Comparative Study Between Endoscopic Sinus Surgery Using Microdebrider and Conventional Techniques with It's Impact on Pulmonary Function Tests: A Randomized Control Trial.

The nasal airways and their close association to paranasal sinuses are an integral part of the respiratory tract. Mucociliary clearance is the predominant clearance mechanism for both upper and lower airways. The two components of mucociliary clearance are cilia and the secretions above them. It is known that CRS coexists in as many as 40-75% of patients with BA. CRS can present with polyposis or without polyposis. Treatment options for CRS include medical therapy, surgical intervention or both. According to recent guidelines, ESS is the most favourable surgical approach in patients who fail to respond adequately to medical therapy. To assess the extent of improvement in CRS following ESS (either microdebrider or conventional) and if it brings an improvement in the pulmonary function tests. This also assesses symptom scores, endoscopic appearances and CT findings pre-operatively and post-operatively. This study was carried out at the outpatient Department of Otorhinolaryngology and Head and Neck Surgery in Meenakshi Medical College, Hospital and Research Institute, Tamil Nadu. Patients were consented and started on medical treatment with systemic steroids for 2 weeks and topical nasal steroids for 1 month. If the disease persisted after medical therapy, patients were equally randomized into two groups of 30 each-microdebrider and conventional technique. Subjective symptoms of CRS were based on the CRS criteria. Symptoms score were given with Lund-Mckay symptoms scoring, pre-operatively 1 week before and post-operatively 2 months after surgery. Lund-Mckay CT scoring system separately assessed the extent of opacification of sinuses. PFT was assessed using Spirometer (KOKO Legend). There was a statistically considerable difference in the FEV1 values in microdebrider ESS than conventional ESS. Microdebrider ESS is considered superior when we have to address the coexistence of lower airway diseases along with CRS.