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The microdebrider, a step forward or an expensive gadget?

M E Cornet1, S M Reinartz, C Georgalas

  • 1Department of Otorhinolaryngology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands. m.e.cornet@amc.uva.nl

Rhinology
|May 23, 2012
PubMed
Summary

The microdebrider (shaver) significantly reduces operating time in endoscopic sinus surgery (FESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). It is also user-friendly and safe, with no impact on blood loss or healing.

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Area of Science:

  • Otolaryngology
  • Surgical Technology
  • Rhinology

Background:

  • Limited comparative data exists on microdebrider vs. traditional instruments in Functional Endoscopic Sinus Surgery (FESS).
  • Key areas of comparison include operative time, blood loss, and user-friendliness.
  • This study addresses the evidence gap in microdebrider utility for FESS.

Purpose of the Study:

  • To compare the microdebrider with traditional instruments in FESS.
  • To evaluate differences in operating time, intra-operative blood loss, and user-friendliness.
  • To assess safety and postoperative healing outcomes.

Main Methods:

  • Prospective randomized double-blind controlled trial with 60 chronic rhinosinusitis with nasal polyposis (CRSwNP) patients.
  • Bilateral FESS performed, with one side using traditional instruments and the other incorporating a microdebrider (patient as own control).

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  • Primary outcomes: operation time, blood loss, user-friendliness; Secondary outcomes: safety, postoperative healing up to 3 months.

    • Main Results:

    • Operating time was 37% longer without the microdebrider (highly significant).
    • Microdebrider scored significantly higher on user-friendliness, excluding instrument preparation.
    • No significant differences were found in intra-operative blood loss or postoperative healing.

    Conclusions:

    • Microdebrider use in FESS for CRSwNP is efficient, demonstrating reduced operating times.
    • The microdebrider is safe and user-friendly for FESS procedures.
    • The study supports the microdebrider as a valuable tool in FESS for CRSwNP.