Enhanced Evaluation of Bioresorbable Steroid-Releasing Stents and Corticosteroid-Infused Nasal Dressings in Postoperative Management of Chronic Rhinosinusitis
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Introduction: Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition of the nasal and paranasal mucosa that significantly impacts quality of life. Postoperative inflammation and polyp recurrence remain common despite advances in endoscopic sinus surgery (ESS), prompting interest in localized corticosteroid delivery systems. Methods: This review analyzes bioresorbable steroid-releasing implants and corticosteroid- impregnated nasal dressings, focusing on their pharmacologic mechanisms, safety, and clinical outcomes. A synthesis of findings from randomized trials and observational studies was performed, with emphasis on devices such as Propel™, NasoPore, Merocel, SinuBand FP, and gel-based dressings. Results: The Propel implant demonstrated robust evidence for reducing adhesions and inflammation with negligible systemic absorption. NasoPore and Merocel provided structural support and localized steroid delivery but lacked controlled-release kinetics. Gel-based dressings and SinuBand FP offered anatomic adaptability, with limited systemic effects. Some methods showed systemic steroid exposure in cortisol monitoring. Conclusion: Corticosteroid-releasing devices enhance ESS outcomes through localized therapy. While Propel is the most validated, other devices remain viable alternatives in specific clinical contexts. Comprehensive safety monitoring and standardized trials are essential to optimize their integration into postoperative care.