Summary

Advice

The technology described in this briefing is PROPEL. It is used to maintain patency of the ethmoid or frontal sinus opening after sinus surgery for chronic rhinosinusitis.
The innovative aspects are that it keeps the sinus open and delivers corticosteroids directly to the sinus mucosa while gradually dissolving.
The intended place in therapy would be as an alternative to topical corticosteroids and spacers or nasal packing in adults with chronic sinusitis after sinus surgery. The procedure used to insert PROPEL is covered by NICE's interventional procedures guidance on corticosteroid-eluting bioabsorbable stent or spacer insertion during endoscopic sinus surgery to treat chronic rhinosinusitis, which recommends that corticosteroid‑eluting bioabsorbable stents or spacers should only be used with special arrangements for clinical governance, consent, and audit or research.
The main points from the evidence summarised in this briefing are from 3 randomised studies including a total of 266 adult patients in surgical centres in the US. They show that PROPEL is more effective than a stent alone in people with chronic rhinosinusitis who have had sinus surgery.
Key uncertainties around the evidence or technology are that all the evidence is from the US, and the comparators are limited and do not fully reflect treatments available in the NHS.
Safety issues identified are fungal infections and the stents migrating or being expelled after placement.
The cost of PROPEL is £580 per unit (excluding VAT). The resource impact would be greater than standard care, which is around £60 (excluding VAT).