To evaluate the efficacy and prognosis of modified Draf 2b frontal sinusotomy combined with drug-eluting stents in the treatment of refractory sinusitis.

Patients who were diagnosed with refractory sinusitis and underwent surgical treatment at the Department of Otorhinolaryngology Head and Neck Surgery, Huai’an Hospital Affiliated to Xuzhou Medical University from April 2022 to April 2024 were enrolled. The patients were divided into 3 groups (n=50 each): traditional surgery group (receiving standard functional endoscopic sinus surgery), control group (receiving modified Draf 2b frontal sinusotomy), and experimental group (receiving modified Draf 2b frontal sinusotomy with glucocorticoid-eluting sinus stents implanted at the frontal sinus ostium). Patients’ general data were collected. Repeated-measures ANOVA, chi-square tests, and ANOVA were used to compare nasal cavity volume, frontal sinus ostium cysts/polyps, Sinonasal Outcome Test-20 (SNOT-20) scores, symptom improvement, recurrence rates, and patient satisfaction at different time points (preoperatively and 1 week, 1 month, 6 months, and 1 year postoperatively).

After one-year follow-up, significant hierarchical differences in postoperative efficacy were observed among the three groups. The experimental group exhibited a lower recurrence rate compared to the control and traditional surgery groups (χ²=18.250, P<0.001). At 6 months and 1 year postoperatively, statistically significant differences were observed among the three groups in nasal cavity volume (χ²=18.200, P<0.001; χ²=21.692, P<0.001), SNOT-20 scores (χ²=135.710, P<0.001; χ²=101.260, P<0.001), and frontal sinus ostium cysts/polyps (χ²=21.692, P<0.001; χ²=24.009, P<0.001).

The modified Draf 2b frontal sinusotomy combined with drug-eluting stents demonstrates significant clinical benefits in refractory sinusitis, effectively improving nasal obstruction, headaches, nasal cavity volume, and frontal sinus ostium pathology while reducing recurrence rates.