Bioabsorbable steroid-eluting implants for mucosal graft fixation in Draf III frontal sinus surgery.

OBJECTIVES

The modified endoscopic Lothrop (Draf III) procedure requires reliable mucosal coverage of the exposed bone within the frontal neo-ostium to prevent post-operative restenosis. Free mucosal grafts are effective but difficult to secure due to limited access and absent anchoring sites. We describe a novel use of bioabsorbable steroid-eluting implants as a pragmatic approach to achieve mucosal graft fixation.

METHODS

Following completion of a Draf III frontal sinusotomy, a PROPEL™ implant is deployed over a free mucosal graft within the frontal neo-ostium. Endoscopic assessment is performed at standard post-operative intervals.

RESULTS

In our experience, the technique provides mechanical stabilisation and local steroid delivery and is associated with visually satisfactory graft apposition and mucosalisation in the post-operative period.

CONCLUSION

The use of bioabsorbable steroid-eluting implants offers a practical and complementary endoscopic adjunct in patients undergoing Draf III frontal sinus surgery, supporting graft fixation and contributing to improved long-term neo-ostium patency.