Joseph K Han1, Robert C Kern2. 1. Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA. 2. Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) causes severe symptoms that lead to poor quality of life. When optimal medical therapy does not improve CRS symptoms, then endoscopic sinus surgery (ESS) can be used in patients with persistent symptoms and radiographic evidence of CRS to improve patients' symptoms and quality of life. Despite appropriate and complete sinus surgery, there can be issues after sinus surgery such as synechiae formation and recurrence of polyps in certain CRS patients that can decrease long-term outcomes. Corticosteroids are used to decrease postoperative scarring and edema as well as prevent recurrence of nasal polyp formation after sinus surgery. However, the use of oral or systemic steroid can lead to serious short-term and long-term complications. Therefore, a safer alternative would be the topical delivery of steroid via steroid-eluting sinus implants. METHODS: A literature review was performed to identify clinical studies evaluating steroid-eluting implants. Two forms of steroid-eluting implants were identified, Propel family products and Sinuva. The research findings from clinical studies using various steroid-eluting sinus implants are reviewed and discussed. RESULTS: Four prospective randomized clinical studies were identified for the Propel family products. Two prospective randomized clinical studies were identified for Sinuva. The results from the clinical studies showed that the use of the various steroid-eluting sinus implants can improve postoperative results after ESS as well as treat the recurrence of nasal polyps after sinus surgery without the need for additional sinus surgery. CONCLUSION: The novel steroid-eluting implants appear to be beneficial for CRS patients immediately post-operatively as well as for nasal polyps patients. Interestingly, these implants could be used as a substitute for the beneficial effect of systemic steroid use for CRS patients.
BACKGROUND:Chronic rhinosinusitis (CRS) causes severe symptoms that lead to poor quality of life. When optimal medical therapy does not improve CRS symptoms, then endoscopic sinus surgery (ESS) can be used in patients with persistent symptoms and radiographic evidence of CRS to improve patients' symptoms and quality of life. Despite appropriate and complete sinus surgery, there can be issues after sinus surgery such as synechiae formation and recurrence of polyps in certain CRSpatients that can decrease long-term outcomes. Corticosteroids are used to decrease postoperative scarring and edema as well as prevent recurrence of nasal polyp formation after sinus surgery. However, the use of oral or systemic steroid can lead to serious short-term and long-term complications. Therefore, a safer alternative would be the topical delivery of steroid via steroid-eluting sinus implants. METHODS: A literature review was performed to identify clinical studies evaluating steroid-eluting implants. Two forms of steroid-eluting implants were identified, Propel family products and Sinuva. The research findings from clinical studies using various steroid-eluting sinus implants are reviewed and discussed. RESULTS: Four prospective randomized clinical studies were identified for the Propel family products. Two prospective randomized clinical studies were identified for Sinuva. The results from the clinical studies showed that the use of the various steroid-eluting sinus implants can improve postoperative results after ESS as well as treat the recurrence of nasal polyps after sinus surgery without the need for additional sinus surgery. CONCLUSION: The novel steroid-eluting implants appear to be beneficial for CRSpatients immediately post-operatively as well as for nasal polypspatients. Interestingly, these implants could be used as a substitute for the beneficial effect of systemic steroid use for CRSpatients.
Authors: Kyle Battiston; Ian Parrag; Matthew Statham; Dimitra Louka; Hans Fischer; Gillian Mackey; Adam Daley; Fan Gu; Emily Baldwin; Bingqing Yang; Ben Muirhead; Emily Anne Hicks; Heather Sheardown; Leonid Kalachev; Christopher Crean; Jeffrey Edelman; J Paul Santerre; Wendy Naimark Journal: Nat Commun Date: 2021-05-17 Impact factor: 14.919
Authors: Jakub Spałek; Przemysław Ociepa; Piotr Deptuła; Ewelina Piktel; Tamara Daniluk; Grzegorz Król; Stanisław Góźdź; Robert Bucki; Sławomir Okła Journal: Int J Mol Sci Date: 2022-02-25 Impact factor: 5.923