Conventional versus Microdebrider Assisted Endoscopic Sinus Surgery for Sinonasal Polyposis - A Comparative Study

摘要

BACKGROUND : Sinonasal polyposis is frequently encountered in rhinology practice and has a significant effect on the quality of life. Functional Endoscopic Sinus Surgery with conventional instruments or powered tools is the modality of choice. The objective of our study was to compare the efficacy of microdebrider assisted endoscopic sinus surgery versus conventional instruments and to assess the intraoperative and postoperative outcomes in both methods. METHODS : A prospective study was conducted on 50 patients with bilateral sinonasal polyposis of which 25 patients underwent conventional polypectomy and the rest 25 patients underwent microdebrider assisted endoscopic polypectomy. The study aimed at comparing the intraoperative (blood loss, duration of surgery) and post operative results (postoperative pain, symptoms, scarring, synechiae formation, polyp recurrence) and the data was statistically analysed. RESULTS : Paired t test was used for statistical analysis of the data obtained. The intraoperative mean blood loss and duration of surgery were significantly higher in the conventional group (p-value <0.001) as compared to microdebrider group. Postoperative pain in both groups were compared and was significantly higher in the conventional group (p-value<0.001). Scarring, synechiae formation and recurrence of polyps were significantly higher in the conventional group in our follow up period of 6 months, however results were not statistically significant. CONCLUSION : Microdebrider assisted polypectomy is precise, relatively bloodless surgery, with cutting and suction in a single tool making the duration of surgery shorter with minimal trauma and thus offers better intraoperative and postoperative outcomes and better therapeutic results in comparison to endoscopic sinus surgery using conventional instruments.