Journal
INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY
Volume 4, Issue 11, Pages 861-870Publisher
WILEY
DOI: 10.1002/alr.21426
Keywords
corticosteroid; mometasone furoate; CRSwNP; drug-eluting; safety; efficacy; sinusitis; endoscopic sinus surgery; nasal polyps; refractory
Categories
Funding
- Intersect ENT
Ask authors/readers for more resources
BackgroundPatients with recurrent sinonasal polyposis after endoscopic sinus surgery (ESS) have limited treatment options. This study evaluated the safety and efficacy of a bioabsorbable steroid-eluting implant with 1350 g of mometasone furoate for its ability to dilate obstructed ethmoid sinuses, reduce polyposis, and reestablish sinus patency. MethodsThis was a randomized, controlled, blinded study including 100 patients chronic rhinosinusitis with nasal polyposis (CRSwNP) refractory to medical therapy and considered candidates for revision ESS. Follow-up included endoscopic grading by investigators and patient-reported outcomes. ResultsTreated patients (n = 53; age as mean standard deviation [SD] 47.8 +/- 12.6years; 55% male) underwent in-office bilateral placement. Control patients (n = 47; age 51.6 +/- 13.1years; 66% male) underwent a sham procedure. At 3months, treated patients experienced a significant reduction in bilateral polyp grade (p = 0.0269) and ethmoid sinus obstruction (p = 0.0001) compared to controls. Treated patients also experienced a 2-fold improvement in the mean nasal obstruction/congestion score (-1.33 +/- 1.47 vs -0.67 +/- 1.45; p = 0.1365). This improvement reached statistical significance (p = 0.025) in patients with greater polyp burden (grade 2 bilaterally; n = 74). At 3months, 53% of treated patients compared to only 23% of controls were no longer indicated for repeat ESS. There was no serious adverse event or clinically significant increases in intraocular pressure or cataract formation. ConclusionThe symptomatic improvement and statistically significant reduction in polyp grade and ethmoid sinus obstruction supported the efficacy of the steroid-eluting implant for in-office treatment of CRS patient with recurrent polyposis after ESS. The study results demonstrated that the steroid-eluting implant represents a safe and effective alternative to current management for this patient population.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available