Use of balloon catheter dilation and steroid-eluting stent in light and severe rhinosinusitis of frontal sinus: a multicenter retrospective randomized study
Use of balloon catheter dilation and steroid-eluting stent in light and severe rhinosinusitis of frontal sinus: a multicenter retrospective randomized study
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DOI：
10.26355/eurrev_201811_16289
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发表时间：
2018-11-01
影响因子：
3.3
通讯作者：
De Vincentiis, M.
中科院分区：
文献类型：
--
作者：
Minni, A.;Dragonetti, A.;De Vincentiis, M.
目的：与其他鼻窦手术相比，额窦手术的再狭窄率增加。它主要取决于复发性炎症和额隐窝处的异常瘢痕，其减少是治疗成功的关键之一。球囊导管扩张（BCD）和植入式鼻窦支架/间隔器代表了改善鼻窦通气的策略，同时考虑到粘膜的完整性并减少术后异常瘢痕形成。本研究的目的是评估BCD和不可吸收支架（Relieva Stratus（TM）MicroFlow间隔器）在治疗慢性鼻窦炎（CRS）的额窦中的有效性、安全性和正确适应症：患者和方法：在这项多中心回顾性研究中，我们纳入了76例额窦非息肉样CRS患者。41个额窦单独使用BCD，35个额窦使用BCD + Spacer。我们分析了（Zinreich改良的Lund-McKay CT评分）和病理学结果（SNOT-20问卷）术前和术后12个月，将我们的人群分为两个主要组：（轻度/轻度额叶CRS）和“S”组（中度/重度额叶CRS）。我们的研究结果证实了BCD在治疗额部CRS中具有良好的安全性和有效性，Relieva Stratus（TM）具有良好的安全性，但有效性不显著。MicroFlow间隔时，添加到BCD在轻，重额慢性鼻窦炎的管理。结论：BCD是一个受欢迎的选择，在管理额CRS和在不久的将来，利用支架/间隔可以成为一个新的和有效的武器，在鼻窦炎的管理，都像一个辅助标准疗法。以及禁忌使用全身性药物的患者人群。
OBJECTIVE: Frontal sinus surgery has an increased rate of re-stenosis, if compared to other sinuses. It depends mainly on recurrent inflammation and abnormal scarring at the frontal recess and its reduction represents one of the keys to therapeutic success. Balloon catheter dilation (BCD) and implantable sinus stents/spacers represent strategies to improve sinus ventilation respecting the integrity of mucosa and reducing abnormal post-surgical scarring. The purpose of this study was to evaluate the effectiveness, safety and correct indication about the use of BCD and a non-absorbable stent (Relieva Stratus (TM) MicroFlow spacer) in the management of chronic rhinosinusitis (CRS) of the frontal sinus.PATIENTS AND METHODS: In this multicentric retrospective study we included a population of 76 frontal sinuses with non-polypoid CRS. 41 frontal sinuses were treated with BCD alone and 35 frontal sinuses with BCD + Spacer. We analyzed both radiological (Lund-McKay CT scoring modified by Zinreich) and symptomatological results (SNOT-20 questionnaire) before surgery and after 12 months, dividing our population in two main groups: group "L" (light/ mild frontal CRS) and group "S" (moderate/severe frontal CRS).RESULTS: Our results confirm a good safety and effectiveness of BCD in the management of frontal CRS and show a good safety but a not significative effectiveness of Relieva Stratus (TM) MicroFlow spacer when added to BCD in the management of light and severe frontal chronic rhinosinusitis.CONCLUSIONS: BCD is an acclared option in the management of frontal CRS and in the near future, utilization of stents/spacers could become a new and effective weapon in the management of rhinosinusitis, both like an adjunct to standard therapies. and in patient population where the use of systemic drugs is contraindicated.