title: Single seventh day debridement compared to frequent debridement after endoscopic sinus surgery: a randomized controlled trial.
abstract: The aim of this study was to evaluate the postoperative debridement frequency following endoscopic sinus surgery. Individual randomized controlled trial. Sixty-two adult patients with a diagnosis of chronic rhino sinusitis (CRS) with nasal polyps (NP) and CRS without NP meeting the inclusion criteria were enrolled in this prospective study. The patients were randomized equally to frequent debridement (FD; at postoperative weeks 1, 2 and 4) or to a single debridement (SD; at postoperative week 1) after surgery. The outcomes were assessed with visual analog scale (VAS) for nine main symptoms concerning patient discomfort within the first 4 weeks, with the modified Lund-Kennedy endoscopic score (MLKES) at weeks 4 and 24 and with the sino-nasal outcome test-20 (SNOT-20) at week 24. Thirty-seven of the patients were male, and twenty-five were female. The mean age was 36.1 ± 13.5 in FD group and 39.2 ± 14.7 in SD group. In the SD group, the VAS scores at postoperative week four showed significantly less discomfort at visits (p = 0.004) and less negative effects on their work (p = 0.013). There was no statistically significant difference between the two groups in the week 4 and 24 MLKES and in the week 24 SNOT-20 scores (p > 0.05). The endoscopic findings did not show significant differences between the groups. Our data indicate that FD causes more discomfort at the required visits, more facial pain and more negative effects on patients' work; this method is not superior to postoperative single seventh day debridement in terms of the 24-week quality of life and endoscopic scores.
  
  
  METHODS
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authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey. kursadvarsak@gmail.com.
authors.forename: Yasin Kursad
authors.initials: YK
authors.lastname: Varsak
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Selcuk University, Konya, Turkey.
authors.forename: Koksal
authors.initials: K
authors.lastname: Yuca
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Eryılmaz
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey.
authors.forename: Hamdi
authors.initials: H
authors.lastname: Arbag
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis / Q000601:surgery; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D010147:Pain Measurement; D010256:Paranasal Sinuses / Q000601:surgery; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000175:diagnosis / Q000601:surgery; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome
keywords: Chronic rhino sinusitis; Endoscopic sinus surgery; Nasal polyposis; Postoperative debridement; Quality of life