Studies on efficacy of a bioabsorbable steroid-eluting sinus stent in the frontal sinus opening of chronic rhinosinusitis with nasal polyps.
10.3760/cma.j.cn115330-20200809-00655
- VernacularTitle:缓释糖皮质激素支架在全组慢性鼻窦炎伴鼻息肉患者额窦口植入中的疗效观察
- Author:
Xiao Qiong SHI
1
;
Hai Hong TANG
1
;
Hong Liang ZHENG
1
;
Zheng Ming CHEN
1
;
Ling Yue XIAO
1
;
Yi Qun HUANG
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital, Shanghai 200433, China.
- Publication Type:Randomized Controlled Trial
- MeSH:
Absorbable Implants;
Adult;
China;
Chronic Disease;
Endoscopy;
Female;
Frontal Sinus/surgery*;
Humans;
Male;
Middle Aged;
Nasal Polyps/complications*;
Paranasal Sinuses;
Rhinitis/complications*;
Stents;
Steroids;
Treatment Outcome
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2021;56(8):824-829
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the efficacy of a bioabsorbable steroid-eluting sinus stent in improving surgical outcomes when placed in the frontal sinus ostium (FSO) following full endoscopic sinus surgery (ESS) in patients with whole group chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients with whole group CRSwNP who had similar lesions on bilateral sinus between September 2019 and March 2020 in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital were chosen. Patients with CRSwNP who underwent extended ESS were randomly assigned to receive a steroid-eluting sinus stent in one FSO whereas the contralateral side received surgery alone. Endoscopic evaluations recorded at 30, 90 days postoperative were graded by an independent assessment panel to assess the need for interventions in the FSO. Semi-quantitative data with CT and endoscopic score were performed by rank sum test. The need for postoperative intervention and the patency rate of FSO were analyzed using the McNemar test. Results: Thirty-one patients with whole group CRSwNP met all eligible criteria, including 17 males and 14 females, with the age of (44.5±11.8) years(x¯±s). Stents were successfully placed in one FSO of all patients. At 30 days post-ESS, the assessment panel reported that steroid-eluting stents reduced the need for postoperative interventions by 41.0% (χ2=5.314,P=0.021), the need for oral steroid interventions by 40.0% (χ2=4.133,P=0.042) and the need for surgical interventions by 74.8% (χ2=4.292,P=0.038) compared to control sinuses with no stents. Clinical surgeons also reported greater diameter of FSO compared to control sinuses at 30 days post-ESS (74.2% vs 48.4%, χ2=4.351, P=0.037). These results at 90 days post-ESS were consistent with those at 30 days post-ESS. Conclusion: Bioabsorbable steroid-eluting sinus stents in the FSO can reduce polyp formation, adhesion, and the need for postoperative interventions in FSO of CRSwNP patients and improve the early postoperative outcomes.
