Bioabsorbable steroid-eluting sinus stents for patients with refractory frontal diseases undergoing a revision Draf 3 procedure: a case series

Abstract

Background: Bioabsorbable steroid-eluting sinus stents are safe and effective in maintaining the patency of the frontal sinus ostium.Aims/objectives: To assess the efficacy of steroid-eluting sinus stents in improving postoperative outcomes following revision and re-revision Draf 3 procedures in patients with frontal diseases.Material and methods: Patients with recalcitrant chronic frontal rhinosinusitis (FRS) and mucocele who underwent revision and re-revision Draf 3 procedures from 2015 to 2017 were included. Preoperative disease parameters, demographics, and endoscopic and radiographic images were recorded.Results: Seven patients undergoing the Draf 3 procedure for recalcitrant chronic FRS (43%) and mucocele after complete resection of benign tumours in the frontal sinus (57%) were followed up for a mean of 16.5 months. At the end of follow-up, seven (100%) patients were asymptomatic and all patients (100%) had patent neo-ostia.Conclusions and significance: The use of bioabsorbable steroid-eluting sinus stents had no unanticipated consequences, and the drainage pathways of the frontal neo-ostium remained patent. Steroid-eluting sinus stents may decrease recurrence rates in revision cases where patients have extensive scarring or neo-osteogenesis of the operative field from prior Draf 2 or 3 procedures. Further follow-up of the current cases and studies with larger cohorts are needed.