Repeated early debridement does not provide significant symptomatic benefit after ESS

Postoperative debridement is considered essential after endoscopic sinus surgery (ESS), however, its effect on postoperative symptoms is largely unexplored.

In the present study 90 patients undergoing ESS were randomized to debridement of the nasal cavities either three times during the first postoperative week (intervention group), or once on the 7th postoperative day (control group). Postoperative saline douching was used in both groups. The primary outcome measure was the postoperative Lund-MacKay Symptom Score.

The patients in the intervention group reported less severe symptoms on all domains of the Lund-MacKay Score compared with the patients in the control group both at one and four weeks. The difference between the groups was statistically significant in discharge at one week (4.1 +/- 2.3 in the intervention group and 5.4 +/- 2.6 in the control group, p = 0.0025). At four weeks, significantly fewer nasal cavities presented with nasal secretions in the intervention group compared with the control group (14/84 vs. 38/93).

Repeated debridement during the first postoperative week produced minor symptomatic benefit in patients recovering from ESS. Therefore, in terms of subjective recovery and health care costs repeated debridement is not justified during the first postoperative week after ESS.