Bury Sean, Singh Ameet
a Division of Otolaryngology , George Washington University , Washington , DC , USA.
Expert Rev Med Devices. 2017 Feb;14(2):93-101. doi: 10.1080/17434440.2017.1281740.
Management of the frontal sinus places great demands on the otolaryngologist. Given that the fronto-ethmoidal region is susceptible to recurrent inflammation, scarring, and stenosis, maintaining long-term patency of the frontal sinus is a difficult challenge. Oral and topical anti-inflammatory therapy, post-operative stenting, and 'home-brew' drug elution have been used for the treatment of the frontal sinus with mixed success. Recently an implant has been approved for post-operative placement into the frontal recess. This implant provides reliable and consistent steroid drug elution to address inflammation of the frontal recess secondary to chronic sinusitis. Areas covered: This review discusses the development and application of steroid eluting implants in the postoperative care of patients with chronic frontal sinusitis. All randomized controlled trials evaluating steroid eluting implants are discussed. Relevant supporting material discussing background, economics, safety are included. Expert commentary: Steroid eluting implants fulfill a unique niche in the treatment following frontal sinus surgery. They are shown to decrease the need for post-operative interventions and improve outcomes in patients with chronic sinusitis. There is significant potential for growth in the use of steroid eluting implants.
额窦的管理对耳鼻喉科医生有很高要求。鉴于额筛区域易发生反复炎症、瘢痕形成和狭窄，维持额窦的长期通畅是一项艰巨挑战。口服和局部抗炎治疗、术后支架置入以及“自制”药物洗脱已用于额窦治疗，但效果不一。最近，一种植入物已被批准用于术后放置在额隐窝。这种植入物可提供可靠且持续的类固醇药物洗脱，以解决慢性鼻窦炎继发的额隐窝炎症。涵盖领域：本综述讨论了类固醇洗脱植入物在慢性额窦炎患者术后护理中的开发和应用。讨论了所有评估类固醇洗脱植入物的随机对照试验。还包括讨论背景、经济学、安全性的相关支持材料。专家评论：类固醇洗脱植入物在额窦手术后的治疗中占据独特地位。它们已被证明可减少术后干预的需求，并改善慢性鼻窦炎患者的治疗效果。类固醇洗脱植入物的使用有很大的增长潜力。
