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Effect of steroid-releasing sinus implants after endoscopic sinus surgery (ESS) on postoperative outcomes: A meta-analytical study

Abstract

Aims

a meta-analysis to evaluate the steroid-releasing sinus implants in chronic rhinosinusitis (CRS) patients after functional endoscopic sinus surgery (FESS) in order to assess its efficacy.

Settings and Design

Meta analysis.

Methods and Material

The 4 trials enrolled a total of 539 patients utilizing an intrapatient control design. Postoperative day 30 videos were obtained for each patient, randomly ordered for grading of efficacy endpoints. The need for postoperative interventions, formation of polyposis, and adhesions were assessed. Results from the 4 studies were then pooled.

Statistical analysis used

Comprehensive Meta-Analysis© version 2 (BiostatTM, NJ, USA).

Results

Implants were successfully placed. According to the grading done by the panel, drug-releasing implants reduced significant adhesions by 2.5% (P=0.971), middle turbinate lateralization occurrence was 2.5% (P=0.954), polyp formation was 2% (P=0.830), the need for oral steroid intervention was 22% (P=0.173), significantly less need for postoperative therapeutic intervention 33% (P=0.305), or Surgical Lysis of Adhesions (LOA) intervention 14% (P=0.951), compared to controls.

Conclusions

Steroid-releasing implants improve surgical outcomes by reducing frank polyp formation, sinus adhesions, and middle turbinate lateralization. Steroid-releasing implants reduce the need for surgical intervention, and the need for oral steroid treatment.

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Corresponding author

Correspondence to Tamer S. Sobhy MD.

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Stefan, M.M., Rabie, N.A., Sobhy, T.S. et al. Effect of steroid-releasing sinus implants after endoscopic sinus surgery (ESS) on postoperative outcomes: A meta-analytical study. Egypt J Otolaryngol 35, 250–255 (2019). https://doi.org/10.4103/ejo.ejo_92_18

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Keywords

  • bio absorbable nasal packing/spacer
  • corticosteroid
  • drug releasing
  • mometasone
  • sinus implant
  • steroid-eluting stents/devices