药物洗脱支架在耳科手术中预防再狭窄的新应用。

IF 1.3 4区 医学 Q3 OTORHINOLARYNGOLOGY Annals of Otology Rhinology and Laryngology Pub Date : 2025-01-04 DOI:10.1177/00034894241312142
Daniel Karasik, Daniel E Killeen, Samantha Anne, Sarah E Mowry
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引用次数: 0

摘要

目的:本病例系列的主要目的是评估超说明书使用PROPEL药物洗脱支架的有效性,该支架传统上已获fda批准用于鼻窦手术,用于预防慢性耳科疾病或先天性异常患者的管成形术后再狭窄。该支架既提供机械支持以维持管道通畅,又提供局部类固醇递送以减少炎症和瘢痕形成。方法:4例患有不同耳科疾病的患者行外耳道成形术,并在外耳道内放置药物洗脱支架。置入支架以解决术后狭窄。通过定期随访评估临床结果,包括耳道通畅、听力改善和再狭窄率。结果:所有患者的耳道通畅程度均有改善,随访期间再狭窄发生率极低。4例患者中有3例报告听力改善。儿童病例表现出轻微的内侧管狭窄,尽管支架置入,但整体改善是值得注意的。没有不良反应与支架使用相关。结论:药物洗脱支架在成人管成形术中的说明书外使用似乎可以有效地降低再狭窄率并保持管通畅。进一步的研究是必要的,以标准化的协议和扩大其适应症的耳科手术,特别是在儿科情况下,结果可能会有所不同。
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Novel Use of Drug-eluting Stent in Otologic Surgery to Prevent Restenosis.

Objectives: The primary objective of this case series is to assess the effectiveness of the off-label use of the PROPEL drug-eluting stent, traditionally FDA-approved for sinus surgery, in preventing restenosis following canalplasty in patients with chronic otologic conditions or congenital anomalies. The stent provides both mechanical support to maintain canal patency and localized steroid delivery to reduce inflammation and scarring.

Methods: Four patients with various otologic conditions underwent canalplasty, followed by the placement of drug-eluting stents into the external auditory canal. The stents were inserted to address postoperative stenosis. Clinical outcomes, including ear canal patency, hearing improvement, and the rate of restenosis, were evaluated through regular follow-ups.

Results: All patients showed improved ear canal patency, with minimal restenosis observed during follow-up. Hearing improvement was reported in 3 out of 4 patients. The pediatric case exhibited mild medial canal stenosis despite stent placement, but overall improvement was noted. No adverse effects were associated with the stent usage.

Conclusions: The off-label use of a drug-eluting stent in canalplasty appears to reduce restenosis rates and maintain canal patency in adults effectively. Further research is warranted to standardize protocols and expand its indications for otologic surgery, particularly in pediatric cases where outcomes may vary.

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来源期刊
CiteScore
3.10
自引率
7.10%
发文量
171
审稿时长
4-8 weeks
期刊介绍: The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.
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