Steroid-eluting sinus implants in endoscopic sinus surgery: results of an Italian Nationwide Survey

Objective. To investigate current clinical practice patterns and perceptions regarding steroid-eluting sinus implants (SESIs) among Italian rhinologists.
Methods. A nationwide survey on SESIs use in endoscopic sinus surgery (ESS) was developed by an advisory board of 5 Italian experts from tertiary referral centres and distributed to rhinology surgeons across Italy. Of 145 invited physicians, 103 responded (71%). Three respondents without experience or interest in SESIs were excluded, leaving 100 participants for analysis.
Results. Among respondents, 46% were SESI Users and 54% Non-Users. SESIs were mainly used in revision ESS, frontal sinus surgery, and in patients with contraindications to systemic corticosteroids. Users valued SESIs for reducing restenosis and promoting controlled healing. In frontal sinus surgery, SESIs were commonly recommended in revision cases, especially for scarring-related restenosis. In ethmoid surgery, middle turbinate preservation influenced recommendations. Nonusers cited high costs, lack of reimbursement, and limited guideline clarity as the main barriers.
Conclusions. This survey shows marked variability in SESI adoption in Italy. While benefits are acknowledged in selected cases, economic and guideline-related issues limit wider use, highlighting the need for cost-effectiveness studies and national guidelines to better define the role of SESIs in ESS.