Effect evaluation of repeated debridement after endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Surgical Innovation
• Postoperative Care

Background:

• Functional endoscopic sinus surgery (FESS) is a common treatment for chronic sinusitis.
• Optimizing postoperative care is crucial for patient recovery and surgical outcomes.
• The role of early-phase debridement frequency in recovery after FESS requires further investigation.

Purpose of the Study:

• To evaluate the impact of varying debridement frequencies during the early postoperative period on symptom recovery and mucosal healing after FESS.
• To compare patient-reported outcomes and endoscopic findings between different debridement schedules.

Main Methods:

• A study involving 67 patients undergoing FESS, divided into an intervention group (debridement at weeks 1, 4, 8) and a control group (weekly debridement).
• Both groups received standard postoperative care including intranasal corticosteroids, macrolide antibiotics, and saline douching.
• Outcomes were assessed using the Visual Analogue Scale (VAS) for symptoms and the Lund-Kennedy Endoscopic Score (LKES) for mucosal status.

Main Results:

• At week 4, the control group showed better nasal block relief and reduced crusting compared to the intervention group.
• The intervention group reported significantly less facial pain and discomfort (VAS 2.74 ± 1.41) compared to the control group (VAS 5.92 ± 0.91).
• By week 8, no significant differences in VAS or LKES were observed between groups, except for less scarring in the control group.

Conclusions:

• Frequent early postoperative debridement after FESS is not positively correlated with improved symptom recovery.
• Excessive debridement may lead to increased surgical trauma and patient discomfort (facial pain).
• Extending postoperative management time and reducing intervention frequency can maintain therapeutic efficacy while potentially improving patient subjective recovery and reducing healthcare costs.