Effects of a dexamethasone-releasing stent on osteoneogenesis in a rabbit model.
BACKGROUND
This study is an evaluation of wound healing in an animal model for surgery of frontal sinusitis and treatment effect of topically released dexamethasone using a drug-releasing stent with special emphasis of osteoneogenesis.


METHODS
A prospective, controlled, randomized, double-blinded animal study was performed. Nineteen New Zealand white rabbits were subjected to surgery via an external approach, a 4-mm circular wound was created on the medial side of the maxillary sinus and the underlying bone was denuded of periosteum. The wound was covered in a randomized fashion with either a silicone foil or a new dexamethasone-releasing stent system. Twelve to 30 days later, the animals were killed and a histological examination was performed.


RESULTS
In comparison with the baseline bony thickness (40 micrometer) obtained in one animal, osteoneogenesis occurred on both paranasal sides but was significantly less if a dexamethasone-releasing stent was applied (117 [95% CI, 116-128]; 52 [95% CI, 43-64]; p < 0.001). Maximal bony thickness was observed in both treatment groups between days 20 and 25 with a tendency toward a higher percentage decrease in the dexamethasone-treated sides (p < 0.08). Using a visual analog scale (0-5) a significantly smoother bony surface was observed for dexamethasone (2 [95% CI, 1.1-1.9]; 2 [95% CI, 1.8-2.2]; p < 0.01).


CONCLUSIONS
Using a new drug-releasing stent system, dexamethasone efficiently decreases postoperative osteoneogenesis in a standardized animal wound model for endoscopic sinus surgery. Therefore, the use of this system may be of value to decrease restenosis rates using corticosteroids in selected patients after frontal sinus surgery, especially the endoscopic modified Lothrop procedure.
Beule
Achim G
AG
Department of Otorhinolaryngology, Head and Neck Surgery, University of Greifswald, Greifswald, Germany. achim.beule@uni-greifswald.de
Steinmeier
Elke
E
Kaftan
Holger
H
Biebler
Karl-Ernst
KE
Göpferich
Achim
A
Wolf
Eduard
E
Hosemann
Werner
W
D000818:Animals; D003907:Dexamethasone / Q000494:pharmacology*; D004195:Disease Models, Animal; D004322:Drainage / Q000295:instrumentation*; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D015522:Frontal Sinusitis / Q000473:pathology / Q000601:surgery*; D005938:Glucocorticoids / Q000494:pharmacology*; D008297:Male; D010012:Osteogenesis / Q000187:drug effects*; D010521:Periosteum / Q000187:drug effects / Q000473:pathology; D011446:Prospective Studies; D011817:Rabbits; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D005938:Glucocorticoids; D003907:Dexamethasone