Sinus implants for chronic rhinosinusitis: technology evaluation

Expert Opin Drug Deliv. 2013 Dec;10(12):1735-48. doi: 10.1517/17425247.2013.839654. Epub 2013 Oct 3.

Abstract

Introduction: Endoscopic sinus surgery (ESS) plays an integral role in the treatment of chronic rhinosinusitis (CRS), with well-documented benefits in both symptoms and quality of life. However, synechiae formation, polypoid change, and mucosal edema can compromise long-term surgical outcomes. Corticosteroids have been found to be effective in managing such postsurgical inflammation, but current delivery methods are limited by poor sinonasal distribution and potential systemic side effects. Sinus implantation offers a novel vehicle for topical drug delivery in CRS; enabling sustained, controlled corticosteroid application directly to sinonasal mucosa.

Areas covered: The bioengineering, mechanism of drug delivery, degradation and resorption of sinus implantation will be delineated. Research findings from animal and clinical studies will be assessed as well as alternative devices. Future directions for this technology in the management of CRS will also be discussed.

Expert opinion: The sinus implant is a revolutionary mode of localized drug delivery in CRS. Its utilization enhances wound healing, with diminished need for secondary postoperative medical and surgical interventions. Such novel technology has far-reaching implications, with future indications likely extending beyond the operating room into the clinic setting, to treat CRS patients, with inflammatory exacerbations or recurrent polypoid disease, who would otherwise require additional surgery.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / administration & dosage*
  • Chronic Disease
  • Drug Implants
  • Endoscopy
  • Humans
  • Mometasone Furoate
  • Postoperative Complications
  • Pregnadienediols / administration & dosage*
  • Rhinitis / drug therapy*
  • Rhinitis / surgery
  • Sinusitis / drug therapy*
  • Sinusitis / surgery

Substances

  • Anti-Inflammatory Agents
  • Drug Implants
  • Pregnadienediols
  • Mometasone Furoate