Hussain Alsaffar1, Leigh Sowerby, Brian W Rotenberg. 1. Department of Otolaryngology-Head and Neck Surgery, St Joseph's Health Care London, Schulich School of Medicine and Dentistry, Western University, London, Canada.
Abstract
OBJECTIVES: Postoperative debridement is a controversial subject in the rhinology literature. The objective of this randomized controlled trial was to determine the effect of regular debridement versus no debridement on disease-specific outcomes and patient inconvenience. METHODS:Patients with chronic rhinosinusitis with polyposis who were to undergo basic sinus surgery (antrostomy, ethmoidectomy, and polypectomy) were randomized to either debridement (at postoperative weeks 2 and 4) or no debridement, and their outcomes were assessed at 4 weeks and at 6 months with the Lund-Kennedy Endoscopic Score (LKES), the Sino-Nasal Outcome Test-21 (SNOT-21), a visual analog scale for postoperative pain, and a novel scoring system for postoperative inconvenience (Post-Operative Inconvenience Scale; POIS). All patients were instructed to use high-volume saline rinses twice daily. RESULTS: At 4 weeks after operation, there was no difference between the groups in regard to LKESs (control group, 2.1 of 20; debridement group, 2.4 of 20; p = 0.59) or SNOT scores (control group, 9.1; debridement group, 8.3; p = 0.47). The visual analog scale pain scores showed significance (control group, 19 mm; debridement group, 38 mm; p = 0.019), as did the POIS scores (control group, 18.3; debridement group, 6.1; p = 0.002). At 6 months after surgery, again no difference was seen between the groups on either LKESs or SNOT scores. CONCLUSIONS: In our patient population, debridement after surgery did not affect disease-specific outcomes.
RCT Entities:
OBJECTIVES: Postoperative debridement is a controversial subject in the rhinology literature. The objective of this randomized controlled trial was to determine the effect of regular debridement versus no debridement on disease-specific outcomes and patient inconvenience. METHODS:Patients with chronic rhinosinusitis with polyposis who were to undergo basic sinus surgery (antrostomy, ethmoidectomy, and polypectomy) were randomized to either debridement (at postoperative weeks 2 and 4) or no debridement, and their outcomes were assessed at 4 weeks and at 6 months with the Lund-Kennedy Endoscopic Score (LKES), the Sino-Nasal Outcome Test-21 (SNOT-21), a visual analog scale for postoperative pain, and a novel scoring system for postoperative inconvenience (Post-Operative Inconvenience Scale; POIS). All patients were instructed to use high-volume saline rinses twice daily. RESULTS: At 4 weeks after operation, there was no difference between the groups in regard to LKESs (control group, 2.1 of 20; debridement group, 2.4 of 20; p = 0.59) or SNOT scores (control group, 9.1; debridement group, 8.3; p = 0.47). The visual analog scale pain scores showed significance (control group, 19 mm; debridement group, 38 mm; p = 0.019), as did the POIS scores (control group, 18.3; debridement group, 6.1; p = 0.002). At 6 months after surgery, again no difference was seen between the groups on either LKESs or SNOT scores. CONCLUSIONS: In our patient population, debridement after surgery did not affect disease-specific outcomes.