Endoscopic Sinus Surgery for Sinonasal Polyposis: Microdebrider or Conventional Instruments

Area of Science:

• Otolaryngology
• Surgical Innovation
• Rhinology

Background:

• Sinonasal polyposis is a frequent cause of nasal obstruction requiring surgical intervention.
• Endoscopic sinus surgery (ESS) is the primary treatment modality.
• The microdebrider offers potential advantages over traditional surgical instruments.

Purpose of the Study:

• To compare the outcomes of endoscopic sinus surgery for sinonasal polyposis using a microdebrider versus conventional instruments.
• To evaluate the efficacy and safety of microdebrider-assisted ESS.

Main Methods:

• A cross-sectional descriptive study involving 51 patients aged 13 years and above diagnosed with sinonasal polyposis.
• Each patient underwent surgery on one side with a microdebrider and on the contralateral side with conventional instruments.
• Postoperative assessment included subjective evaluation of nasal obstruction and endoscopic examination for mucosal edema, synechiae, and recurrence at 4 and 8 weeks.

Main Results:

• No statistically significant difference in mucosal edema incidence between microdebrider and conventional groups at 4 and 8 weeks (P=0.089, P=0.322).
• Synechiae incidence was lower in the microdebrider group (2%) versus the conventional group (7.8%) at 4 weeks, but not statistically significant (P=0.773).
• Recurrence rates were 3.9% for the microdebrider group and 5.8% for the conventional group, with no statistical significance (P=0.532).

Conclusions:

• Microdebrider use in sinonasal polyposis surgery demonstrated a trend towards fewer synechiae and recurrences.
• Despite observed benefits, the study did not find a statistically significant advantage of microdebriders over conventional instruments for these outcomes.
• Further research with larger sample sizes may be warranted to confirm the microdebrider's statistical superiority.