title: Pilot study using doxycycline-releasing stents to ameliorate postoperative healing quality after sinus surgery.
abstract: Poor postoperative healing after sinus surgery is associated with high concentrations of matrix metalloproteinase-9 (MMP-9). The frontal recess is especially vulnerable to restenosis, and frontal sinus stents have been used to overcome this problem. However, the long-term success rate is still controversial and may be poor. In this perspective, we developed doxycycline (DC)-releasing stents, delivering the MMP-9 synthesis-suppressing agent locally to the frontal recess area. We evaluated postoperative MMP-9 levels, bacterial colonization, healing quality, and symptom scores in patients suffering from chronic rhinosinusitis with (CRSwNP) and without nasal polyposis (CRSsNP) (n=10) who underwent functional endoscopic sinus surgery during which the DC-releasing and placebo stents were placed. We found that MMP-9 concentrations were significantly lower at the side of the DC-releasing stent (3,414+/-582 ng/mL) compared with the contralateral placebo stent (9,172+/-2,564 ng/mL) (p<0.05) at month 3 postsurgery. DC stents adequately suppressed bacterial growth compared with placebo stents. Furthermore, the visual analog scale (VAS) for the frontal region was significantly better (mean value 75.1 vs. 52.8, p<0.001) compared with its placebo counterpart. We conclude that compared with placebo stents, DC-releasing stents significantly lowered MMP-9 concentrations and bacterial colonization locally, and improved postoperative healing quality after functional endoscopic sinus surgery, as demonstrated by visual analog scale and ostial closure.
authors.affiliation: Upper Airway Research Laboratory (URL), ENT-Department, Ghent University Hospital, Ghent, Belgium. Wouter.Huvenne@UGent.be
authors.forename: Wouter
authors.initials: W
authors.lastname: Huvenne
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Edze
authors.initials: E
authors.lastname: Tijsma
authors.forename: Britt
authors.initials: B
authors.lastname: Hissong
authors.forename: Judtih
authors.initials: J
authors.lastname: Huurdeman
authors.forename: Gabriele
authors.initials: G
authors.lastname: Holtappels
authors.forename: Sofie
authors.initials: S
authors.lastname: Claeys
authors.forename: Paul
authors.initials: P
authors.lastname: Van Cauwenberge
authors.forename: Hans
authors.initials: H
authors.lastname: Nelis
authors.forename: Tom
authors.initials: T
authors.lastname: Coenye
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
mesh_terms: D000328:Adult; D004318:Doxycycline / Q000008:administration & dosage*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D004318:Doxycycline