By Sara Browning
Increasing numbers of patients who live
with chronic sinusitis are turning to the Propel® implant to relieve
acute sinus symptoms and improve outcomes for sinus surgery.
For
the 35 to 40 million patients who suffer from chronic sinusitis, The
Propel (mometasone furoate) implant can be a breakthrough tool in
achieving relief from symptoms and a pathway to an increased quality of
living. For otolaryngologists, Ira D. Uretzky, MD and James A. Geraghty,
MD, at Peoria Ear, Nose & Throat Group, commonly known as Peoria
ENT, it is a medical breakthrough in sinus technology.
“This
product is the real thing,” says Dr. Uretzky. “The level of clinical
evidence is unparalleled in the management of chronic sinusitis; quite
simply this is a wonderful product —
absolutely amazing.”
Peoria ENT, a team of board-certified medical experts with a mission to
provide patients the highest quality of care, was among the first to
begin using the implant when it came to the forefront in October 2012.
“Peoria ENT was one of the first practices to begin making use of this
device outside of the academic centers where it was being used and
tested,” according to Dr. Geraghty. “At Peoria ENT, when we decide
whether to use a product on our patients, we look at: What will allow us
to do something better and with safer results? Propel met both these
criteria.”
Introducing Propel
Propel’s popularity among otolaryngologists and patients alike is based
in its ability to provide substantial relief for chronic sinusitis
patients following surgery. Chronic sinusitis occurs when sinus pathways
become inflamed and swollen and cause blockage and infections in the
nasal area. Chronic sinusitis may be caused by growths in the sinuses,
such as nasal polyps, or by a deviated nasal septum. Symptoms include
difficulty breathing and swelling around the eyes, cheeks, nose and
forehead as well as facial pain and headache. Such symptoms can
significantly interfere with patients’ quality of life, affecting their
work, sleep, daily activities and personal relationships.
Before
the Propel implant was introduced, surgeons attempted a variety of
methods to combat chronic sinusitis symptoms. “Surgeons tried inserting
dissolvable sponges, non-dissolvable sponges, even products similar to
seaweed into the sinus pathways. But these attempts were the results of
individual surgeons trying to figure out for themselves what works,”
says Dr. Geraghty. “This was a hodgepodge of what might work rather than
what we know helps.”
Many patients choose to undergo endoscopic
sinus surgery (ESS) to remove obstructions, such as nasal polyps, that
block the sinus passageways and obstruct air flow. But patients do not
always experience successful surgical outcomes. Some report recurrent
symptoms within the first year following surgery due to scar formation
or new polyp growth. As a result, as much as 25 percent of patients
undergo revision surgery as the sinus cavity becomes obstructed once
again.
Fortunately for chronic sinusitis sufferers, the Propel
implant has been proven to effectively reduce the need for revision
surgery and to strengthen surgical outcomes, ensuring the longevity of
surgical results. The Propel implant has been studied in three
prospective clinical trials conducted in the country, the first of which
received the 2010 Maurice Cottle Research Award from the American
Rhinologic Society in recognition of the study’s best use of clinical
science. The studies, enlisting 205 patients, analyzed safety,
endoscopic outcomes and patient symptoms.
“This product is at
the forefront of sinus surgery. It has been approved by the FDA as real,
evidence-based medicine. The Propel implant is the only sinus surgery
product supported by Level 1-A clinical evidence to improve sinus
surgery outcomes for chronic sinusitis patients,” says Dr. Uretzky.
“Level 1-A evidence is the best you can get!”
Inserting the Propel Implant
At the conclusion of sinus surgery, the Propel implant is inserted
into the sinus opening. “The implant has a spring-like mechanism to help
prevent the sinus opening from closing,” Dr. Uretzky explains. “The
spring-like action holds the sinus area open until it stabilizes while
the implant itself, which is made from a polymer coated with mometasone
(a corticosteroid) dissolves over a six-week period following insertion.
As the implant dissolves, it releases a localized, controlled delivery
of a low-dose steroid directly to the sinus tissue to maintain the
openings created during surgery and to prevent scar formation or polyp
regrowth.”
According to Dr. Geraghty, the model for the Propel
sinus implant is borrowed from the technology used in cardiac stents
that widen the heart vessels and maintain blood flow. Just as stents
release medication for patients with clogged arteries, the Propel
implant holds open the sinus and delivers anti-inflammatory medication,
maintaining the opening of the sinus pathway long after surgery is
complete.
Life-Changing Surgery
According
to Dr. Geraghty: “In theory, any individual who lives with chronic
sinusitis or nasal polyps is a candidate for the Propel implant.”
Marelyn Credi, a Peoria ENT patient, underwent endoscopic sinus
surgery in November 2013 to alleviate chronic sinusitis symptoms that
she says she had been battling for over two decades. “I had been having
sinus infections for twenty-plus years every month or every other
month,” she says. “I was always sick, tired, or not feeling well, and it
seemed to progressively get worse. This last year had been the worst
for me.”
After undergoing endoscopic sinus surgery and receiving
the Propel implant, Marelyn is breathing easier. “The implant really
helped keep my sinuses open. I can breathe so much better. My breathing
is amazing! I can’t even remember the last time I could breathe like
this.”
Marelyn felt very little apprehension about the surgery,
thanks to Dr. Uretzky. “Dr. Uretzky explained the surgery beforehand and
told me what would happen, so I really didn’t need to ask a lot of
questions. He’s really up to date on all the new technology. And the
staff is great! The people at Peoria ENT are all very caring.”
Having
noticed a significant change in her life, Marelyn is now enjoying daily
activities symptom-free. “I would highly recommend this surgery to
others. Instead of feeling sick all the time and in constant pain from
infection, I feel good again!”
Statistically, patients who use
Propel have shown a significant decrease in the amount of additional
medications and recurrent surgical procedures (35 percent less than
patients who do not use the implant). Additionally, patients’ need for
oral steroid intervention decreased by 40 percent, and regrowth of
polyps in the sinus pathway decreased by 46 percent. Dr. Uretzky gives
his highest recommendation for the Propel implant. “I was impressed with
the attention to detail and the level of research and testing that went
into this product. This is a well-researched FDA-approved product.”
But the primary concern for otolaryngologists at Peoria ENT is that
patients feel better using Propel. “This is a device with a proven
success rate,” says Dr. Geraghty. “It’s safe for patients with less
scarring and less need for additional surgery. We have not seen any
complications or downside to the Propel implant so far. In terms of
complete patient care and advanced technology, it’s what we’ve been
waiting for.”
Dr. James Geraghty is
Board-certified by the American Board of Otolaryngology and a Fellow of
both The American College of Surgeons and The American Academy of
Otolaryngology – Head and Neck Surgery. He is a Diplomat of the
prestigious National Board of Medical Examiners and a member of the
American Rhinologic Society. Dr. Geraghty is a Clinical Assistant
Professor of Surgery at the University of Illinois College of Medicine –
Peoria. He completed his residency at the University of Illinois
College of Medicine – Chicago in the Department of Otolaryngology – Head
and Neck Surgery.
Dr. Ira Uretzky is
board-certified by the American Board of Otolaryngology and a Fellow of
the American Academy of Otolaryngology – Head and Neck Surgery, Fellow,
American Academy of Facial Plastic and Reconstructive Surgery, Fellow,
American College of Surgeons and a Member, American Academy of
Otolaryngologic Allergy. He is a Diplomat of the American Board of
Otolaryngology. Dr. Uretzky graduated from The George Washington
University School of Medicine and completed his residency at the
Uniformed Services University of the Health Sciences, Walter Reed Army
Medical Center. Additionally, Dr. Uretzky currently serves as an
Assistant Clinical Professor, Department of Otolaryngology at the SIU School of Medicine.
For more information on Peoria ENT, visit www.peoriaent.com or call 309-589-5900. Peoria ENT is located at 7301 North Knoxville, Peoria, IL 61614.