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Indications for absorbable steroid-eluting sinus implants: Viewpoint via the Delphi method.

Victoria S Lee1, Prayag Patel2, Daniel O'Brien3

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Illinois Chicago, Chicago, Illinois, USA.

International Forum of Allergy & Rhinology
|June 22, 2022
PubMed
Summary
This summary is machine-generated.

Absorbable steroid-eluting sinus implants offer targeted corticosteroid delivery to prevent sinus adhesion and restenosis. Experts recommend their use in specific patient groups, including diabetics and those with recurrent stenosis.

Keywords:
PROPELSINUVAendoscopic sinus surgerysteroid-eluting implants

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Area of Science:

  • Otolaryngology
  • Rhinosinusology
  • Biomaterials Science

Background:

  • Sinus surgery complications include adhesion formation and ostia restenosis.
  • Absorbable steroid-eluting sinus implants deliver corticosteroids locally to mitigate these issues.
  • Evidence supporting optimal use and timing for these implants requires expert consensus.

Purpose of the Study:

  • To review existing evidence on steroid-eluting sinus implants.
  • To establish expert consensus on indications and timing for implant placement using a Delphi process.

Main Methods:

  • Systematic review of current literature on steroid-eluting sinus implants.
  • Delphi process involving expert otolaryngologists to achieve consensus on 12 statements regarding implant use.
  • Analysis of consensus achieved on indications and timing for intraoperative or in-office placement.

Main Results:

  • Consensus was reached on 6 out of 12 statements.
  • Experts agreed on using implants for diabetic patients, those intolerant to oral steroids, during extended frontal sinus surgery, and for recurrent stenosis.
  • Lack of consensus on other key statements highlights areas for further research.

Conclusions:

  • Steroid-eluting sinus implants show promise in preventing sinus adhesion and restenosis.
  • Expert opinion supports specific indications for implant use, particularly in challenging surgical cases.
  • Shared decision-making is crucial for patient selection due to limited consensus on broader applications.