Name of the Procedure:

Mometasone Furoate Sinus Implant Common names: Sinus stent, Drug-eluting sinus implant
Technical/medical term: Mometasone furoate sinus implant (HCPCS Code: J7401)

Summary

The mometasone furoate sinus implant is a small, dissolvable device inserted into the sinus cavities to deliver a corticosteroid, mometasone, directly to the sinus tissues. This helps reduce inflammation and aids in the healing process following sinus surgery or to treat chronic sinusitis.

Purpose

This procedure is primarily aimed at reducing sinus inflammation, relieving symptoms of chronic sinusitis, and promoting healing post-sinus surgery. The goals are to enhance sinus drainage, reduce the need for oral steroids, and manage sinus symptoms effectively.

Indications

• Chronic sinusitis unresponsive to standard treatments.
• Frequent sinus infections or inflammation.
• Post-operative care following sinus surgery to prevent recurrence of inflammation.
• Nasal polyps leading to recurrent sinus blockages.

Preparation

• Patients may be advised to fast for a few hours before the procedure if anesthesia is involved.
• Medication adjustments, such as pausing blood thinners, may be necessary.
• Pre-procedure diagnostic tests may include CT scans or nasal endoscopy to assess the sinus structures.

Procedure Description

1. Preparation: The patient is positioned comfortably, usually under local or general anesthesia depending on the case.
2. Access: A nasal endoscope is used to visualize the sinus cavities.
3. Insertion: The mometasone furoate sinus implant is placed in the targeted sinus passage using specialized tools.
4. Deployment: The implant expands to fit the cavity and releases the medication gradually.
5. Completion: The patient is monitored briefly post-procedure before discharge.

Duration

The procedure typically takes about 20-30 minutes.

Setting

This procedure is usually performed in an outpatient clinic, surgical center, or hospital setting.

Personnel

• Otolaryngologist (ENT specialist)
• Nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Common: Mild discomfort, nasal bleeding, irritation at the implant site.
• Rare: Allergic reactions, infection, migration of the implant, sinus blockage.

Benefits

• Reduction in sinus inflammation and symptoms.
• Decreased reliance on oral steroids.
• Improved sinus drainage and overall sinus health.
• Benefits typically become noticeable within a few days to weeks post-procedure.

Recovery

• Patients can usually go home the same day.
• Post-procedure instructions may include avoiding strenuous activities, nose blowing, and using saline sprays to keep nasal passages moist.
• Follow-up appointments are necessary to monitor progress and remove residual implant material if needed.
• Recovery time is generally short, with most patients resuming normal activities within a week.

Alternatives

• Medications: Oral or topical steroids, antibiotics, saline irrigation.
• Surgery: Traditional sinus surgery or balloon sinuplasty.
• Comparison: Alternatives may offer varying degrees of symptom relief and come with their own sets of risks and benefits.

Patient Experience

• During the procedure: Minimal discomfort if local anesthesia is used; sedation with general anesthesia.
• Post-procedure: Mild pain or pressure in the nasal area, which can be managed with pain relievers.
• Comfort measures: Ice packs and over-the-counter pain medications are often sufficient for managing discomfort.