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Prospective, randomised controlled trial comparing intense endoscopic cleaning versus minimal intervention in the early post-operative period following functional endoscopic sinus surgery

Published online by Cambridge University Press:  28 March 2011

J M Fishman ,
S Sood ,
M Chaudhari ,
P Martinez-Devesa ,
L Orr  and
D Gupta
J M Fishman*
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
S Sood
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
M Chaudhari
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
P Martinez-Devesa
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
L Orr
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
D Gupta
Affiliation:
Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK
*
Address for correspondence: Mr Jonathan Fishman, ENT Registrar & Royal College of Surgeons of England Surgical Research Fellow, Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire SN3 6BB, UK E-mail: [email protected]
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Abstract

Objective:

There is currently no standardised management protocol following functional endoscopic sinus surgery. This study assessed frequent endoscopic cleaning versus minimal intervention in the early post-operative period following such surgery.

Study design:

Prospective, randomised controlled, single-blinded, within-subject trial involving 24 patients with bilateral chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery.

Main outcome measure:

The primary outcome measure was ethmoid cavity healing, based on endoscopic appearance, graded using a modified Lund–MacKay endoscopic score.

Secondary outcome measure:

Lund–MacKay symptom score before and after surgery.

Results:

There was no overall statistically significant difference between the two groups (p = 0.37). Subgroup analysis revealed a significant effect of regular suction clearance on adhesions at three months (p = 0.048), but not on oedema, polyps, granulation, discharge or crusting.

Conclusion:

There is no evidence from this study to support frequent endoscopic cleaning in the early post-operative period after functional endoscopic sinus surgery. Less intensive post-operative management is recommended, resulting in decreased patient morbidity and fewer post-operative follow-up appointments.

Keywords

Post-Operative ComplicationsPost-Operative CareSinusitisEndoscopyWound Healing
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 6 , June 2011 , pp. 585 - 589
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented and awarded first prize for best oral presentation at the 8th Annual Meeting of the British Rhinological Society, 15 May 2009, Cheltenham, UK

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