Comparing the microdebrider and standard instruments in endoscopic sinus surgery: a double-blind randomised study

Abstract

Comparing the microdebrider and standard instruments in endoscopic sinus surgery: a double-blind randomised study.

Objective: It is frequently stated that microdebriders provide better mucosal preservation in endoscopic sinus surgery (ESS), and therefore better and faster healing, when compared to the standard Blakesley instruments. However, evidence from comparative prospective studies is lacking. In this study, we compared the results of microdebriders with traditional surgical instruments for ESS.

Methods: A prospective, randomised, comparative, double-blind study in 50 patients undergoing bilateral ESS. Each patient was operated on with both instruments: one side of the nose with the microdebrider only, and the other side with standard instruments. The outcome of surgery was measured by using a symptom score and an endoscopic score at five time points during the first six postoperative months.

Results: Both instruments resulted in symptom improvement and in endoscopically visible healing over time, but no significant difference was found between the two techniques. In endoscopic evaluation, only the total score at 3 weeks after surgery was significantly better in the microdebrider group. No significant difference was found at any other time point. Synechia formation, patency of middle meatal antrostomy, and open access to the ethmoid were the same in both groups.

Conclusion: In this study of endoscopic sinus surgery the use of the microdebrider does not offer major advantages compared to the standard instruments.