Long-term effects of postoperative measures after sinus surgery

Area of Science:

• Otolaryngology
• Surgical Innovation
• Rhinology

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) and acute recurrent rhinosinusitis (ARR) significantly impact quality of life.
• Functional endoscopic sinus surgery (FESS) is a common treatment, but optimal postoperative care requires further investigation.

Purpose of the Study:

• To compare the long-term efficacy of different postoperative treatment regimens following FESS.
• To evaluate the impact of nasal packing and debridement on symptom resolution in CRSwNP and ARR patients.

Main Methods:

• A randomized controlled trial involving 121 patients undergoing their first FESS.
• Patients were assigned to postoperative nasal packing, saline irrigation, or debridement at 6 and 12 days.
• Symptom severity (nasal congestion, facial pain, smell, discharge, etc.) was assessed using Visual Analogue Scale (VAS) at baseline and 56 weeks.

Main Results:

• Patients with CRSwNP receiving debridement showed significantly greater improvement in nasal congestion (20 mm) and sneezing (18 mm) compared to saline irrigation (P=0.041, P=0.011).
• Nasal packing demonstrated positive but non-significant effects on symptom improvement.
• Debridement post-FESS led to significantly better long-term symptom improvement in CRSwNP patients than saline irrigation alone.

Conclusions:

• Postoperative debridement is a superior treatment strategy for CRSwNP patients following FESS, offering enhanced long-term symptom relief.
• Saline irrigation alone provides less effective symptom management for CRSwNP patients post-FESS.
• Further research may explore optimal timing and techniques for debridement in FESS recovery.