Safety and Efficacy of Frontal Sinus Stents: A Systematic Review

Abstract

Objectives:

Postsurgical stenosis of frontal sinus can be a challenging problem for the endoscopic sinus surgeon. Frontal sinus stents are often used in an attempt to maintain frontal outflow patency. The current study systematically reviews the literature to determine the safety and efficacy of frontal stents.

Methods:

The Pubmed, Google Scholar, and Cochrane databases were reviewed and studies evaluating the usage and reliability of frontal sinus stents were extracted based on defined inclusion criteria.

Results:

Eleven studies comprising a total of 192 patients met inclusion criteria and were evaluated for stent material, stenting duration, surgical techniques, patient outcomes, and complication. All studies were classified as level 4 evidence provided by the Oxford Center for Evidence Based Medicine. Multiple stent materials were used with varying duration. Complications were generally minor and included stent migration, pain, epistaxis, and infection. Frontal sinus patency following stent replacement varied from 71.4% to 100%, however, the efficacy of stent placement in maintaining frontal sinus patency could not be evaluated due to a lack of controlled studies.

Conclusions:

Current literature evaluating the use of frontal sinus stents is limited and comprised entirely of level 4 studies. The efficacy of frontal sinus stenting could not be accurately evaluated because of the small number of studies and variable outcome measures. Larger, high-quality studies are needed to support the use of stents in endoscopic surgery of frontal sinus.