title: The efficacy and safety of an office-based polypectomy with a vacuum-powered microdebrider.
abstract: BACKGROUND
  The waiting time for functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) in the Canadian public healthcare system can be lengthy. Many such patients have significant nasal obstruction resulting in a poor quality of life. A simple and safe office-based polypectomy device to debulk nasal polyps allows immediate alleviation of nasal obstruction and better access for topical medications. The aim of this study is to assess the efficacy, safety, and patient tolerability of a vacuum-powered microdebrider in the outpatient clinic setting.
  
  
  METHODS
  The clinical charts of patients with CRSwNP who underwent office polypectomy with a vacuum-powered microdebrider between May 2012 and February 2013 were retrospectively reviewed. These patients were either awaiting surgery or had recurrent polyposis postsurgery that was amenable to office polypectomy. Previously completed procedural and clinical outcomes questionnaires by the patients and surgeon were analyzed.
  
  
  RESULTS
  Sixty-eight patients underwent office polypectomy in this case series. Fifty-nine procedures (87%) were successfully completed. Failed complete polyp resections were due to fibrous polyps (n = 7; 10%), device failure (n = 1; 1.5%), and obstruction from a deviated nasal septum (n = 1; 1.5%). There was a 43% improvement in nasal obstruction score and significant reduction in polyp grade postpolypectomy. Majority of patients (n = 66; 97%) reported a comfort level of "fair" to "excellent." Bleeding was "light" in 61 cases (90%). There were no complications encountered.
  
  
  CONCLUSIONS
  The vacuum-powered microdebrider is a safe, effective, and well-tolerated instrument to resect nonfibrous nasal polyps in the outpatient setting.
authors.affiliation: Division of Otolaryngology, University of British Columbia, St. Paul's Sinus Centre, Vancouver, British Columbia, Canada.
authors.forename: Eng Cern
authors.initials: EC
authors.lastname: Gan
authors.forename: Al-Rahim R
authors.initials: AR
authors.lastname: Habib
authors.forename: Iain
authors.initials: I
authors.lastname: Hathorn
authors.forename: Amin R
authors.initials: AR
authors.lastname: Javer
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D002170:Canada; D003646:Debridement / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D009298:Nasal Polyps / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014618:Vacuum
keywords: equipment; nasal polyps; outpatient clinic; safety; treatment efficacy