A Comparison Study of Microdebrider Assistedendoscopic Sinus Surgery Versus Conventionalendoscopic Sinus Surgery For Sinonasal Polyp

Background: Sinonasal polyposis is a chronic inflammatory condition commonly managed by endoscopic sinus surgery. The introduction of microdebrider-assisted techniques has aimed to improve surgical precision, reduce operative time, and minimize complications compared to conventional methods. Microdebrider-assisted endoscopic sinus surgery (MESSS) has been proposed as an alternative for endoscopic sinus surgery (ESS) in selected patients. Objective: To compare the intra- and post-operative results between patients undergoing microdebrider-assisted endoscopic sinus surgery (MESSS) and those undergoing conventional ESS in patients with sinonasal polyposis. Material and Methods: The study involved 30 patients who were diagnosed with SNPs and were divided into two groups, group A (n = 15) and group B (n = 15), of which the first group underwent microdebrider-assisted surgery and the second, conventional surgery. Intraoperative blood loss, surgical duration, intraoperative visualization, postoperative symptoms improvement, and endoscopic improvement and recurrence at 6 months were evaluated. Appropriate statistical analyses were carried out, and a p-value of < 0.05 were considered significant. Results: The mean blood loss during the operation in Group A and Group B was 85 mL ± 15 mL and 130 mL ± 20 mL, respectively, which was significantly different between the two groups (p<0.001). The mean operative time for the microdebrider group was also significantly shorter compared with the other group (95 ± 12 minutes versus 120 ± 15 minutes, p < 0.001). At 3 months, symptomatic improvement was higher in Group A (good improvement in nasal congestion: 86.7 vs. 60%, p= 0.04 and in nasal discharge: 80 vs. 60%, p= 0.05 respectively). Postoperative morbidity (crusting) was significantly reduced in the microdebrider group as compared to the other group (20% vs 46.7%, p = 0.04). There was no significant difference between groups with regard to the 6-month recurrence rates (40% vs 20%, p = 0.62). Conclusion: Endoscopic sinus surgery with the assistance of a microdebrider is superior to conventional methods with regard to a number of advantages: minimal blood loss, the efficiency of the surgery, improved visualization, and better early postoperative results and outcomes, while long-term recurrence rates will be similar.

Keywords: Sinonasal polyposis, Microdebrider, Endoscopic sinus surgery, Nasal polyps, Surgical outcomes, Recurrence.