Assessing the effect of absorbable steroid sinus implant: a state-of-the-art systematic review.

Autor: Calvo-Henriquez C; Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.; ENT Department, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain., García-Lliberós A; Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France. ainhoagarcialliberos@gmail.com.; ENT Department, Valencia University General Hospital, Valencia, Spain. ainhoagarcialliberos@gmail.com., Sánchez-Gómez S; ENT Department, Virgen Macarena University Hospital, Seville, Spain., Alobid I; ENT Department, Rhinology and Skull Base Unit, Hospital Clinic, Barcelona University, IDIBAPS, CIPERES, Barcelona, Spain.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Aug; Vol. 281 (8), pp. 3915-3928. Date of Electronic Publication: 2024 Mar 09.
DOI: 10.1007/s00405-024-08531-1
Abstrakt: Objectives: Endoscopic sinus surgery is not a definitive treatment for chronic rhinosinusitis (CRS). The use of sinus stents after surgery to maintain sinus patency and deliver local steroids has gained popularity. The first steroid-eluting bioabsorbable implant (SEBI) approved for this indication, later Propel, was developed in 2011. This state-of-the-art review aims to summarize the available evidence, as well as to point out potential pitfalls and lack of specific analyses to guide future research on this new therapeutic option.
Data Sources: Pubmed (Medline), the Cochrane Library, EMBASE, SciELO.
Review Methods: Nine research questions were defined: Are steroid-eluting Sinus implants useful for the control of CRS symptoms after surgery? Do they improve surgical field healing after CRS surgery? Do they decrease polyp regrowth after ESS? Do they decrease the need for ESS? Are they useful in symptom control as in-office procedure? Are they better than other steroid-impregnated resorbable materials? Do they have a positive impact on olfaction? Are they safe? Are they cost-effective? Retrieved articles were reviewed by two authors.
Results: Twenty nine studies were included: 3 metanalysis, 1 systematic review, 10 randomized clinical trials, 4 quasi-experimental studies, 1 retrospective cohort study, 4 cost studies, 3 case series and 2 expert consensus. The review encompassed a population of 3,012 patients treated with SEBI and 2826 controls.
Conclusions: This is the first state-of-the-art review assessing steroid eluting bioabsorbable stent evidence. Despite the effort in recent years, still several questions remain unanswered. This review will hopefully guide future research efforts to better define the role of SEBI in the otolaryngology practice.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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