The Effects of Debridement After Endoscopic Sinus Surgery

Bugten, Vegard; Nordgård, Ståle; Steinsvåg, Sverre K.

doi:10.1097/01.mlg.0000241362.06072.83

Cited by 63 publications

(57 citation statements)

References 22 publications

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“…Many surgeons consider the postoperative treatment regimen to be as important as the surgery itself [9], and there is strong evidence that postoperative endoscopic examination of the sinonasal cavity provides prognostic information concerning the potential for future episodes of sinusitis and that patients whose cavities became normal postoperatively are less likely to require revision [10]. An evidence-based review of early postoperative care strategies by Rudmik et al was recently published, with recommendations given for nasal saline irrigations, sinus cavity debridement and topical steroids [11].…”

Section: Body Of Reviewmentioning

confidence: 99%

The PROPEL™ steroid-releasing bioabsorbable implant to improve outcomes of sinus surgery

Kennedy¹

2012

Expert Review of Respiratory Medicine

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Chronic rhinosinusitis is widely recognized as one of the most common chronic disease entities. Since its introduction in the USA in 1985, the role of functional endoscopic sinus surgery as an adjunct to medical therapy in the treatment of chronic sinus disease has expanded significantly. Corticosteroids are an integral part of the management of the mucosal inflammation in chronic rhinosinusitis, and it is generally accepted that existing routes of delivery to the sinus mucosa are suboptimal. The PROPEL™ steroid-releasing implant (Intersect ENT) initiates a new era in topical therapy providing controlled drug delivery directly to the sinus tissue. The mometasone furoate-releasing implant has been clinically proven to prevent obstruction of the ethmoid sinus following surgery and recently received US FDA approval. Initial studies demonstrate improved postoperative healing with the device, thus reducing the need for additional surgical procedures such as adhesion lysis and systemic steroids.

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Section: Body Of Reviewmentioning

confidence: 99%

The PROPEL™ steroid-releasing bioabsorbable implant to improve outcomes of sinus surgery

Kennedy¹

2012

Expert Review of Respiratory Medicine

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“…On the contrary, the benefit of this treatment for prophylaxis of adhesions and synechiae is stressed by other sources [98], [279], [280], [281], [282]. Especially in differentiated and extended surgeries, e.g.…”

Section: “Minor” Complicationsmentioning

confidence: 99%

Danger points, complications and medico-legal aspects in endoscopic sinus surgery

Hosemann

Draf

2013

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 12:Doc06; ISSN 1865-1011

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“…Complications in the postoperative period, including scarring of the sinus ostia, the development of mucosal adhesions and middle turbinate lateralization, all may contribute to surgical failure 9. Perhaps even more important, persistent inflammation presenting as mucosal edema, polypoid mucosal change, or persistent polyps will also compromise results 10,11. Several intraoperative techniques have been utilized to prevent complications, including placement of packing, stents, sponges, and gels 12–15.…”

Section: Obstacles In Treating Chronic Rhinosinusitismentioning

confidence: 99%

Mometasone implant for chronic rhinosinusitis

Wei¹,

Kennedy²

2012

MDER

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The Propel mometasone-eluting stent (Intersect ENT, Palo Alto, CA) is the first Food and Drug Administration-approved device for delivering steroid medication into the ethmoid cavity following surgery. The implant is composed of a biodegradable polymer in a lattice pattern that expands in a spring-like fashion to conform to the walls of a dissected ethmoid cavity and contains a total of 370 μg of mometasone furoate designed for gradual release over 30 days. The purpose of this article is to review the mode of action and the evidence supporting the efficacy of this novel technology. Three recently published clinical trials have demonstrated that the mometasone-eluting stent produced statistically significant reductions in inflammation, polyp formation, and postoperative adhesions. In addition, the implant has been found to significantly reduce the need for postoperative administration of oral steroids and to decrease the frequency of postoperative lysis of adhesions. Minimal adverse effects were reported in these trials and included infection, crusting, and granulation tissue formation. Although the placement of steroid-impregnated packing, stents, sponges, and gels has previously been used in the postoperative sinus cavities, the Propel mometasone-eluting stent introduces a new mechanism for localized and controlled delivery of topical therapy directly to the nasal mucosa for chronic rhinosinusitis.

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The Effects of Debridement After Endoscopic Sinus Surgery

Abstract: Crusts in the middle meatus after sinus surgery is associated with postoperative adhesions. Debridement of the nasal cavity reduces crusts and postoperative adhesions significantly compared with saline irrigation only. However, the procedure induces more postoperative nasal pain.

Cited by 63 publications

References 22 publications

The PROPEL™ steroid-releasing bioabsorbable implant to improve outcomes of sinus surgery

The PROPEL™ steroid-releasing bioabsorbable implant to improve outcomes of sinus surgery

Danger points, complications and medico-legal aspects in endoscopic sinus surgery

Mometasone implant for chronic rhinosinusitis

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