title: Prospective, randomised controlled trial comparing intense endoscopic cleaning versus minimal intervention in the early post-operative period following functional endoscopic sinus surgery.
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.
  
  
  METHODS
  Prospective, randomised controlled, single-blinded, within-subject trial involving 24 patients with bilateral chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery.
  
  
  METHODS
  The primary outcome measure was ethmoid cavity healing, based on endoscopic appearance, graded using a modified Lund-MacKay endoscopic score.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire, UK. jfishman@doctors.org.uk
authors: J M
authors: JM
authors: Fishman
authors: S
authors: S
authors: Sood
authors: M
authors: M
authors: Chaudhari
authors: P
authors: P
authors: Martinez-Devesa
authors: L
authors: L
authors: Orr
authors: D
authors: D
authors: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D013396:Suction / Q000379:methods; D000267:Tissue Adhesions / Q000517:prevention & control; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult