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Invited Commentary
January 2018

Frontal Sinus Drug-Eluting Implants—Effective, but for Which Patients and at What Cost?

Author Affiliations
  • 1Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
  • 2Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. 2018;144(1):35-36. doi:10.1001/jamaoto.2017.1891

Surgical intervention for chronic rhinosinusitis (CRS) is an important treatment option for patients refractory to medical therapy. Despite advances in surgical techniques and operative technology, revision endoscopic sinus surgery (ESS) is necessary in 6% to 19% of patients.1,2 Reasons for revision surgery include scarring and adhesion formation, recurrent polyposis, and persistent inflammation.3 These issues are especially problematic in the frontal recess given the narrow anatomic boundaries that limit the size of the surgical sinusotomy that can be created. Long-term patency rates are reported in the range of 67% to 92%.4 Attempts to improve the success of frontal sinus surgery by decreasing scarring and inflammation have been long standing and a variety of stenting options exist. Recent advancements in bioabsorbable and drug-eluting stents provide a new possibility for improving postoperative sinus surgery outcomes.