Comparison of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

Open access

Abstract

OBJECTIVE. To study and compare the benefits of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery in terms of subjective and objective improvement in symptoms of nasal polyposis.

MATERIAL AND METHODS. This study involved 60 patients with bilateral sinonasal polyposis scheduled to undergo Endoscopic Sinus Surgery. The patients were randomized into two groups: Group A -Conventional endoscopic sinus surgery and Group B -Microdebrider-assisted endoscopic sinus surgery.

RESULTS. There was a significant difference in the mean VAS at 3 months postoperatively in Group B, but no significant difference at 6 months postoperatively following either of the two methods. The mean time for surgery (p<0.01) and the mean intraoperative blood loss (p<0.01) were significantly lower in Group B.

CONCLUSION. A well-trained surgeon with proper anatomical knowledge, good instruments, hypotensive anaesthesia, minimal mucosal injury and regular proper follow-up will have similar postoperative results with both methods.

1. Mygind N, Lund JV, Jones RJ. Nasal polyposis and surgical management of rhinosinusitis. In: Gleeson M, Browning GG, Burton JM, Clarke R, Hibbert J, Jones NS, et al. Scott and Brown’s Otorhinolaryngology: Head and neck surgery. 7th edition, volume 2. Edward Arnold Publishers Ltd; 2008, p.1549-50,1552-6,1480-1.

2. Davidson TM, Murphy C, Mitchell M, Smith C, Light M. Management of chronic sinusitis in cystic fibrosis. Laryngoscope. 1995;105(4 Pt 1):354-8.

3. Bachert C, Hörmann K, Mosges R, Rasp G, Riechelmann H, Muller R, et al. An update on the diagnosis and treatment of sinusitis and nasal polyposis. Allergy. 2003;58(3):176-91.

4. Nores JM, Avan P, Bonfils P. Medical management of nasal polyposis: a study in a series of 152 consecutive patients. Rhinology. 2003;41(2):97-102.

5. Marks SC. Endoscopic sinus surgery. In: Marks SC. Textbook on nasal and sinus surgery. W.B. Saunders Company; 2000, p.119,125-6,140-1.

6. Becker SS. Surgical management of polyps in the treatment of nasal airway obstruction. Otolaryngol Clin North Am. 2009;42(2):377-85, x. DOI: 10.1016/j.otc.2009.01.002.

7. Bruggers S, Sindwani R. Innovations in microdebrider technology and design. Otolaryngol Clin North Am. 2009;42(5):781-7, viii. DOI: 10.1016/j.otc.2009.07.003.

8. Bernstein JM, Lebowitz RA, Jacobs JB. Initial report on postoperative healing after endoscopic sinus surgery with the microdebrider. Otolaryngol Head Neck Surg. 1998;118(6):800-3.

9. Stammberger H. Functional endoscopic sinus surgery: The Messerklinger Technique. Mosby Inc; 1991.

10. Bettega S, Soccol AT, Koerner HN, Mocellin M. Epidemiological analisys in patients with nasal polyps. Int Arch Otorhinolaryngol. 2007;11(3):243-7.

11. Larsen K, Tos M. The estimated incidence of symptomatic nasal polyps. Acta Otolaryngol. 2002;122(2):179-82.

12. Saafan ME, Ragab SM, Albirmawy OA, Elsherif HS. Powered versus conventional endoscopic sinus surgery instruments in management of sinonasal polyposis. Eur Arch Otorhinolaryngol. 2013;270(1):149-55. DOI: 10.1007/s00405-012-1969-8. Epub 2012 Apr 10.

13. Ceylan K, Bayiz U, Kizilkaya Z, Lale O, Emir H, Unlu I, et al. Impact of microdebrider in surgical treatment of nasal polyposis in terms of health related quality of life and objective findings: A comparative randomized single blinded clinical study. KBB-Forum. 2007;6(2):60-5.

14. Krouse JH, Christmas DA Jr. Powered instrumentation in functional endoscopic sinus surgery. II: A comparative study. Ear Nose Throat J. 1996;75(1):42-4.

15. Singh R, Hazarika P, Nayak DR, Balakrishnan R, Gangwar N, Hazarika M. A comparison of microdebrider assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for nasal polypi. Indian J Otolaryngol Head Neck Surg. 2013;65(3):193-6. DOI: 10.1007/s12070-011-0332-5. Epub 2011 Nov 30.

16. Kumar N, Sindwani R. Bipolar microdebrider reduces intraoperative blood loss and operating time during nasal polyp surgery. Laryngoscope. 2009;119(S1):S143. DOI: 10.1002/lary.20459.

17. Selivanova O, Kuehnemund M, Mann WJ, Amedee RG. Comparison of conventional instruments and mechanical debriders for surgery of patients with chronic sinusitis. Am J Rhinol. 2003;17(4):197-202.

18. Setliff RC 3rd. The hummer: a remedy for apprehension in functional endoscopic sinus surgery. Otolaryngol Clin North Am. 1996;29(1):95-104.

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 52 52 29
PDF Downloads 38 38 18