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Prospective, randomised controlled trial comparing intense endoscopic cleaning versus minimal intervention in the

J M Fishman¹, S Sood, M Chaudhari

¹Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK. jfishman@doctors.org.uk

The Journal of Laryngology and Otology

|March 29, 2011

Abstract

Objective:

There is currently no standardised management protocol following functional endoscopic sinus surgery. This study assessed frequent endoscopic cleaning versus minimal intervention in the early post-operative period following such surgery.

Study Design:

Prospective, randomised controlled, single-blinded, within-subject trial involving 24 patients with bilateral chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery.

Main Outcome Measure:

The primary outcome measure was ethmoid cavity healing, based on endoscopic appearance, graded using a modified Lund-MacKay endoscopic score.

Secondary Outcome Measure:

Lund-MacKay symptom score before and after surgery.

Results:

There was no overall statistically significant difference between the two groups (p = 0.37). Subgroup analysis revealed a significant effect of regular suction clearance on adhesions at three months (p = 0.048), but not on oedema, polyps, granulation, discharge or crusting.

Conclusion:

There is no evidence from this study to support frequent endoscopic cleaning in the early post-operative period after functional endoscopic sinus surgery. Less intensive post-operative management is recommended, resulting in decreased patient morbidity and fewer post-operative follow-up appointments.

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