Steroid-Eluting Stents for Maintaining Frontal Sinus Patency After Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis.
Meshal S Alsaedi, Hassan H Alshurafa, Amal M Sunyur et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis assessed steroid-eluting stents (SES) for maintaining frontal sinus ostium patency and improving outcomes after endoscopic sinus surgery. It included 6 studies—4 randomized controlled trials and 2 non-randomized studies—with 412 patients from the U.S. and China. SES use was associated with a non-significant trend toward less postoperative oral steroid use (odds ratio: 0.58, 95% CI: 0.25 to 1.32). The review reported a 15.6% rate of frontal ostium occlusion or restenosis and found benefits versus surgery alone, but not versus large-volume steroid irrigations.
Key findings
- SES use showed a non-significant trend toward reduced postoperative oral steroid use (odds ratio: 0.58, 95% CI: 0.25 to 1.32).
- The pooled proportion requiring additional surgery was 6.9% (95% CI: -0.1% to 13.8%, P = .052).
- Frontal sinus ostium occlusion or restenosis occurred at a rate of 15.6% (95% CI: 10.5% to 20.8%, P < .001).
- SES showed benefit compared with surgery alone, but not compared with large-volume steroid irrigations.
Why it matters
Maintaining frontal sinus ostium patency is an important postoperative outcome, and this review suggests SES may reduce inflammation and restenosis in some comparisons. However, the findings do not establish a clear advantage over large-volume steroid irrigations, and the trend in oral steroid use was not statistically significant. These distinctions matter when interpreting the potential role of stents in postoperative care.
What to keep in mind
The evidence combines only 6 studies, including non-randomized studies, and the review notes that patient selection and cost-effectiveness require further study.