Cutting forceps in functional endoscopic sinus surgery.

Twenty years of Functional Endoscopic Sinus Surgery have brought about a large amount of innovations and a variety of instruments, all claiming to result in better endoscopic procedures and/or better postoperative outcome. An example of such an innovation is the cutting forceps, which has been claimed to result in better wound healing. However, like several other instruments, it has never been proven to be superior to conventional non-cutting forceps techniques. A prospective, randomised double-blind study in 100 consecutive patients, undergoing bilateral FESS, compared the short term clinical outcome of surgery using cutting instruments to that of non-cutting instruments. Symptoms and endoscopic findings were evaluated at four time points during the first three postoperative weeks. Both types of surgery resulted in reduction of symptoms and in endoscopically visible healing over time, but no significant difference between the two methods was found, neither in symptom relief, nor in endoscopic impression of improvement. In conclusion, endoscopic sinus surgery with cutting instruments can be considered effective in resolving sinus disease. However, these instruments do not generate a better healing process than non-cutting instruments in the first weeks postoperatively.

RCT Entities:   Population Interventions Outcomes