In October this year, a biodegradable intranasal stent has been placed in a patient with recurrent nasal polyposis for the first time at the Clinic of Ear, Nose and Throat Diseases at UMHAT "St. Marina"–Varna. This new medical product in Bulgaria is intended both for maintaining the openings of the sinuses after surgical intervention and for delivering medication locally. The medication is incorporated into the structure and material of the stent and is delivered slowly, in precisely defined small amounts, continuously and, most importantly, exactly where it is needed inside the sinuses after surgery.
The head of the Clinic of Ear, Nose and Throat Diseases at UMHAT "St. Marina"–Varna, Prof. Dr. Nikolay Sapundzhiev, clarifies that this method is suitable for combined treatment of chronic sinusitis and explains, "Mometasone furoate is delivered directly into the tissues of the sinus openings. Similar drug-eluting stents (DES) have been applied for many years to treat ischemic heart disease, in which they are placed in the coronary vessels through selective angiography."
Sinus implants are small, resorbable devices that are placed during or after sinus surgery. Their key advantages are: delivery of medication locally, biodegradable material and maintenance of the sinus opening - the implant serves as a dilator that physically supports the sinus openings after surgery, preventing adhesions and re-narrowing.
These implants are currently approved for use only in adult patients (18 years of age or older) who suffer from chronic sinusitis, nasal polyps, and are undergoing endoscopic sinus surgery. They help reduce inflammation and the risk of infection after surgery, prevent the formation of adhesions that can lead to recurrent sinus blockage, and improve overall recovery and surgical outcomes.
"The first patient to receive an intranasal stent at UMHAT "St. Marina"–Varna has been a very severe clinical case with Woakes' syndrome.
This is the most severe condition of nasal polyps.
Not only is the nasal cavity completely filled with polyps, preventing patients from breathing through their nose, but they also lose their sense of smell. The polyposis is so aggressive that it distorts the external nose, pushing out even its bones and generally deforming the nasal pyramid," elaborates Prof. Sapundzhiev.
This was the patient's fourth consecutive operation, and in this particular case, the specialists at the ENT Clinic conducted thorough preoperative preparation with imaging tests and treatment with medications. Regarding the intervention, Prof. Sapundzhiev explains, "We performed an endoscopic intervention with a microdebrider, and through this technique, we were able to remove the polyps from the nose and all paranasal sinuses in less than an hour, after which we applied innovative biodegradable intranasal stents with controlled delivery of medication locally."
The biodegradable intranasal stent, which provides new opportunities for treatment of patients with nasal polyps, is reimbursed by the National Health Insurance Fund, and the specialists at UMHAT "St. Marina"–Varna are fully prepared to apply this innovative technology in their daily practice.
