A comparative study of microdebrider assisted versus conventional endoscopic sinus surgery for nasal polyposis

Abstract

<p class="abstract"><strong>Background:</strong> Nasal polyps are benign, chronic, inflammatory lesions arising from the mucosa of the nasal sinuses or from the mucosa of the nasal cavity. They are a challenge to treat due to their uncertain etiology and tendency to recur. Therapy involves both medical and surgical treatment. Surgical management includes Endoscopic sinus surgery using conventional instruments or by microdebrider.</p><p class="abstract"><strong>Methods:</strong> We conducted a study on 80 patients with nasal polyposis in whom conservative management failed. They were equally randomised into powered and conventional instruments Endoscopic Sinus Surgery (ESS) groups. The groups were compared for surgical outcomes, intra and postoperative complications and recurrence rates. </p><p class="abstract"><strong>Results:</strong> Age of patients suffering from bilateral nasal polyposis ranged from 18 to 55 years with maximum number of patients in the group 31 to 40 years. Nasal polyps were more commonly seen in men (53.75%) than women (46.25%). Most common symptom experienced was nasal obstruction (100%), followed by olfactory disturbance in 88.7% and nasal discharge in 76.25%. There was statistically significant difference in operative time, blood loss and postoperative synechiae, with the microdebrider group showing better outcomes. There was no statistically significant difference in the postoperative VAS (visual analogue score) and recurrence rates between the two groups.</p><p class="abstract"><strong>Conclusions:</strong> Powered endoscopic sinus surgery offers a better therapeutic approach for patients with nasal polyposis than with conventional instruments. It provides bloodless operative field with better visualisation for a more precise, less traumatic procedure with shorter operative time.</p>