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Published on: June 20, 2018
The microdébrider and its complications in endoscopic surgery for nasal polyposis
Mustafa Cenk Ecevit1, Semih Sutay, Taner Kemal Erdag
1Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. cenk.ecevit@deu.edu.tr
Objective:
The aim of this study was to assess the rate of complications of the microdébrider in endoscopic sinus surgery (ESS) for nasal polyposis.
Study Design And Setting:
A retrospective study was done on the complications occurring during ESS for nasal polyposis and chronic rhinosinusitis (CRS) without nasal polyps in which a microdébrider had been used on 275 sides of 139 patients in a tertiary university practice setting.
Results:
The mean sinus opacification scores in computed tomography, according to the Lund-Mackay staging system, were 9.2 +/- 2.28 for the nasal polyposis group and 4.8 +/- 1.54 for the CRS group. There was one major complication, a cerebrospinal fistula that was repaired during the surgery. The minor and major complication rates for the nasal polyposis group were 11.8% and 0.5%, respectively. The minor complication rate for the CRS group was 4%.
Conclusion:
Knowledge of endonasal anatomy, surgical experience, a bloodless operating field, and being careful about every colour change during the operation are the fundamental essentials for lowering the complication rate. With its lower incidence of complications, even in high-risk cases such as nasal polyposis, a microdébrider provides acceptable complication rates in ESS. Also, the severity of the disease is the main determining factor for the final complication rate.
Insights
The microdébrider is a safe tool for endoscopic sinus surgery (ESS), even for nasal polyposis. This study found acceptable complication rates, with disease severity being a key factor in outcomes.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Endoscopic sinus surgery (ESS) is a common treatment for chronic rhinosinusitis (CRS) and nasal polyposis.
- The microdébrider is an instrument increasingly used in ESS to improve surgical outcomes.
- Assessing the complication rate of the microdébrider is crucial for patient safety and surgical technique refinement.
Purpose of the Study:
- To evaluate the complication rate associated with microdébrider use in endoscopic sinus surgery (ESS).
- To compare complication rates between patients with nasal polyposis and those with chronic rhinosinusitis (CRS) without nasal polyps undergoing ESS with a microdébrider.
Main Methods:
- A retrospective study analyzed complications from 275 ESS procedures using a microdébrider in 139 patients.
- Patients included those with nasal polyposis and CRS without nasal polyps.
- Complication rates were calculated for both patient groups.
Main Results:
- The nasal polyposis group had mean Lund-Mackay scores of 9.2 ± 2.28, while the CRS group had scores of 4.8 ± 1.54.
- One major complication (cerebrospinal fistula) occurred, with a major complication rate of 0.5% in the nasal polyposis group.
- Minor complication rates were 11.8% for nasal polyposis and 4% for CRS.
Conclusions:
- Microdébrider use in ESS is associated with acceptable complication rates, even in high-risk cases like nasal polyposis.
- Key factors for reducing complications include anatomical knowledge, surgical experience, maintaining a bloodless field, and careful observation.
- Disease severity is the primary determinant of the overall complication rate in ESS.
