Department of Otolaryngology & Head and Neck Surgery , David Geffen School of Medicine at UCLA , USA.
Expert Opin Drug Deliv. 2013 Dec;10(12):1735-48. doi: 10.1517/17425247.2013.839654. Epub 2013 Oct 3.
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.
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.
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.
内镜鼻窦手术(ESS)在慢性鼻-鼻窦炎(CRS)的治疗中起着重要作用,其在症状和生活质量方面均具有明确的获益。然而,粘连形成、息肉样变和黏膜水肿会影响长期手术效果。皮质类固醇已被证实可有效治疗此类术后炎症,但目前的给药方法受到较差的鼻窦分布和潜在全身副作用的限制。鼻窦植入物为 CRS 中的局部药物递送提供了一种新的载体;能够将持续、受控的皮质类固醇直接应用于鼻-鼻窦黏膜。
鼻窦植入物的生物工程、药物递送机制、降解和吸收将被阐述。将评估动物和临床研究的研究结果以及替代设备。还将讨论该技术在 CRS 管理中的未来发展方向。
鼻窦植入物是 CRS 中局部药物递送的一项革命性模式。其利用增强了伤口愈合,减少了对二次术后医疗和手术干预的需求。这种新型技术具有深远的意义,未来的适应症可能不仅限于手术室,还将扩展到临床环境,以治疗需要额外手术的 CRS 患者,这些患者因炎症加重或复发性息肉样疾病而需要进一步治疗。