How Does the PROPEL Sinus Implant Deliver Medication After Sinus Surgery?

How Does the PROPEL Implant Deliver Medication?

The PROPEL sinus implant contains 370 micrograms of mometasone furoate, a corticosteroid medication. The medication is incorporated into a bioabsorbable polymer matrix covering the implant.

After the implant is placed in a surgically opened sinus, the polymer gradually releases mometasone furoate to the surrounding sinus lining over approximately 30 days. At the same time, the implant’s self-expanding structure supports the healing tissues and helps maintain the opening created during surgery.

The implant’s structural material is designed to bioabsorb over approximately 30 to 45 days. It is not intended to remain permanently.

Why Might an Implant Be Used After Sinus Surgery?

Chronic sinusitis involves ongoing inflammation of the sinus lining. This inflammation may contribute to nasal congestion, facial pressure, drainage, postnasal drip, and a reduced sense of smell.

When appropriate medical treatment does not provide adequate relief, an ENT provider may discuss sinus surgery. Surgery may enlarge obstructed sinus openings and remove diseased tissue so the sinuses can ventilate and drain more effectively.

The healing period after surgery is important. Swelling, inflammation, adhesions, or scar tissue may narrow the treated area. Postoperative care therefore focuses on supporting healing, managing inflammation, and helping the surgically opened pathways remain patent, or open.

The PROPEL implant combines two functions:

• It provides temporary structural support to the surgically treated area.
• It delivers mometasone furoate directly to the surrounding sinus tissue.

The implant is an adjunct to sinus surgery and postoperative care. It does not replace the surgery itself, follow-up appointments, saline rinses, debridement, or other care recommended by the surgeon.

What Is the PROPEL Sinus Implant?

The PROPEL sinus implant is a small, self-expanding, bioabsorbable device placed under endoscopic visualization following sinus surgery.

Its open, spring-like structure is designed to:

• Support the surgically opened sinus cavity
• Separate surrounding healing tissues
• Help prevent obstruction caused by adhesions
• Deliver corticosteroid medication locally
• Allow mucus clearance and prescribed topical rinses to pass through the area

PROPEL is a drug-eluting implant, meaning that medication is gradually released from the device after placement.

What Medication Does PROPEL Release?

Each PROPEL implant contains 370 micrograms of mometasone furoate. Mometasone is a corticosteroid with anti-inflammatory activity.

Corticosteroids may reduce inflammatory activity in the sinus lining. With PROPEL, the medication is delivered directly to the nearby tissue rather than taken as an oral medication.

Local delivery does not mean that side effects are impossible. Patients should review the medication’s potential risks, their medical history, and any previous corticosteroid reactions with their surgeon.

How Is the Medication Released?

Mometasone furoate is embedded in a bioabsorbable polymer matrix on the implant. Once the device is placed against the sinus lining, the medication is gradually released into the surrounding tissue over approximately 30 days.

This approach is intended to provide medication at the surgical site during the early healing period.

The implant does not use a pump, battery, or electronic component. Medication release occurs through the design and composition of the polymer coating.

The implant is also designed to remain open rather than forming a solid barrier. This allows room for mucus clearance and postoperative saline rinses when they are recommended.

Where Can PROPEL Implants Be Placed?

PROPEL is a family of implants with different configurations for specific sinus locations. They should not be described simply as three interchangeable sizes.

Current manufacturer labeling identifies the following uses for patients 18 and older after sinus surgery:

• PROPEL: Intended for placement in the ethmoid sinus
• PROPEL Mini: Intended for the ethmoid sinus or frontal sinus opening
• PROPEL Contour: Intended for the frontal sinus ostium in patients with chronic rhinosinusitis

The appropriate configuration depends on which sinus was treated, the surgical anatomy, and the surgeon’s clinical judgment.

PROPEL Contour should not be described as indicated for the maxillary sinus under the current manufacturer labeling.

What Happens to the Implant After Placement?

The implant is bioabsorbable. Its structural backbone is designed to dissolve over approximately 30 to 45 days as the treated area heals.

A separate procedure is not generally required solely to remove the entire implant. However, postoperative care varies. The surgeon may perform routine debridement or remove portions of the implant when clinically appropriate.

Patients should continue attending scheduled follow-up visits so the surgeon can monitor healing, clear crusting or debris when necessary, and determine whether additional treatment is needed.

What Are the Potential Benefits?

For appropriate patients, PROPEL may help maintain the surgically opened space while delivering anti-inflammatory medication locally.

Clinical studies evaluated whether the implants reduced certain postoperative interventions, including:

• Surgical treatment of adhesions or scar tissue
• Use of oral corticosteroids for recurrent inflammation

Study findings supported reductions in specified postoperative interventions in the evaluated patients. However, individual results vary, and use of the implant does not guarantee that a patient will avoid scarring, inflammation, additional medication, or another procedure.

The potential benefit should be considered alongside the implant’s risks, the sinus location being treated, and the patient’s overall treatment plan.

Who May Be a Candidate?

PROPEL sinus implants are indicated for patients 18 years and older following sinus surgery in the specific sinus locations included in the product labeling.

An ENT surgeon may consider factors such as:

• The type and location of sinus disease
• Which sinuses are being treated
• The degree of inflammation
• The patient’s history of nasal polyps or scarring
• Previous sinus procedures
• Medication allergies or intolerances
• Pregnancy or nursing status
• The expected benefits and risks

Not every adult undergoing sinus surgery needs or qualifies for an implant. The surgeon can determine whether it may be appropriate for the individual procedure and anatomy.

Who Should Not Receive the Implant?

According to the manufacturer’s safety information, PROPEL sinus implants are contraindicated for patients with:

• Suspected or confirmed intolerance to mometasone furoate
• A known hypersensitivity to the implant’s bioabsorbable polymers

The safety and effectiveness of the implant have not been established in pediatric patients. They also have not been studied in pregnant or nursing patients.

Patients should provide their surgeon with a complete medical history, including medication reactions, allergies, pregnancy status, and previous sinus procedures.

What Are the Potential Risks?

Potential risks associated with PROPEL may include:

• Pain or pressure
• Implant displacement
• Nasal irritation or burning
• Nosebleeds
• Sinusitis
• Infection
• Crusting around the implant
• Headache
• Foreign-body response
• Possible side effects associated with intranasal mometasone furoate

Small implant fragments may occasionally move or be swallowed. Aspiration of a fragment is listed as a potential risk, although it was not observed in the referenced clinical trials.

The implant does not have antimicrobial properties, so it does not prevent or treat a bacterial infection.

This is not a complete list of possible risks. Patients should review the current instructions for use and discuss individual concerns with their ENT surgeon.

Does PROPEL Replace Other Postoperative Care?

No. The implant is one component of postoperative care.

Patients may still need:

• Saline sprays or rinses
• Follow-up endoscopic examinations
• Postoperative debridement
• Other prescribed medications
• Temporary activity restrictions
• Monitoring for infection, bleeding, or other complications

Following the surgeon’s instructions remains important even though the implant delivers medication locally and dissolves over time.

Questions to Ask Before Sinus Surgery

Patients considering sinus surgery may want to ask:

• Which sinuses need treatment?
• Is PROPEL indicated for the area being treated?
• Why might the implant be recommended in my case?
• What benefits may reasonably be expected?
• What are the potential risks?
• Will I still need nasal rinses or other medications?
• What follow-up care will be required?
• What symptoms should prompt a call after surgery?

Understanding the implant’s role can help patients make informed decisions about surgery and recovery.

Learn Whether a Sinus Implant May Be Appropriate

The PROPEL sinus implant provides temporary structural support while gradually releasing mometasone furoate to the surrounding sinus tissue after surgery. It may be appropriate for certain adults, but its use depends on the surgical location, individual anatomy, medical history, and the surgeon’s clinical judgment.

Schedule an appointment with New Braunfels Breathe Free to discuss persistent sinus symptoms, possible surgical treatment, and whether a steroid-releasing sinus implant may be appropriate.