Safety and efficacy of a novel bioabsorbable, steroid‐eluting sinus stent

Murr, Andrew H.; Smith, Timothy L.; Hwang, Peter H.; Bhattacharyya, Neil; Lanier, Brent; Stambaugh, James W.; Mugglin, Andrew S.

doi:10.1002/alr.20020

Cited by 160 publications

(260 citation statements)

References 43 publications

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“…There was also no significant corticosteroid systemic absorption or ocular toxicity. 1307,1317,1318 A meta-analysis combined the results from the 2 RCTs to demonstrate statistically significant reductions in the need for postoperative intervention, oral corticosteroid usage, polyposis, and adhesions. 1319 An economic evaluation also demonstrated that Propel TM is cost-effective in decreasing postoperative intervention.…”

Section: Xd6 Surgical Principles/techniques: Drug Eluting Packingmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

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554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Xd6 Surgical Principles/techniques: Drug Eluting Packingmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

554

888

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“…However, few studies have focused on patient-reported QOL outcomes with the use of this device, and the relative efficacy in the treatment of different phenotypes of CRS has not been analyzed in previous studies [6][7][8]12]. The goal of this study was to determine if a bioabsorbable steroid-eluting implant would have a differential effect on patient-reported QOL relative to the status of baseline eosinophilia.…”

Section: Discussionmentioning

confidence: 99%

“…Topical intranasal steroids can minimize systemic effects and are an integral component in treatment; however, penetration into the middle meatus and sinus cavities can be limited by postoperative edema and crusting [7]. Current efforts are focused on improving steroid delivery to the diseased sinuses while limiting their systemic effects [8].…”

Section: Introductionmentioning

confidence: 99%

“…Only one such implant is currently available, marketed under the trade name Propel (Intersect ENT, Menlo Park, CA, USA), which combines the release of 370 µg of mometasone furoate with a spring-like spacer activity that is designed for gradual release over 30 days [11]. This offers the potential benefits of decreasing postoperative inflammation and mucosal edema, reducing polyposis and adhesions, securing the middle turbinate in a medialized position, and separating raw mucosal edges [8,10].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies examining the utility of adjuvant use of a bioabsorbable steroid-eluting implant in ESS have demonstrated its safety and clinical effectiveness in CRS patients in general [6][7][8]12]. However, it is unclear which patient groups are most likely to benefit from this technology.…”

Section: Introductionmentioning

confidence: 99%

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Eosinophilia and Quality of Life in Patients Receiving a Bioabsorbable Steroid-Eluting Implant during Endoscopic Sinus Surgery

Pou

Riley

Tipirneni³

et al. 2017

Sinusitis

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Abstract:Introduction: Bioabsorbable steroid-eluting implants are available as an adjunct for endoscopic sinus surgery (ESS) in the treatment of chronic rhinosinusitis (CRS). It is unclear which patients are most likely to benefit from this technology. We sought to determine if the severity of preoperative sinonasal inflammation influences the postoperative changes in patient-reported quality of life (QOL) and endoscopic appearance following ESS with implant placement; Methods: Consecutive adult patients undergoing ESS for CRS with ethmoidectomy and placement of a steroid-eluting implant over an 18-month period were prospectively included for study. Pre-operative sinus computed tomography (CT) opacification was evaluated using the Lund-Mackay score (LMS). Sinonasal Outcome Test (SNOT-22) scores and Lund-Kennedy endoscopic scores (LKES) for each patient were collected preoperatively and at three-and six-month intervals postoperatively. Serum eosinophilia (>6.0% on peripheral smear) and sinus tissue eosinophilia were recorded; Results: One hundred and thirty-six patients were included for analysis. Of these, 36.7% had polyposis, 15.4% had serum eosinophilia and 64.0% had tissue eosinophilia. The mean (standard deviation) SNOT-22 score was 45.5 (19.4) preoperatively, which improved postoperatively to 18.8 (14.1) at three months (p < 0.001) and 16.5 (14.0) at six months (p < 0.001). Similar results were found when stratified by the presence of polyposis, serum eosinophilia, tissue eosinophilia or high-grade CT findings (LMS > 6). Higher baseline LKES was observed for patients with eosinophilia or high-grade LMS, but these differences normalized at six months postoperatively; Conclusions: Patient-reported QOL and endoscopic appearance show improvement six months after placement of a steroid-eluting implant during ESS, irrespective of the presence of polyposis or eosinophilia.

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