A Comparative Study of Microdebrider Versus Cold Steel Instruments in Nasal Polypectomy: Recurrence Rates and Post Operative Synechiae Formation

Abstract

Objective: To evaluate and compare the effectiveness of microdebrider and cold steel instruments in nasal polypectomy, focusing on the recurrence of polyps and the formation of post-operative synechiae.
Study Design: Comparative observational study.
Place and Duration of Study: ENT department, Fauji Foundation Hospital Rawalpindi, from 1st July 2022 to 30th June 2023.
Materials and Methods: After the approval of the Hospital Ethical Committee, 96 patients from both genders between 10-60 years of age, presenting with nasal polyps, and fulfilling the selection criteria, were selected by non-probability consecutive technique. By lottery method two equal groups from these patients were formed, Group A & Group B. Patients in Group A underwent microdebrider assisted polypectomy while patients in Group B underwent surgery with cold steel instruments. After taking a detailed history and conducting a thorough ENT and general physical examination, nasal endoscopy was performed on all patients. CT scan PNS, both axial and coronal views were done. Post-operative follow ups of these patients were carried out in the 1st week, 3rd month and 6th month and all the patients were examined endoscopically. The data was expressed as frequency & percentage and analyzed using SPSS version 25.0.
Results: The mean age of the patients was 39.22 (±5.67) years. There were 36.5% females and 63.5% males. Recurrence of nasal polyps was observed in 54.2% patients. Postoperative synechiae formation was observed in 30.2% of patients. Recurrence was found to be statistically lower among patients in Group A, i.e., 41.7% vs 66.7% in Group B. (p=0.007). Postoperative synechiae formation was also found statistically lower among patients in Group A, i.e., 18.75% vs 41.7% in Group B. (p= 0.007).
Conclusion: The results indicated that the microdebrider was more effective than cold steel instruments in reducing the recurrence of nasal polyps and minimizing post-operative synechia formation in patients undergoing nasal polypectomy.