Scholarlink

Introduction <p>Endoscopic frontal sinus surgery frequently poses significant technical challenges due to the complex anatomy of the frontal recess, and carries a substantial risk of restenosis and revision surgery. Removable frontal sinus stents have been used to maintain postoperative patency, but their limitations and complications are well recognised. Bioabsorbable steroid-eluting implants have emerged as an alternative designed to support wound healing and reduce postoperative scarring and restenosis. The aim of this study was to describe real-world utilisation patterns and clinical outcomes of bioabsorbable steroid-eluting implants in high-risk primary and revision frontal sinus surgery cases at a UK tertiary centre, extending existing data to a European setting.</p> Methods <p>A retrospective review was undertaken at a tertiary rhinology centre, including consecutive patients undergoing endoscopic frontal sinusotomy with intraoperative placement of a PROPEL™ implant delivering mometasone furoate (370&#xa0;µg) into the frontal sinus outflow tract. Standardised postoperative care included saline irrigations and intranasal corticosteroids. Outcomes were assessed at predefined intervals using the 22-item Sino-Nasal Outcome Test (SNOT-22) and endoscopic evaluation of frontal neo-ostium patency.</p> Results <p>Seventy patients (median age 45.5 years, range 17–72 years) were included between 1 April 2019 and 31 December 2024, the majority undergoing revision procedures. Mean SNOT-22 scores improved from 49.2 ± 23.7 at baseline to 32.9 ± 27.9 at 6 months postoperatively (<i>p</i> &lt; 0.001), exceeding the minimal clinically important difference. Frontal sinus patency at last review was observed in 58/70 patients (82.9%) at a median follow-up of 18.2 months (IQR 8.0–26.5 months), and no further frontal intervention was required in these cases. No implant-related adverse events were documented over the follow-up period.</p> Conclusion <p>In this single-centre, real-world European cohort, bioabsorbable corticosteroid-eluting implants were associated with sustained frontal sinus patency and clinically meaningful symptom improvement in high-risk primary and revision frontal sinus surgery, with a favourable safety profile. These findings support the selective use of bioabsorbable steroid-eluting implants in complex frontal disease, while highlighting the need for comparative and multicentre European studies to better define their relative effectiveness.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Bioabsorbable steroid-eluting implants in high-risk primary and revision frontal sinus surgery: real-world outcomes at a UK tertiary centre

  • 期刊论文

  • 发表日期：

    2026年2月12日

查看全文
  • Guled M. Jama,
  • Faaizah Chishty,
  • Jennifer Magill,
  • Robert Doorly,
  • William E. Grant,
  • Mark Ferguson,
  • Catherine E. Rennie,
  • Hesham Saleh

摘要

Introduction

Endoscopic frontal sinus surgery frequently poses significant technical challenges due to the complex anatomy of the frontal recess, and carries a substantial risk of restenosis and revision surgery. Removable frontal sinus stents have been used to maintain postoperative patency, but their limitations and complications are well recognised. Bioabsorbable steroid-eluting implants have emerged as an alternative designed to support wound healing and reduce postoperative scarring and restenosis. The aim of this study was to describe real-world utilisation patterns and clinical outcomes of bioabsorbable steroid-eluting implants in high-risk primary and revision frontal sinus surgery cases at a UK tertiary centre, extending existing data to a European setting.

Methods

A retrospective review was undertaken at a tertiary rhinology centre, including consecutive patients undergoing endoscopic frontal sinusotomy with intraoperative placement of a PROPEL™ implant delivering mometasone furoate (370 µg) into the frontal sinus outflow tract. Standardised postoperative care included saline irrigations and intranasal corticosteroids. Outcomes were assessed at predefined intervals using the 22-item Sino-Nasal Outcome Test (SNOT-22) and endoscopic evaluation of frontal neo-ostium patency.

Results

Seventy patients (median age 45.5 years, range 17–72 years) were included between 1 April 2019 and 31 December 2024, the majority undergoing revision procedures. Mean SNOT-22 scores improved from 49.2 ± 23.7 at baseline to 32.9 ± 27.9 at 6 months postoperatively (p < 0.001), exceeding the minimal clinically important difference. Frontal sinus patency at last review was observed in 58/70 patients (82.9%) at a median follow-up of 18.2 months (IQR 8.0–26.5 months), and no further frontal intervention was required in these cases. No implant-related adverse events were documented over the follow-up period.

Conclusion

In this single-centre, real-world European cohort, bioabsorbable corticosteroid-eluting implants were associated with sustained frontal sinus patency and clinically meaningful symptom improvement in high-risk primary and revision frontal sinus surgery, with a favourable safety profile. These findings support the selective use of bioabsorbable steroid-eluting implants in complex frontal disease, while highlighting the need for comparative and multicentre European studies to better define their relative effectiveness.