instead of inhalational agents helps keep bleeding to a minimum,
which limits the need to pack the nasal cavity after surgery and pro-
motes the faster recoveries needed in the office setting.
Patients love showing up for their procedures only 30 minutes
before they're scheduled. "We actually ask them to eat lunch before-
hand, so they don't get nauseous," says Dr. Perkins. "They're ready to
head home 15 to 20 minutes after surgery and are back to normal life
activity the next day."
Drug-eluting implants improve recoveries
The only FDA-approved drug-eluted implant for sinus surgery
contains the topical steroid mometasone. The implants are placed at
the time of surgery or during the early follow-up period in the frontal
and ethmoid sinuses. "The idea is to help with the healing of the cavity.
They stay in place for a month — they're bioabsorbable, but remnants
are removed at that time," says David Kennedy, MD, a rhinology pro-
fessor at in the department of otorhinolaryngology: head and neck
surgery at the University of Pennsylvania's Perelman School of
Medicine in Philadelphia, Pa.
The implants offer mechanical support, because when the ethmoid
sinus is opened, the middle turbinate can lateralize and close off the
area, says Dr. Kennedy. The implants also place mometasone right
where it's needed most. "It keeps the swelling under control," says Dr.
Kennedy. "These patients experience a great deal of post-op inflamma-
tion, and if you don't manage that properly, scar tissue and adhesions
will form."
Drug-eluting implants have been proven to reduce polypoid tissue
following surgery, reduce the number of post-op debridements and
improve patients' symptoms scores. "The hope is that they'll also
reduce disease recurrence, but that hasn't yet been proven," says Dr.
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