title: Postoperative nasal debridement after endoscopic sinus surgery: a randomized controlled trial.
abstract: OBJECTIVE
  Postoperative debridement is a controversial subject in the rhinology literature. The objective of this randomized controlled trial was to determine the effect of regular debridement versus no debridement on disease-specific outcomes and patient inconvenience.
  
  
  METHODS
  Patients with chronic rhinosinusitis with polyposis who were to undergo basic sinus surgery (antrostomy, ethmoidectomy, and polypectomy) were randomized to either debridement (at postoperative weeks 2 and 4) or no debridement, and their outcomes were assessed at 4 weeks and at 6 months with the Lund-Kennedy Endoscopic Score (LKES), the Sino-Nasal Outcome Test-21 (SNOT-21), a visual analog scale for postoperative pain, and a novel scoring system for postoperative inconvenience (Post-Operative Inconvenience Scale; POIS). All patients were instructed to use high-volume saline rinses twice daily.
  
  
  RESULTS
  At 4 weeks after operation, there was no difference between the groups in regard to LKESs (control group, 2.1 of 20; debridement group, 2.4 of 20; p = 0.59) or SNOT scores (control group, 9.1; debridement group, 8.3; p = 0.47). The visual analog scale pain scores showed significance (control group, 19 mm; debridement group, 38 mm; p = 0.019), as did the POIS scores (control group, 18.3; debridement group, 6.1; p = 0.002). At 6 months after surgery, again no difference was seen between the groups on either LKESs or SNOT scores.
  
  
  CONCLUSIONS
  In our patient population, debridement after surgery did not affect disease-specific outcomes.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, St Joseph's Health Care London, Schulich School of Medicine and Dentistry, Western University, London, Canada.
authors.forename: Hussain
authors.initials: H
authors.lastname: Alsaffar
authors.forename: Leigh
authors.initials: L
authors.lastname: Sowerby
authors.forename: Brian W
authors.initials: BW
authors.lastname: Rotenberg
mesh_terms: D002908:Chronic Disease; D003646:Debridement; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011184:Postoperative Period; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*