BlueCross BlueShield of Tennessee Medical Policy Manual

Steroid-Eluting and Non-Steroid-Eluting Sinus Stents


Steroid-eluting sinus stents are devices used postoperatively following endoscopic sinus surgery (ESS) or for treatment of recurrent sinonasal polyposis following ESS. These devices (e.g., PROPEL®, PROPEL® mini, PROPEL® Contour, Sinuva™) are proposed to maintain patency of the sinus openings and/or serve as a local drug delivery vehicle. Reducing postoperative inflammation and maintaining patency of the sinuses may be important in achieving optimal sinus drainage and may impact recovery from surgery and/or reduce the need for additional surgery.  Standard management includes topical steroid, packing and irrigation.







Long-term studies for drug-eluting sinus implants are limited, and the results of comparative studies are conflicting. The evidence for implantable drug-eluting sinus stents in those individuals that experience recurrent sinonasal polyposis is scant, and the risk of bias is very high due to unblinded outcome assessment.



American Academy of Otolaryngology – Head & Neck Surgery. (2015, September). Position Statement: The use of biomaterials in sinonasal procedures. Retrieved June 12, 2017 from

BlueCross BlueShield Association. Evidence Positioning System. (3:2019). Steroid-eluting sinus stents. (7.01.134). Retrieved May 22, 2019 from  (16 articles and/or guidelines reviewed)

ECRI Institute. Health Technology Assessment Information Service. Emerging Technology Evidence Report. (2012, December; last updated March 2017). Steroid-eluting sinus implants (Propel and Propel mini) for maintaining patency after sinus surgery. Retrieved June 12, 2017 from ECRI Institute. (92 articles and/or guidelines reviewed)

Forwith, K. D., Han, J. K., Stolovitzky, J. P., Yen, D. M., Chandra, R. K., Karanfilov, B., Matheny, K. E. (2016). RESOLVE: bioabsorbable steroid-eluting sinus implants for in-office treatment of recurrent sinonasal polyposis after sinus surgery: 6-month outcomes from a randomized, controlled, blinded study. International Forum of Allergy & Rhinology, 6 (6), 573-581. Abstract retrieved October 20, 2016 from PubMed database.

Luong, A., Ow, R.A., Singh, A., Weiss, R.L., Han, J.K., Gerencer, R., et al. (2018). Safety and effectiveness of a bioabsorbable steroid-releasing implant for the paranasal sinus ostia - a randomized clinical trial. JAMA Otololaryngology - Head & Neck Surgery, 144 (1), 28-35. (Level 2 evidence)

Massey, C.J., Suh, J.D., Tessema, B., Gray, S.T., & Singh, A. (2016). Biomaterials in rhinology. Otolaryngology - Head and Neck Surgery, 154 (4), 606-617. Abstract retrieved June 8, 2018 from PubMed database.

National Institute for Health and Clinical Excellence. (2016, March). Interventional procedural guidance: Corticosteroid-eluting bioabsorbable stent or spacer insertion during endoscopic sinus surgery to treat chronic rhinosinusitis. Retrieved October 20, 2016 from

Sedaghat, A.R. (2017). Chronic rhinosinusitis. American Family Physician, 96 (8), 500-506. (Level 2 evidence)

Smith, T. L., Singh, A., Luong, A., Ow, R. A., Shotts, S. D., Sautter, N. B., et al. (2016). Randomized controlled trial of a bioabsorbable steroid-releasing implant in the frontal sinus opening. Laryngoscope, 126 (12), 2659-2664. Abstract retrieved June 8, 2018 from PubMed database.

U. S. Food and Drug Administration. (2011, August). Center for Devices and Radiological Health. Premarket approval decision P100044 (PROPEL™). Retrieved October 20, 2016 from

Winifred S. Hayes, Inc. Health Technology Brief. (2017, August; last update search August 2018). Propel and Propel mini bioabsorbable steroid-releasing sinus implants for treatment of chronic rhinosinusitis in adults. Retrieved May 22, 2019 from (43 articles and/or guidelines reviewed)


MOST RECENT REVIEW DATE:  8/8/2019         


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