The dragonfly splint : a new disposable device designed to prevent both medial and lateral turbinate synechiae after sinonasal surgery

Periturbinal adhesions are among the most frequent and challenging complications of sinonasal surgery. Endonasal paraseptal splints have proved to be very efficient in preventing medial synechiae, that is, adhesions located between the medial faces of the middle/inferior turbinates and the septum. However, none of these devices for guiding mucosal healing can prevent lateral synechiae (adhesions between the lateral face of the middle turbinate and the lateral nasal wall) inside the middle meatal cleft, which is a very critical area for the physiology of the anterior sinus system. For this reason, if followed by the formation of lateral synechiae, the surgical maneuvers used to treat sinus diseases could paradoxically become a cause of persistent functional impairment and lead to iatrogenic sinusitis or mucocele. We describe our preliminary experience with a new endonasal splint called Dragonfly (because of its shape), which has been designed to prevent both medial and lateral postsurgical synechiae. This device has a long lateral wing designed to separate the mucosal surfaces of the middle meatal/ethmoid cavities and prevent adhesions during the postoperative process of healing. The device must be kept in situ for 3 to 4 weeks to permit the re-epithelialization of the internal nasal surfaces. Our experience shows that the splints are well tolerated and highly efficient, preventing both medial and lateral synechiae in 100% of cases. A randomized controlled study has now been started to confirm these positive preliminary findings in a larger patient population.