price, granted (in usd per share)				$ 23.03
Aggregate intrinsic value of options outstanding				$ 6.9
Aggregate intrinsic value of options outstanding and exercisable				$ 3.9
Weighted-average remaining contractual term of options outstanding				8 years
Weighted-average remaining contractual term of options exercisable				6 years 6 months
Aggregate intrinsic value of options exercised				$ 1.2	$ 1.2
Market Based Vesting Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)				427,147
Options price, granted (in usd per share)				$ 20.44
Restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value, outstanding				$ 13.2
Weighted-average remaining contractual term, outstanding				2 years 3 months 18 days
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value, outstanding				$ 6.1
Weighted-average remaining contractual term, outstanding				2 years 1 month 6 days
Employee stock purchase plan shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock, capital shares reserved for future issuance, increase during period (in shares)		1,200,000
Shares reserved for issuance (in shares)				893,829
Shares authorized for future issuance (in shares)		1,696,092	496,092
Shares issued (in shares)				0

Stock-based Compensation Expe_4

Stock-based Compensation Expense - Summary of Stock Option Activity (Detail) - Common stock options shares in Thousands	3 Months Ended
	Mar. 31, 2021$ / sharesshares
Options
Outstanding, beginning of period (in shares) | shares	3,599
Granted (in shares) | shares	691
Exercised (in shares) | shares	(101)
Forfeited (in shares) | shares	(104)
Outstanding, end of period (in shares) | shares	4,085
Exercisable (in shares) | shares	1,666
Weighted Average Exercise Price
Outstanding, beginning of period (in usd per share) | $ / shares	$ 22.01
Granted (in usd per share) | $ / shares	23.03
Exercised (in usd per share) | $ / shares	11.10
Forfeited (in usd per share) | $ / shares	27.01
Outstanding, end of period (in usd per share) | $ / shares	22.33
Exercisable (in usd per share) | $ / shares	$ 23.09

Stock-based Compensation Expe_5

Stock-based Compensation Expense - Summary of Restricted Stock Units Activity (Detail) - Restricted stock units shares in Thousands	3 Months Ended
	Mar. 31, 2021$ / sharesshares
RSUs
Outstanding, beginning of period (in shares) | shares	488
Awarded (in shares) | shares	277
Vested (in shares) | shares	(99)
Forfeited (in shares) | shares	(32)
Outstanding, end of period (in shares) | shares	634
Weighted Average Fair Value
Outstanding, beginning of period (in usd per share) | $ / shares	$ 23.88
Awarded (in usd per share) | $ / shares	23.07
Vested (in usd per share) | $ / shares	29.98
Forfeited (in usd per share) | $ / shares	21.37
Outstanding, end of period (in usd per share) | $ / shares	$ 22.70

Stock-based Compensation Expe_6

Stock-based Compensation Expense - Summary of Performance Stock Unit Activity (Detail) - Performance Shares shares in Thousands	3 Months Ended
	Mar. 31, 2021$ / sharesshares
RSUs
Outstanding, beginning of period (in shares) | shares	130
Awarded (in shares) | shares	167
Forfeited (in shares) | shares	(7)
Outstanding, end of period (in shares) | shares	290
Weighted Average Fair Value
Outstanding, beginning of period (in usd per share) | $ / shares	$ 15.94
Awarded (in usd per share) | $ / shares	25.35
Forfeited (in usd per share) | $ / shares	17.28
Outstanding, end of period (in usd per share) | $ / shares	$ 21.31

Stock-based Compensation Expe_7

Stock-based Compensation Expense - Summary of Stock Based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 4,061	$ 4,356
Cost of sales
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	321	441
Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,091	3,552
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 649	$ 363

Net Loss per Share - Schedule o

Net Loss per Share - Schedule of Potentially Dilutive Securities Outstanding Excluded from the Computations of Diluted Weighted Average Shares Outstanding (Detail) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	11,381	4,657
Common stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	3,658	3,372
Market-based performance stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	427	427
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	634	596
Market-based performance stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	290	192
Employee stock purchase plan shares
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	63	70
Stock issuable upon conversion of convertible note
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	6,309	0

Convertible Notes - Additional

Convertible Notes - Additional Information (Detail)	May 11, 2020USD ($)day$ / shares	Mar. 31, 2021USD ($)	Mar. 31, 2020USD ($)
Debt Instrument [Line Items]
Amortization of the convertible debt discount and issuance costs		$ 220,000	$ 0
Embedded Derivative Financial Instruments
Debt Instrument [Line Items]
Embedded derivative liability	$ 1,800,000
Convertible Debt
Debt Instrument [Line Items]
Face amount of debt	$ 65,000,000
Interest rate	4.00%
Long-term debt	$ 61,800,000	64,216,000
Debt instrument, convertible, conversion ratio	0.0643501
Debt instrument, convertible, conversion price (in usd per share) | $ / shares	$ 15.54
Percentage of shares held after conversion of convertible notes	4.985%
Debt instrument, covenant, enterprise value threshold	50.00%
Debt instrument, unamortized discount	$ 1,800,000
Debt issuance costs, net	3,200,000
Amortization of the convertible debt discount and issuance costs		200,000
Outstanding principal amount of convertible notes	$ 65,000,000	65,000,000
Accrued interest		$ 600,000
Convertible Debt | Minimum
Debt Instrument [Line Items]
Debt instrument, redemption, notification period | day	10
Convertible Debt | Maximum
Debt Instrument [Line Items]
Debt instrument, redemption, notification period | day	60
Convertible Debt | On or after the second anniversary of issuance date
Debt Instrument [Line Items]
Redemption of convertible notes	$ 32,500,000
Debt instrument, convertible, threshold trading days | day	20
Debt instrument, convertible, threshold consecutive trading days | day	30
Debt instrument, redemption price, percentage	150.00%
Convertible Debt | On or after the third anniversary of issuance date
Debt Instrument [Line Items]
Redemption of convertible notes	$ 65,000,000
Debt instrument, convertible, threshold trading days | day	20
Debt instrument, convertible, threshold consecutive trading days | day	30
Debt instrument, redemption price, percentage	200.00%

Convertible Notes - Summary of

Convertible Notes - Summary of net carrying amount of the convertible notes (Detail) - USD ($)	Mar. 31, 2021	May 11, 2020
Debt Instrument [Line Items]
Fair value of embedded derivatives	$ 3,400,000
Convertible Debt
Debt Instrument [Line Items]
Outstanding principal amount of convertible notes	65,000,000	$ 65,000,000
Unamortized debt discount and transaction costs	(4,178,000)
Fair value of embedded derivatives	3,394,000
Convertible notes, net	$ 64,216,000	$ 61,800,000

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Millions	Mar. 31, 2021USD ($)
Statement of Financial Position [Abstract]
Loss contingency accrual	$ 0.3

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Provision for income tax (benefit)	$ (422)	$ 0

Subsequent Event (Details)

Subsequent Event (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Subsequent Event [Line Items]
Revenue	$ 24,328	$ 19,826
PROPEL And PROPEL Mini | Europe
Subsequent Event [Line Items]
Revenue	$ 400