Chinese expert consensus on evidence-based use of steroid-eluting sinus stents in chronic rhinosinusitis management

Chronic rhinosinusitis, with or without nasal polyps, severely impairs the quality of life and imposes heavy economic costs. Standard care, including intranasal corticosteroids and endoscopic sinus surgery, is limited by poor drug penetration into narrow recesses and high rates of postoperative restenosis and recurrence. Biodegradable steroid-eluting stents provide sustained, targeted corticosteroid delivery directly to diseased mucosa. It has been 8 years since the first fully biodegradable steroid-eluting stent was approved for the treatment of chronic rhinosinusitis in China. In clinical practice, the standardized application of the stent calls for guidance based on high-quality evidence, while its real-world use continues to broaden the exploration of its clinical utility. To standardize the clinical use of sinus stents, experts from the Rhinology Group, National Medical Quality Control Center of Otorhinolaryngology (China), convened to establish this consensus based on current clinical evidence. An analysis of 13 randomized controlled trials (2011–2025) demonstrated that these devices significantly reduced polyp formation, eosinophilic inflammation, adhesions, and the need for revision surgery or systemic steroids, while maintaining frontal-sinus patency. Office-based implantation effectively manages recurrent polyposis. Safety data demonstrated minimal systemic exposure and a rare incidence of serious adverse events. Its optimal use was reported in refractory chronic rhinosinusitis with nasal polyps (guided by T2/eosinophilic endotype), high-risk ostial stenosis, and early postoperative care to prevent middle-turbinate lateralization. Although long-term efficacy and cost-effectiveness remain variable, steroid-eluting stents integrate surgical and pharmacologic strategies for achieving durable disease control.