News update: Many insurance companies have recently approved coverage for the PROPEL steroid implant for patients with chronic sinus inflammation and/or sinus polyps who have had prior sinus surgery.
PROPEL implants are bioabsorbable steroid-releasing units placed in the sinus cavity in the office under local anesthesia. The procedure is painless. Frequently it can be performed simultaneously with endoscopic polyp removal or other sinus surgery. The implant is designed to dissolve over a period of 30 days with the gradual release of a steroid, mometasone furoate.
Mometasone furoate is the optimum steroid in terms of safety and effectiveness compared to ALL the other nasal steroids. The PROPEL implant is not felt by the patient and does not block nasal respiration. The mometasone furoate implant decreases the need for oral steroids and recurrent polypectomy surgery.
Multiple studies support these claims. A randomized clinical trial using the PROPEL implant at the time of surgery demonstrated decreased need for postoperative intervention, reduction in postoperative inflammation and reduction in frontal sinus restenosis (1). Another study demonstrated safety with no changes in intraocular pressures, lens opacity or change in 24 hour urine cortisol using a less effective steroid, Fluticasone propionate. Efficacy was demonstrated with less inflammation, polyp scores and adhesion formation (2). A 2 year follow-up study demonstrated patients receiving steroid stents compared to those without: had fewer medical interventions after sinus surgery and fewer revision sinus procedures in patients with polyps (3). In another randomized, controlled blinded study of 100 patients with chronic rhinosinusitis with nasal polyps, treated with or without mometasone PROPEL stents, at six months: demonstrated reduction of nasal obstruction and recurrent polyps formation by two fold comparing treated to untreated patients (4).
Various sizes and shapes have been developed for patients’ differing shapes and sized sinus cavities. Please review the PROPEL website regarding the PROPEL implant for more information and call the Santos Sinus Center to see if you are a candidate for this novel development.
References
- Luong, A., Ow, R. A., Singh, A., Weiss, R. L., Han, J. K., Gerencer, R., … & Raman, A. (2018). Safety and effectiveness of a bioabsorbable steroid-releasing implant for the paranasal sinus ostia: a randomized clinical trial. JAMA Otolaryngology–Head & Neck Surgery, 144(1), 28-35.
- Adriaensen, G. F., Lim, K. H., & Fokkens, W. J. (2017, August). Safety and efficacy of a bioabsorbable fluticasone propionate–eluting sinus dressing in postoperative management of endoscopic sinus surgery: a randomized clinical trial. In International forum of allergy & rhinology (Vol. 7, No. 8, pp. 813-820).
- Hoffman, V., Ia Topuria, K.M., Gawlicka, A.K., & Kallman, J.E. (2023): Reduction in healthcare resource use through 24 months following sinus surgery with steroid-eluting implants in chronic rhinosinusitis patients with and without nasal polyps: a real-world study, Current Medical Research and Opinion, DOI: 10.1080/03007995.2023.2194776
- Forwith KD, Han JK, Stolovitzky JP, et al. RESOLVE: bioabsorbable steroid-eluting sinus implants for in-office treatment of recurrent sinonasal polyposis after sinus surgery: 6-month outcomes from a randomized, controlled, blinded study. Int Forum Allergy Rhinol. 2016;6:573–581.
