Corticosteroid-eluting bioabsorbable stent or spacer insertion during endoscopic sinus surgery to treat chronic rhinosinusitis

Current evidence on the safety of corticosteroid‑eluting bioabsorbable stent or spacer insertion during endoscopic sinus surgery to treat chronic rhinosinusitis raises no major safety concerns. The evidence on efficacy is limited; there is some evidence of improving sinus patency in the short term, but there is inadequate evidence on patient‑reported outcomes and quality of life. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.

Clinicians wishing to insert a corticosteroid‑eluting bioabsorbable stent or spacer during endoscopic sinus surgery to treat chronic rhinosinusitis should:

• Inform the clinical governance leads in their NHS trusts.

• Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In addition, the use of the information for the public is recommended.

• Audit and review clinical outcomes of all patients having a corticosteroid‑eluting stent or spacer inserted during endoscopic sinus surgery to treat chronic rhinosinusitis (see section 6.1).

NICE encourages further research on corticosteroid‑eluting bioabsorbable stent or spacer insertion during endoscopic sinus surgery and, specifically, controlled studies designed for between‑patient (rather than within‑patient) comparisons. Outcomes should include symptom scores, quality of life and the need for retreatment in the long term. All complications should be reported. NICE may update this guidance on publication of further evidence.