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Prospective, randomised controlled trial comparing intense endoscopic cleaning versus minimal intervention in the early post-operative period following functional endoscopic sinus surgery

Published online by Cambridge University Press:  28 March 2011

J M Fishman ,
S Sood ,
M Chaudhari ,
P Martinez-Devesa ,
L Orr  and
D Gupta
J M Fishman*
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
S Sood
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
M Chaudhari
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
P Martinez-Devesa
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
L Orr
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
D Gupta
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
*
Address for correspondence: Mr Jonathan Fishman, ENT Registrar & Royal College of Surgeons of England Surgical Research Fellow, Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire SN3 6BB, UK E-mail: [email protected]
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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.

Keywords

Post-Operative ComplicationsPost-Operative CareSinusitisEndoscopyWound Healing
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 6 , June 2011 , pp. 585 - 589
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented and awarded first prize for best oral presentation at the 8th Annual Meeting of the British Rhinological Society, 15 May 2009, Cheltenham, UK

References

1Wigand, ME. Endoscopic Surgery of the Paranasal Sinuses and Anterior Skull Base. New York: Thieme, 1990Google Scholar
2Lund, VJ, MacKay, IS. Outcome assessment of endoscopic sinus surgery. J R Soc Med 1994;87:70–2CrossRefGoogle ScholarPubMed
3Ryan, RM, Whittet, HB, Norval, C, Marks, NJ. Minimal follow-up after functional endoscopic sinus surgery. Does it affect outcome? Rhinology 1996;34:44–5Google ScholarPubMed
4Fernandes, SV. Postoperative care in functional endoscopic sinus surgery? Laryngoscope 1999;109:945–8CrossRefGoogle ScholarPubMed
5Schulz, KF, Altman, DG, Moher, D, for the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c332CrossRefGoogle ScholarPubMed
6Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;31:183–4Google Scholar
7Lund, VJ, Kennedy, DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:S35–40CrossRefGoogle ScholarPubMed
8Nilssen, EL, Wardrop, P, El-Hakim, H, White, PS, Gardiner, Q, Ogston, S. A randomized control trial of post-operative care following endoscopic sinus surgery; debridement versus no debridement. J Laryngol Otol 2002;116:108–11CrossRefGoogle ScholarPubMed
9Lee, JY, Byun, JY. Relationship between the frequency of postoperative debridement and patient discomfort, healing period, surgical outcomes, and compliance after endoscopic sinus surgery. Laryngoscope 2008;118:1868–72CrossRefGoogle ScholarPubMed
10Kemppainen, T, Seppa, J, Tuomilehto, H, Kokki, H, Nuutinen, J. Repeated early debridement does not provide significant symptomatic benefit after ESS. Rhinology 2008;46:238–42Google Scholar
11Bugten, V, Nordgard, S, Steinsvag, S. The effects of debridement after endoscopic sinus surgery. Laryngoscope 2006;116:2037–43CrossRefGoogle ScholarPubMed