Comparative study of conventional versus microdebrider assisted endoscopic sinus surgery in sinonasal polyposis

Abstract

<p class="abstract"><strong>Background:</strong> Functional endoscopic sinus surgery, conventional or with powered instruments is the standard surgical modality in sinonasal polyposis refractive to medical therapy. The recent modality, microdebrider assisted endoscopic sinus surgery offers better therapeutic approach for patients when compared to endoscopic sinus surgery with the conventional instruments. The objective was to evaluate the utility of microdebrider in endoscopic sinus surgery versus conventional instruments and to compare the intraoperative and postoperative results in both the methods.</p><p class="abstract"><strong>Methods:</strong> A prospective, randomized, comparative study was conducted on 30 patients with bilateral sinonasal polyposis. The subjects were selected by applying all the inclusion and exclusion criteria and divided into two groups i.e. the right and left side of nose were operated and compared for efficacy of microdebrider and conventional instruments. Each patient served as his or her own control. This study emphasizes the utility of microdebrider. It compares the intraoperative and postoperative results in the conventional and microdebrider assisted endoscopic sinus surgery.  </p><p class="abstract"><strong>Results:</strong> The intraoperative mean blood loss and duration of surgery were significantly higher in the conventional group (p-value &lt;0.001) as compared to microdebrider group. Postoperative symptom and endoscopy scores (discharge, scarring, crusting and polyp recurrence) were significantly higher in the conventional group (p-value &lt;0.001) as compared to the microdebrider group in 6 months follow up.</p><strong>Conclusions:</strong> Microdebriders are more effective as compared to conventional endoscopic sinus surgery due to lesser intraoperative bleeding (relatively bloodless) and duration of surgery, better postoperative endoscopic and symptom scores, combine cutting and suction  in a single  tool, enabling accurate and precise tissue removal without damaging the surrounding mucosa , less scarring/synechiae, fewer complications.