Q: I had sinus surgery many years ago but it failed. Why would I consider it now?
A: The most common reasons for failure after endoscopic sinus surgery include residual disease, nasal polyps and scarring. Sometimes, patients have had conservative surgery and simply need their sinuses to be opened up more widely. Others have had narrowing of the sinuses develop due to recurrence of nasal polyps or scar tissue narrowing the surgical openings. The most common place for trouble is the hourglass-shaped opening of the frontal sinus. After a thorough cleaning, we will often implant a steroid-eluting stent to keep the sinus open and to provide a sustained local concentration of the anti-inflammatory drug mometasone. The new Propel Contour implant was designed specifically for this purpose. A randomized clinical trial reported in the AMA journal of Otolaryngology that placement of the Contour stent following frontal sinus surgery resulted in significantly larger openings and fewer postoperative surgical interventions compared to similar surgery on the opposite side of the same patients.