Swarna Saravanan, V C (2014) Comparative study of microdebrider and conventional instruments in endoscopic sinus surgery for sinonasal polyposis. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
BACKGROUND AND OBJECTIVES: Nasal polyposis is an inflammatory chronic disease of the upper respiratory tract of varied etiology. It is characterized by nasal obstruction, reduction in sense of smell, infection, and impaired quality of life. Endoscopy has enhanced the diagnosis and management of nasal polyps. The initial approach is medical management. Those who fail medical management, a surgery is essential to achieve sufficient ventilation and drainage of the affected sinuses by using either microdebrider or conventional instruments for functional endoscopic sinus surgery (FESS). The present study was undertaken to study and compare the microdebrider assisted endoscopic surgery and conventional methods using sinus endoscopes in the surgical management of nasal polyps at kilpauk medical college,kilpauk ,Chennai. METHODS: Fifty patients with sinonasal polyposis who failed medical therapy were included in the study. They were equally randomized into powered and conventional instruments groups. A subjective visual analogue scale (VAS), endoscopic examination, and coronal CT were done preoperatively. Intraoperatively, the operative time, the surgical visibilty and amount of blood loss were rated and recorded. Postoperatively patients were followed up for a period of 6 months and VAS, edema,crusting,discharge,synechiae and recurrence were recorded. RESULTS: Both groups experienced a significant improvement in VAS .The operative time as well as the surgical conditions and visibility of the operative field ,amount of blood loss were significantly better in the debrider group.In the Post operative period synechiae formation was seen in 5 patients treated with conventional method. Post operatively synechiae formation had considerable statistically differencebetween two methods. The polyp recurred in 2 patient with conventional method and in one patient with debrider method. Significant statistically difference was in post intraoperative blood loss,time for surgery,visibility of surgical field between two methods. CONCLUSION: Powered endoscopic sinus surgery offers a better therapeutic approach for patients with sinonasal polyposis when compared to endoscopic surgery with the conventional instruments. It provides a bloodless operative field with better visualization for a more precise, less traumatic procedure with minimal intraoperative complications and shorter operative time.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Microdebrider; Nasal polyposis; Endoscopic sinus surgery |
| Subjects: | MEDICAL > Otolaryngology |
| Depositing User: | Devi S |
| Date Deposited: | 10 Jul 2017 07:24 |
| Last Modified: | 31 Mar 2018 08:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1285 |
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