Corticosteroid-releasing bioabsorbable stent or spacer insertion during endoscopic sinus surgery for chronic rhinosinusitis

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 2 systematic reviews, 1 retrospective cohort study, 4 randomised controlled trials, 1 prospective cohort before-after study, 2 case reports and a report from the Food and Drug Administration Manufacturer and User Facility Device Experience registry. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: improved quality of life; symptomatic improvement; endoscopic improvement of oedema, polyposis and adhesions; long‑term maintenance of sinus patency on clinical examination; and the need for postoperative intervention.

The professional experts and the committee considered the key safety outcomes to be: infection, and stent migration or expulsion.

A submission was received from a patient organisation.

The committee noted that chronic rhinosinusitis can be a disabling condition. There may be some people who would particularly benefit from this procedure but more evidence is needed to identify how they should be selected.

There is more than 1 device available for this procedure.

The committee was informed that the type of endoscopic sinus surgery that is done is key to the success of the procedure.