Stents und Platzhalter in der endoskopischen endonasalen
                    Nasennebenhöhlenchirurgie

Werner Hosemann; Thomas Kühnel; Rainer Weber

doi:10.1055/a-0646-4223

Laryngo-Rhino-Otologie, Inhaltsverzeichnis

Laryngorhinootologie 2018; 97(09): 606-614
DOI: 10.1055/a-0646-4223

Übersicht

Stents und Platzhalter in der endoskopischen endonasalen Nasennebenhöhlenchirurgie

Stents and spacers in endoscopic endonasal sinus surgery

Authors

Werner Hosemann

¹HNO-Klinik, Universitätsmedizin Greifswald
Thomas Kühnel

²Klinik für HNO-Heilkunde, Universitätsklinikum Regensburg
Rainer Weber

³HNO-Klinik, Städtisches Klinikum Karlsruhe

Abstract

Zusammenfassung

In der endonasalen endoskopischen Chirurgie kam es im letzten Jahrzehnt zu Fortschritten durch ein verbessertes Verständnis der Mikroanatomie, den Zugewinn additiver medikamentöser Therapieoptionen und die Optimierung der instrumentellen Technik. In den gleichen Kontext kann die Weiterentwicklung und Beforschung röhrenförmiger oder solider Platzhalter („stents“ oder „spacer“) mit und ohne simultane Freisetzung von Medikamenten gestellt werden – der vorliegende Übersichtsbeitrag stellt den aktuellen Stand dieser Entwicklungen vor.

Abstract

In endonasal endoscopic sinus surgery continuous progress has been made in the last decade due to better understanding of microanatomy, gains in adjunctive medicative therapy and technical innovations. Moreover, continuous research and clinical trials on innovative stents and spacers with and without defined drug eluting features may be mentioned in this context. A narrative review of the current development status and its therapeutic options referring to the latter is presented.

Schlüsselwörter

Nasennebenhöhlenchirurgie - FESS - Implantate - Platzhalter - Stents

Key words

FESS - endoscopic sinus surgery - implants - stents - spacers

Volltext

Referenzen

Literatur
1 Weber RK. Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie. Laryngo-Rhino-Otol 2015; 94 (Suppl. 01) S64-S142
2 Hopkins C, Slack R, Lund V. et al. Long-term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Laryngoscope 2009; 119: 2459-2465
3 Bassiouni A, Chen PG, Naidoo Y. et al. Clinical significance of middle turbinate lateralization after endoscopic sinus surgery. Laryngoscope 2015; 125: 36-41
4 Chambers DW, Davis WE, Cook PR. et al. Long-term outcome analysis of functional endoscopic sinus surgery: correlation of symptoms with endoscopic examination findings and potential prognostic variables. Laryngoscope 1997; 107: 504-510
5 Friedman M, Landsberg R, Tanyeri H. Middle turbinate medialization and preservation in endoscopic sinus surgery. Otolaryngol Head Neck Surg 2000; 123: 76-80
6 Henriquez OA, Schlosser RJ, Mace JC. et al. Impact of synechiae after endoscopic sinus surgery on long-term outcomes in chronic rhinosinusitis. Laryngoscope 2013; 123: 2615-2619
7 Naidoo Y, Wen D, Bassiouni A. et al. Long-term results after primary frontal sinus surgery. Int Forum Allergy Rhinol 2012; 2: 185-190
8 Chen PG, Wormald PJ, Payne SC. et al. A golden experience: Fifty years of experience managing the frontal sinus. Laryngoscope 2016; 126: 802-807
9 Fletcher Ingals E. New operation and instruments for draining the frontal sinus. Ann Otol Rhinol Laryngol 1905; 14: 515-519
10 Good RH. An intranasal method for opening the frontal sinus establishing the largest possible drainage. Laryngoscope 1908; 18: 266-274
11 Beule AG, Scharf C, Biebler KE. et al. Effects of topically applied dexamethasone on mucosal wound healing using a drug-releasing stent. Laryngoscope 2008; 118: 2073-2077
12 Beule AG, Steinmeier E, Kaftan H. et al. Effects of a dexamethasone-releasing stent on osteoneogenesis in a rabbit model. Am J Rhinol Allergy 2009; 23: 433-436
13 Campbell RG, Kennedy DW. What is new and promising with drug-eluting stents in sinus surgery?. Curr Opin Otolaryngol Head Neck Surg 2014; 22: 2-7
14 Hosemann W, Schindler E, Wiegrebe E. et al. Innovative frontal sinus stent acting as a local drug-releasing system. Eur Arch Otorhinolaryngol 2003; 260: 131-134
15 Weber RK. Nasentamponaden und Stents. Laryngo-Rhino-Otol 2009; 88 (Suppl. 01) S139-S155
16 Ressing M, Blettner M, Klug SJ. Systematische Übersichtsarbeiten und Metaanalysen. Dtsch Arztebl Int 2009; 106: 456-463
17 Huang Z, Hwang P, Sun Y. et al. Steroid-eluting sinus stents for improving symptoms in chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery. Cochrane Database Syst Rev 06/2015; 10 (06) CD010436
18 Massey CJ, Suh JD, Tessema B. et al. Biomaterials in Rhinology. Otolaryngol Head Neck Surg 04/2016; 154 (04) 606-17 Erratum in: Otolaryngol Head Neck Surg 2016; 155: 718
19 Hauser LJ, Turner JH, Chandra RK. Trends in the Use of Stents and Drug-Eluting Stents in Sinus Surgery. Otolaryngol Clin North Am 2017; 50: 565-571
20 Mirza S, Johnson AP. A simple and effective frontal sinus stent. J Laryngol Otol 2000; 114: 955-956
21 Rotenberg BW, Ioanidis KE, Sowerby LJ. Development of a novel T-tube frontal sinus irrigation catheter. Am J Rhinol Allergy 2016; 30: 356-359
22 Santarelli GD, Han JK. Evaluation of the PROPEL mini sinus implant for the treatment of frontal sinus disease. Expert Opin Drug Deliv 2016; 13: 1789-1793
23 Lee JT, Han JK. Sinus implants for chronic rhinosinusitis: technology evaluation. Expert Opin Drug Deliv 2013; 10: 1735-1748
24 Li PM, Downie D, Hwang PH. Controlled steroid delivery via bioabsorbable stent: safety and performance in a rabbit model. Am J Rhinol Allergy 2009; 23: 591-596
25 Wei CC, Kennedy DW. Mometasone implant for chronic rhinosinusitis. Med Devices (Auckl) 2012; 5: 75-80
26 Forwith KD, Chandra RK, Yun PT. et al. ADVANCE: a multisite trial of bioabsorbable steroid-eluting sinus implants. Laryngoscope 2011; 121: 2473-2480
27 Murr AH, Smith TL, Hwang PH. et al. Safety and efficacy of a novel bioabsorbable, steroid-eluting sinus stent. Int Forum Allergy Rhinol 2011; 1: 23-32
28 Marple BF, Smith TL, Han JK. et al. Advance II: a prospective, randomized study assessing safety and efficacy of bioabsorbable steroid-releasing sinus implants. Otolaryngol Head Neck Surg 2012; 146: 1004-1011
29 Smith TL, Singh A, Luong A. et al. Randomized controlled trial of a bioabsorbable steroid-releasing implant in the frontal sinus opening. Laryngoscope 2016; 126: 2659-2664
30 Luong A, Ow RA, Singh A. et al. Safety and Effectiveness of a Bioabsorbable Steroid-Releasing Implant for the Paranasal Sinus Ostia: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 02.11.2017 [Epub ahead of print]
31 Janisiewicz A, Lee JT. In-office use of a steroid-eluting implant for maintenance of frontal ostial patency after revision sinus surgery. Allergy Rhinol (Providence) 2015; 6: 68-75
32 Matheny KE, Carter Jr KB, Tseng EY. et al. Safety, feasibility, and efficacy of placement of steroid-eluting bioabsorbable sinus implants in the office setting: a prospective case series. Int Forum Allergy Rhinol 2014; 4: 808-815
33 Bangiyev JN, Govil N, Sheyn A. et al. Novel Application of Steroid Eluting Stents in Choanal Atresia Repair: A Case Series. Ann Otol Rhinol Laryngol 2017; 126: 79-82
34 Tamaki A, Shammassian B, Ray A. et al. Utilization of sinus stents as a novel approach for benign cystic lesions of the sella. Am J Otolaryngol 2017; 38: 645-647
35 Han JK, Marple BF, Smith TL. et al. Effect of steroid-releasing sinus implants on postoperative medical and surgical interventions: an efficacy meta-analysis. Int Forum Allergy Rhinol 2012; 2: 271-279
36 Varshney R, Lee JT. Current trends in topical therapies for chronic rhinosinusitis: update and literature review. Expert Opin Drug Deliv 2017; 14: 257-271
37 Zhao X, Grewal A, Briel M. et al. A systematic review of nonabsorbable, absorbable, and steroid-impregnated spacers following endoscopic sinus surgery. Int Forum Allergy Rhinol 2013; 3: 896-904
38 Bury S, Singh A. Evaluation of a steroid releasing sinus implant for the treatment of patients undergoing frontal sinus surgery for chronic rhinosinusitis. Expert Rev Med Devices 2017; 14: 93-101
39 Aggarwal R, Cardozo A, Homer JJ. The assessment of topical nasal drug distribution. Clin Otolaryngol Allied Sci 2004; 29: 201-205
40 Jafari A, Tringale KR, Panuganti BA. et al. Short-term morbidity after the endoscopic modified Lothrop (Draf-III) procedure compared with Draf-IIa. Am J Rhinol Allergy 2017; 31: 265-270
41 Ow R, Groppo E, Clutter D. et al. Steroid-eluting sinus implant for in-office treatment of recurrent polyposis: a pharmacokinetic study. Int Forum Allergy Rhinol 2014; 4: 816-822
42 Lavigne F, Miller SK, Gould AR. et al. Steroid-eluting sinus implant for in-office treatment of recurrent nasal polyposis: a prospective, multicenter study. Int Forum Allergy Rhinol 2014; 4: 381-389
43 Han JK, Forwith KD, Smith TL. et al. RESOLVE: a randomized, controlled, blinded study of bioabsorbable steroid-eluting sinus implants for in-office treatment of recurrent sinonasal polyposis. Int Forum Allergy Rhinol 2014; 4: 861-870
44 Forwith KD, Han JK, Stolovitzky JP. et al. RESOLVE: bioabsorbable steroid-eluting sinus implants for in-office treatment of recurrent sinonasal polyposis after sinus surgery: 6-month outcomes from a randomized, controlled, blinded study. Int Forum Allergy Rhinol 2016; 6: 573-581
45 Kern RC, Stolovitzky JP, Silvers SL. et al. RESOLVE II study investigators. A phase 3 trial of mometasone furoate sinus implants for chronic sinusitis with recurrent nasal polyps. Int Forum Allergy Rhinol 2018; 8: 471-481
46 Taulu R, Numminen J, Bizaki A. et al. Image-guided, navigation-assisted Relieva Stratus MicroFlow Spacer insertion into the ethmoid sinus. Eur Arch Otorhinolaryngol 2015; 272: 2335-2340
47 Businco LD, Mattei A, Laurino S. et al. Steroid-Eluting Ethmoidal Stent Versus Antero-Posterior Ethmoidectomy: Comparison Of Efficacy And Safety In Allergic Patients. Otolaryngol Pol 2016; 70: 6-12
48 Taulu R, Bizaki AJ, Numminen J. et al. A prospective, randomized clinical study comparing drug eluting stent therapy and intranasal corticoid steroid therapy in the treatment of patients with chronic rhinosinusitis. Rhinology 2017; 55: 218-226
49 Villari CR, Wojno TJ, Delgaudio JM. Case report of orbital violation with placement of ethmoid drug-eluting stent. Int Forum Allergy Rhinol 2012; 2: 89-92
50 Sjogren PP, Parker NP, Boyer HC. Retained drug-eluting stents and recalcitrant chronic rhinosinusitis: A case report. Allergy Rhinol (Providence) 2013; 4: e45-e48
51 Abuzeid WM, Peterson AZ, Rathor A. et al. Enhanced Irrigant Delivery to the Ethmoid Sinuses Directly Following Ethmoid Punch Sinusotomy. Ann Otol Rhinol Laryngol 2017; 126: 804-812
52 Patel VS, Walgama E, Psaltis A. et al. Biocompatibility and pharmacokinetics of fluticasone-eluting sinus implant in a rabbit model. Am J Rhinol Allergy 2017; 31: 382-388
53 Adriaensen GFJPM, Lim KH, Fokkens WJ. Safety and efficacy of a bioabsorbable fluticasone propionate-eluting sinus dressing in postoperative management of endoscopic sinus surgery: a randomized clinical trial. Int Forum Allergy Rhinol 2017; 7: 813-820
54 Huvenne W. et al. Pilot study using doxycycline-releasing stents to ameliorate postoperative healing quality after sinus surgery. Wound Repair Regen 2008; 16: 757-767
55 Yaniv D, Shlosberg L, Flomenblit J. et al. Removable sinus stent for endoscopic sinus surgery: An animal trial. Am J Rhinol Allergy 2017; 31: 29-32
56 Durisin M, Seitz JM, Reifenrath J. et al. A novel biodegradable frontal sinus stent (MgNd2): a long-term animal study. Eur Arch Otorhinolaryngol 2016; 273: 1455-1467
57 Eifler R, Seitz JM, Weber CM. et al. MgNd2 alloy in contact with nasal mucosa: an in vivo and in vitro approach. J Mater Sci Mater Med 2016; 27: 25
58 Seitz JM, Eifler R, Weber C. et al. In vivo degradation effects of alloy MgNd2 in contact with mucous tissue. J Biomed Mater Res A 2015; 103: 2427-2440
59 Weber CM, Eifler R, Seitz JM. et al. Biocompatibility of MgF2-coated MgNd2 specimens in contact with mucosa of the nasal sinus – a long term study. Acta Biomater 2015; 18: 249-261
60 Chan CL, Elmiyeh B, Woods C. et al. A randomized controlled trial of a middle meatal silastic stent for reducing adhesions and middle turbinate lateralization following endoscopic sinus surgery. Int Forum Allergy Rhinol 2015; 5: 517-523
61 Xu JJ, Busato GM, McKnight C. et al. Absorbable Steroid-Impregnated Spacer After Endoscopic Sinus Surgery to Reduce Synechiae Formation. Ann Otol Rhinol Laryngol 2016; 125: 195-198
62 Mirante JP, Christmas DA, Yanagisawa E. Endoscopic view of a biodegradable middle meatal spacer. Ear Nose Throat J 2014; 93: E34
63 Dautremont JF, Mechor B, Rudmik L. The role of immediate postoperative systemic corticosteroids when utilizing a steroid-eluting spacer following sinus surgery. Otolaryngol Head Neck Surg 2014; 150: 689-695
64 Côté DW, Wright ED. Triamcinolone-impregnated nasal dressing following endoscopic sinus surgery: a randomized, double-blind, placebo-controlled study. Laryngoscope 2010; 120: 1269-1273
65 More Y, Willen S, Catalano P. Management of early nasal polyposis using a steroid-impregnated nasal dressing. Int Forum Allergy Rhinol 2011; 1: 401-404
66 Rudmik L, Mace J, Mechor B. Effect of a dexamethasone Sinu-Foam™ middle meatal spacer on endoscopic sinus surgery outcomes: a randomized, double-blind, placebo-controlled trial. Int Forum Allergy Rhinol 2012; 2: 248-251
67 Hong SD, Kim JH, Dhong HJ. et al. Systemic effects and safety of triamcinolone-impregnated nasal packing after endoscopic sinus surgery: a randomized, double-blinded, placebo-controlled study. Am J Rhinol Allergy 2013; 27: 407-410
68 Catalano P, Hester J, Mandrusov E. Osmotic self-expanding dilation technology for treatment of sinusitis: the Vent-Os sinus dilation system. Expert Rev Med Devices 2015; 12: 19-24
69 Hathorn I, Habib AR, Santos RD. et al. The safety and performance of a maxillary sinus ostium self-dilation device: a pilot study. Int Forum Allergy Rhinol 2014; 4: 625-631
70 Tajudeen BA, Gupta S, Willoughby B. et al. Delivering irrigation to the anterior ethmoid region: evaluation of a lacrimal diversion device in a cadaver model. Int Forum Allergy Rhinol 2017; 7: 794-800
71 Fiore LD, Lavori PW. Integrating Randomized Comparative Effectiveness Research with Patient Care. N Engl J Med 2016; 374: 2152-2158
72 Chen W, Wang Y, Bi Y. et al. Turbinate-septal suture for middle turbinate medialization: a prospective randomized trial. Laryngoscope 2015; 125: 33-35
73 Cai Y, Gudis DA. Is topical high-volume budesonide sinus irrigation safe?. Laryngoscope 2018; 128: 781-782
74 Hong SD, Jang JY, Kim JH. et al. The effect of anatomically directed topical steroid drops on frontal recess patency after endoscopic sinus surgery: a prospective randomized single blind study. Am J Rhinol Allergy 2012; 26: 209-212
75 Kang TW, Chung JH, Cho SH. et al. The Effectiveness of Budesonide Nasal Irrigation After Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Asthma. Clin Exp Otorhinolaryngol 2017; 10: 91-96
76 Orgain CA, Harvey RJ. The role of frontal sinus drillouts in nasal polyposis. Curr Opin Otolaryngol Head Neck Surg 2018; 26: 34-40
77 Smith KA, French G, Mechor B. et al. Safety of long-term high-volume sinonasal budesonide irrigations for chronic rhinosinusitis. Int Forum Allergy Rhinol 2016; 6: 228-232
78 Thomas 3 rd WW, Harvey RJ, Rudmik L. et al. Distribution of topical agents to the paranasal sinuses: an evidence-based review with recommendations. Int Forum Allergy Rhinol 2013; 3: 691-703
79 Unsal AA, Gregory N, Rosenstein K. Current opinions in office-based rhinology. Curr Opin Otolaryngol Head Neck Surg 2018; 26: 8-12
80 Rizzo JA, Rudmik L, Mallow PJ. et al. Budget impact analysis of bioabsorbable drug-eluting sinus implants following endoscopic sinus surgery. J Med Econ 2016; 19: 829-835
81 Rudmik L, Mallow PJ, Palli S. et al. Budget Impact Analysis Of Bioabsorbable Drug-Eluting Sinus Implants For Endoscopic Sinus Surgery. Value Health 2015; 18: A368
82 Rudmik L, Smith TL. Economic Evaluation of a Steroid-Eluting Sinus Implant following Endoscopic Sinus Surgery for Chronic Rhinosinusitis. Otolaryngol Head Neck Surg 2014; 151: 359-366