Outcomes of Frontal Sinus Stenting With Steroid Impregnated Microsponge Versus Steroid-Eluting Implant.

chronic rhinosinusitis endoscopic sinus surgery frontal sinusitis frontal sinusotomy microsponge mometasone sinusitis steroid-eluting implant steroid-eluting stent triamcinolone

Journal

American journal of rhinology & allergy
ISSN: 1945-8932
Titre abrégé: Am J Rhinol Allergy
Pays: United States
ID NLM: 101490775

Informations de publication

Date de publication:
Nov 2023
Historique:
medline: 4 10 2023
pubmed: 6 7 2023
entrez: 6 7 2023
Statut: ppublish

Résumé

Mometasone-eluting poly-L-lactide-coglycolide (MPLG) is available commercially for frontal sinus ostium (FSO) stenting. An alternative chitosan polymer-based drug delivery microsponge is also available at a lower cost per unit. To compare the outcomes of MPLG stents versus triamcinolone-impregnated chitosan polymer (TICP) microsponge in frontal sinus surgery. Patients who underwent endoscopic sinus surgery from December 2018 to February 2022 were reviewed to identify those with the intraoperative placement of TICP microsponge or MPLG stent in the FSO. FSO patency was evaluated by endoscopy at follow-up. Twenty-two-item sinonasal outcome test (SNOT-22) was also recorded, and complications were noted. A total of 68 subjects and 96 FSOs were treated. TICP was first used in August 2021 and MPLG in December 2018. MPLG placement in a Draf 3 cavity was excluded since TICP had not been used during Draf 3 procedure. Both cohorts (TICP 20 subjects, 35 FSOs; MPLG 26 subjects, 39 FSOs) had similar clinical characteristics. At a mean total follow-up of 249.2 days for TICP and 490.4 days for MPLG, FSO patency was 82.9% and 87.1%, respectively ( FSO patency for both stents was similar, although TICP had significantly lower costs per unit. Additional comparative trials may be helpful for guiding clinicians on the appropriate clinical situations for the use of these devices.

Sections du résumé

BACKGROUND BACKGROUND
Mometasone-eluting poly-L-lactide-coglycolide (MPLG) is available commercially for frontal sinus ostium (FSO) stenting. An alternative chitosan polymer-based drug delivery microsponge is also available at a lower cost per unit.
OBJECTIVE OBJECTIVE
To compare the outcomes of MPLG stents versus triamcinolone-impregnated chitosan polymer (TICP) microsponge in frontal sinus surgery.
METHODS METHODS
Patients who underwent endoscopic sinus surgery from December 2018 to February 2022 were reviewed to identify those with the intraoperative placement of TICP microsponge or MPLG stent in the FSO. FSO patency was evaluated by endoscopy at follow-up. Twenty-two-item sinonasal outcome test (SNOT-22) was also recorded, and complications were noted.
RESULTS RESULTS
A total of 68 subjects and 96 FSOs were treated. TICP was first used in August 2021 and MPLG in December 2018. MPLG placement in a Draf 3 cavity was excluded since TICP had not been used during Draf 3 procedure. Both cohorts (TICP 20 subjects, 35 FSOs; MPLG 26 subjects, 39 FSOs) had similar clinical characteristics. At a mean total follow-up of 249.2 days for TICP and 490.4 days for MPLG, FSO patency was 82.9% and 87.1%, respectively (
CONCLUSION CONCLUSIONS
FSO patency for both stents was similar, although TICP had significantly lower costs per unit. Additional comparative trials may be helpful for guiding clinicians on the appropriate clinical situations for the use of these devices.

Identifiants

pubmed: 37408359
doi: 10.1177/19458924231186901
doi:

Substances chimiques

Chitosan 9012-76-4
Steroids 0
Triamcinolone 1ZK20VI6TY

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

679-685

Déclaration de conflit d'intérêts

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Auteurs

Tripti Brar (T)

Division of Rhinology, Department of Otolaryngology, Mayo Clinic in Arizona, Scottsdale, AZ, USA.

Adam Brown (A)

Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA.

Amar Miglani (A)

Division of Rhinology, Department of Otolaryngology, Mayo Clinic in Arizona, Scottsdale, AZ, USA.

Devyani Lal (D)

Division of Rhinology, Department of Otolaryngology, Mayo Clinic in Arizona, Scottsdale, AZ, USA.

Michael J Marino (MJ)

Division of Rhinology, Department of Otolaryngology, Mayo Clinic in Arizona, Scottsdale, AZ, USA.

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Classifications MeSH