Self-expandable sinus implants deliver corticosteroid after endoscopic paranasal sinus surgery – clinical experience

Introduction:

In case of recurrent chronic rhinosinusitis with nasal polyps (rCRSwP) surgical revision is often necessary, despite topical or even systemic application of corticosteroids following the initial surgical treatment, according to official guidelines. However, the distribution of topic agents in the paranasal sinuses is limited and requires a large degree of collaboration of the patient. Mometason releasing implants offer a new treatment option.

Methods:

The springlike bioresorbable implant is placed after functional endoscopic paranasal sinus surgery and delivers mometasone furoate to the tissue for 30 days. All patients that were treated accordingly at the ENT University Hospital in Lübeck since market launch were investigated with regard to indication, handling and duration of surgery.

Results:

In a cohort of 8 patients with rCSwP, median aged 53 years, Propel® sinus implants (Intersect ENT) were insertet during surgery for recurrent disease. Patients had been operated on median twice before. Time to the previous operation averaged 18 months. In all patients, more than three paranasal sinuses were treated (Lund McKay CT score in the median 13). The average duration of the surgery was 51 minutes. In one case, the implant was used to treat an orbital complication in an emergency. With regard to the application there were no postoperative dislocation observed or surgical revision needed.

Conclusion:

Drug releasing sinus implants are promising approaches to extend the treatment of rCRCwP without prolonging the operation time. Within structured follow-up concepts, reliable indication criteria should be developed to justify the additional cost.

Publication History

Publication Date:
18 April 2018 (online)