The Success of 6-Month Stenting in Endonasal Frontal Sinus Surgery

Abstract

The ultimate success orfailure offro ntal sinus surg ical procedures, wliether they be endonasal al' external, is detennined essentially by the rat e of res tenosis of the froutal sinus outflo w tra ct OI' neo-osti utn postop erat ively. Long-terin sten ting f or a period ofseveral months significantly reduces the rate of resteno sis, particularly in difficult cases. We retrospecti vely re viewed the cases of 12 pa tients who recei ved 21 fro ntal na sa l ste nt s, which were left in pla ce f or 6 months. Based on outcoines nieasures that included endos copy O I' rad iologicfindings and pati ents ' self-evaluations, we cone lude that fro ntal nasal stents that a re left in pla ce fo r 6 months are mar e ejfective than stents that are renioved earlier. We recommend that th is type of managem ent be co nsi de red in difficult rev isio n cases and befo re performing an ext ernal operation.

Prolonged stenting of the frontal sinus

“…Recently, it has been shown that when stenting is chosen, prolonged stent placement leads to improved outcomes. Sinuses where stents were left in place for 6 months showed improved patency compared with sinuses stented for shorter periods 1. While one group of experts has thus advocated stenting for up to 6 months prior to removal, the optimal length of stent retention has not been defined.…”

Innovative frontal sinus stent acting as a local drug-releasing system

“…However, there is an ongoing controversial discussion about their effectiveness. We have observed positive effects in our patients [15], but we got the definite impression that stenting should be complemented by specific, long-lasting topical medicamentous therapy. As routine topical therapy does not reach the critical areas of the frontal sinus access [10,13], we had the idea of combining the stent with a local drug-releasing system.…”

Endonasale Mediandrainage

“…Platzhalter für die endonasale Typ-III-Drainage sind bisher nur von wenigen Autoren beschrieben worden [18,35,38,39]. Auch wenn ihr Nutzen für die Typ-II-Drainage in einer prospektiven Studie nachgewiesen wurde [35], ist ihr Einsatz Einzelfällen vorbehalten.…”

“…Auch wenn ihr Nutzen für die Typ-II-Drainage in einer prospektiven Studie nachgewiesen wurde [35], ist ihr Einsatz Einzelfällen vorbehalten. Wir verwenden hierfür individuell angepasste ᭤ H-förmige Silikonrörchen [39].Alternativ können kommerzielle Stirnhöhlenplatzhalter über Kreuz eingelegt werden. Wir verwenden hierfür individuell angepasste ᭤ H-förmige Silikonrörchen [39].Alternativ können kommerzielle Stirnhöhlenplatzhalter über Kreuz eingelegt werden.…”