Stents in Sinus Surgery

MUHAMMAD NAJI-ULLAH NUR IMAN

10-4-215
Introduction
devices that are used postoperatively following endoscopic sinus surgery
(ESS)
to maintain patency of the sinus openings in the postoperative period
to serve as a local drug delivery vehicle
Indications
Circumferentially exposed bone (after modified Lothrop for tumor
resection or extensive mucosal denudation)
Traumatic fracture of outflow tract
Restenosis after surgery
Frontal neo-ostium smaller than 5 mm
Middle turbinate destabilization
Recalcitrant inflammatory disease (purulence, granulation, osteitic bone,
polypoid obstruction, granulomatous disease)
Contraindications
No absolute contraindications exist to placement of a frontal recess stent
Manipulation and trauma of the frontal recess during frontal stent
placement and any inflammatory reaction caused by the stent itself may
lead to scarring and poor healing of the recess
formation of biofilms
limited indications for a well-defined period of time
Type of Stents
Middle meatal stent
Frontal sinus stent
Drug containing stents

Type of Stents
(A)Sheet of 1/100-inch
thick silastic fashioned
into a T-shaped stent

(B) reinforced silastic
sheet used for
Draf 3 cavity

(C) Rains silastic stent
(D) Silastic T-tube stent

(E) Acclarent Relieva
Stratus MicroFlow Spacer

(F) Intersect ENT
Propel sinus implant
Complications
T-tube may occlude due to poor position/incorrect size of T-Tube
Granulation tissue may form at proximal or distal end of T-tube
May be presence of cracking/splintering of the T-tube
References
Operative Techniques in Laryngology, Clark a. Rosen & C. Blake Simpson,
Published by Springer
Role of Stents in E.S.S, Dr. T. Balasubramanian
Frontal Stenting Sinus Techniques, Devyani Lal, MD, American Academy of
Otolaryngology-Head and Neck Surgery and American Rhinologic Society