Subjective and Objective Outcome Assessment in Patients with Sinonasal Disease After Microdebrider Assisted Endoscopic S
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ORIGINAL ARTICLE
Subjective and Objective Outcome Assessment in Patients with Sinonasal Disease After Microdebrider Assisted Endoscopic Sinus Surgery Anil S. Harugop1 • Rajesh R. Havaldar1 • O. Padmavathy1 • Anshika Anand1 P. H. Patil1 • S. Puneeth Nayak1
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Received: 7 October 2020 / Accepted: 9 November 2020 Ó Association of Otolaryngologists of India 2020
Abstract Microdebrider is a modern powered instrument which is electrically driven with a shaver and a suction. The present study aims to assess the subjective and objective outcome in patients with sinonasal disease after microdebrider assisted endoscopic sinus surgery. A prospective observational study was carried out among 40 patients with symptoms suggestive of sinonasal diseases willing to undergo microdebrider assisted sinus surgery at our tertiary care hospital from January 2019 to December 2019. All the patients underwent microdebrider assisted endoscopic sinus surgery (ESS). Patients were subjectively evaluated using the Lund and Mackay staging system using visual analogue score and objectively using nasal endoscopy by the Lund and Kennedy scoring system preoperatively and post operatively after 6 weeks. 40 patients were included in the study. A mean age of 37 years were noted. All patients showed significant statistical improvement in Lund Mackay scoring system by visual analogue scoring and Lund Kennedy endoscopic scoring postoperatively. Thus, microdebrider offers a better therapeutic approach for patients with sinonasal diseases when compared to endoscopic surgery with the conventional instruments. The advantage of using microdebrider in ESS remains to be proper removal of the pathology, good surgical field and better postoperative outcome. Keywords Microdebrider Sinonasal disease Endoscopic sinus surgery
& O. Padmavathy [email protected] 1
Department of Otorhinolaryngology, Head and Neck Surgery, KLE Academy of Higher Education and Research (KAHER’S) JNMC, Belagavi, India
Introduction The nose and the paranasal sinuses acts as a host for lot of conditions and diseases together called as sinonasal diseases. The broad spectrum of sinonasal pathology includes conditions such as chronic rhinosinusitis, antrochoanal polyp, ethmoidal polyposis with or without sinusitis, benign conditions like inverted papilloma, juvenile nasopharyngeal angiofibroma (JNA), mucocele of paranasal sinuses etc. [1]. Surgery for sinonasal disease is effective for those conditions with failed medical therapy. Functional endoscopic sinus surgery (FESS) is now the standard mode of treatment. Better absorption of medications and re-establishment of natural pathway of drainage remains to be the main aim of FESS [2]. The conventional instruments used in Endoscopic Sinus Surgery by their punching, tearing and stripping action creates a blood-filled surgical field with no mucosal preservation and scarring. Visibility of the operating area is the key to the safety of the FESS procedure, which can be compromised by bleeding. It can cause intraoperative complications, prolong t
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