Prolonged stenting of the frontal sinus

Orlandi, Richard R.; Knight, Jesse

doi:10.1002/lary.20081

Cited by 27 publications

(26 citation statements)

References 8 publications

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“…Als Indikation zur Einlage eines Platzhalters im Stirnhöhlenzugang werden in der Literatur genannt: ein intraoperativer Durchmesser von weniger als 5 mm, eine Freilegung von Knochen in großer Fläche bzw. in der gesamten Zirkumferenz des Neo-Ostiums, das Vorliegen einer allergischen Pansinusitis oder ausgeprägten Polyposis, eine lateralisierte oder lockere mittlere Nasenmuschel, ausgeprägte Vernarbungen oder Osteoneogenese nach Voroperation und die Stirnhöhlenrevisionschirurgie [464,473,1410,1411,[1415][1416][1417]. Das Einsetzen von Stirnhöhlenplatzhaltern über lange Zeit (6 Monate) hat zu einer Verbesserung der Offenheitsrate operierter Stirnhöhlen geführt [387,464,822,1414].…”

Section: Stirnhöhlenplatzhalterunclassified

“…Das Einsetzen von Stirnhöhlenplatzhaltern über lange Zeit (6 Monate) hat zu einer Verbesserung der Offenheitsrate operierter Stirnhöhlen geführt [387,464,822,1414]. Kleine Fallserien berichten darüber, dass Stirnhöhlenstents über bis zu 5 Jahre mit nur wenigen Komplikationen (spontane Dislokation in 14 %, komplette Obstruktion 5 %, notwendige Revision 1/11) belassen wurden [1416,1417]. Den genannten Vorzügen müssen folgende Nachteile gegenüber gestellt werden: die Induktion einer chronischen Entzündung durch den Fremdkörper, Verkrustungen, die Gefahr des Verges-sens und Belassens des Fremdkörpers, die Möglichkeit der Dislokation nach außen oder in die Stirnhöhle.…”

Section: Stirnhöhlenplatzhalterunclassified

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Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Weber

2015

Laryngo-Rhino-Otol

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Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases.Appropriate frame conditions provided, the respective procedures are safe and successful.These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery.The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinusoperation with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus.In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving.This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.

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Section: Stirnhöhlenplatzhalterunclassified

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Weber

2015

Laryngo-Rhino-Otol

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“…6 Other indications include extensive polyposis, excessive denuded bone at the neo-ostium, and a floppy middle turbinate. 5 In a retrospective study by Orlandi and Knight, 7 2.2% of 462 patients who underwent frontal sinus exploration had stents placed in cases when mucosal preservation was sacrificed.…”

Section: Discussionmentioning

confidence: 99%

“…Timing for frontal sinus stent removal is surgeon and patient dependent, and authors have reported times varying from 1 week 5 up to 6 years without complications. 7 Multiple studies report success with long-term frontal sinus stenting over 3 months. A study by Weber et al 8 indicated improved outcomes and decreased rates of stenosis with stenting for at least 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…The length of time for frontal sinus stenting is surgeon and patient dependent. Stenting for up to 6 years has been reported without complications, 7 although manufacturers generally recommend removal after 6 months. Current reported complications of frontal sinus stenting include formation of granulation tissue, stent dislocation, and complications of infection, including superinfection, biofilm formation, and toxic shock syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Possible Skull Base Erosion After Prolonged Frontal Sinus Stenting

et al. 2019

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Frontal sinus stenting is widely used with the goal of maintaining nasofrontal duct patency after sinus surgery. The general recommendation is to leave stents in place for 6 months; however, prolonged stenting up to 6 years has been reported with no complication. We present the first reported case of frontal sinus posterior table and skull base erosion following prolonged frontal sinus stenting. A 57-year-old female presented with chronic sinusitis and nasal obstruction. Imaging revealed pansinusitis with retained stents in each frontal sinus that were placed 8 years prior. On the right, there was an area of skull base erosion at the tip of the stent. The patient underwent functional endoscopic sinus surgery with polypectomy. The stents were removed, revealing posterior table erosion on the right side but intact mucosa. Two months after surgery, there were no signs or symptoms of cerebrospinal fluid leak or other complications. Recent literature has suggested that prolonged stenting is safe; however, this case highlights a complication with potentially serious outcomes that can result from prolonged stenting. We recommend stent removal once stable nasofrontal duct patency has been achieved. If prolonged stenting is utilized, patients should be closely monitored and consideration should be given to periodic imaging to evaluate stent position.

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International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

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481

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Prolonged stenting of the frontal sinus

Cited by 27 publications

References 8 publications

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Possible Skull Base Erosion After Prolonged Frontal Sinus Stenting

International consensus statement on allergy and rhinology: rhinosinusitis 2021

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