J7402 Mometasone furoate sinus implant, (sinuva), 10 micrograms

Name of the Procedure:

Common Names: Mometasone furoate sinus implant, Sinuva.

Technical Term: Mometasone furoate sinus implant (J7402).

Summary

The Mometasone furoate sinus implant (Sinuva) is a tiny, drug-eluting device inserted into the sinus cavity to reduce inflammation and treat nasal polyps, which can cause congestion, loss of smell, and other sinus-related issues.

Purpose

Medical Conditions: Chronic rhinosinusitis with nasal polyps.

Goals/Outcomes: Reduce nasal polyps, decrease inflammation, restore normal breathing, and improve sense of smell.

Indications

Symptoms: Chronic nasal congestion, facial pain/pressure, loss of smell, nasal blockage, and persistent sinus infections.

Patient Criteria: Adults with recurrent nasal polyps despite previous medical or surgical therapy.

Preparation

• Pre-procedure Instructions: No special fasting is required. Patients may need to stop certain medications that can affect blood clotting.
• Diagnostic Tests: Nasal endoscopy or CT scans to assess sinus anatomy and extent of disease.

Procedure Description

1. Preparation: The nasal cavity is cleaned and prepared.
2. Insertion: Using endoscopic guidance, the physician places the Sinuva implant into the ethmoid sinus cavity.
3. Deployment: The implant expands upon placement, releasing mometasone furoate, a corticosteroid, directly to the sinus tissues.
4. Follow-Up: The implant gradually dissolves over a 90-day period, releasing medication continuously.

Tools/Equipment: Endoscope, Sinuva implant device.

Anesthesia: Generally performed under local anesthesia.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

This procedure is generally performed in an outpatient clinic or office setting.

Personnel

• Primary: Otolaryngologist (ENT specialist) or a trained physician.
• Support: Nursing staff for preparation and aftercare.

Risks and Complications

• Common: Mild nasal discomfort, nosebleeds (epistaxis).
• Rare: Implant displacement, local infection, or tissue overgrowth around the implant.

Benefits

• Expected Benefits: Significant reduction in nasal polyps, improved sinus airflow, reduced need for oral steroids or repeat surgeries.
• Realization Time: Benefits can be noticed within days to weeks of implantation.

Recovery

• Post-Procedure Care: Patients may use saline nasal sprays and avoid vigorous nose blowing.
• Recovery Time: Most patients resume normal activities immediately.
• Restrictions and Follow-Up: Follow-up visits one month post-procedure and thereafter as needed.

Alternatives

• Medications: Oral corticosteroids, other intranasal steroid sprays.

• Surgical Options: Endoscopic sinus surgery to remove polyps.

  Pros and Cons: The Sinuva implant provides targeted, sustained steroid delivery with fewer systemic effects compared to oral steroids and avoids the need for surgical intervention.

Patient Experience

• During Procedure: Mild discomfort from nasal endoscopy, minimal pain due to local anesthesia.
• After Procedure: Some nasal congestion or discomfort, usually mild and short-lived. Pain management includes over-the-counter analgesics if needed.