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可吸收类固醇洗脱鼻窦植入物的适应证:通过 Delphi 法观察。

Indications for absorbable steroid-eluting sinus implants: Viewpoint via the Delphi method.

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of Illinois Chicago, Chicago, Illinois, USA.

Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Int Forum Allergy Rhinol. 2022 Oct;12(10):1225-1231. doi: 10.1002/alr.23044. Epub 2022 Jul 5.

Abstract

Absorbable steroid-eluting sinus implants provide targeted corticosteroid release over a sustained period and are designed to prevent both undesirable adhesion formation and sinus ostia restenosis. Here, we highlight the key evidence of these implants to date and query a group of experts via a Delphi process on the indications and optimal timing for intraoperative or in-office placement of these implants. Six of a total of 12 statements reached consensus and were accepted. Overall, experts largely agree that intraoperative or in-office use of steroid-eluting stents could be considered for patients: (1) who are diabetic or intolerant of oral steroids, (2) undergoing extended frontal sinus surgery, and (3) with recurrent stenosis. Given the lack of expert consensus on other key statements, clinicians should carefully consider these treatment options on a case-by-case basis after shared decision-making.

摘要

可吸收类固醇洗脱鼻窦植入物可在一段时间内提供靶向皮质类固醇释放,旨在预防不良粘连形成和鼻窦口再狭窄。在这里,我们重点介绍这些植入物迄今为止的关键证据,并通过 Delphi 流程就这些植入物的适应证和最佳放置时机向一组专家提问。总共 12 项声明中有 6 项达成共识并被接受。总的来说,专家们基本上同意可以考虑在术中或在诊室内使用类固醇洗脱支架的患者包括:(1)患有糖尿病或不能耐受口服类固醇的患者,(2)需要进行广泛额窦手术的患者,以及(3)有复发性狭窄的患者。鉴于其他关键声明缺乏专家共识,临床医生应在个案基础上在共同决策后仔细考虑这些治疗选择。

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