Endoscopic Sinus Surgery [ESS] verses conventional intranasal polypectomy for ethmoidal nasal polyposis

ABSTRACT

The purpose of this study was to compare conventional intranasal ethmoidectomy currently in practice with Endoscopic Sinus Surgery [ESS]. The effectiveness, complications and financial effects of both the techniques were also compared. It was a comparative study. This study was carried out at CMH Lahore from June 2002 to June 2004. 100 patients suffering from ethmoidal nasal polyposis bilaterally occluding the nostrils were included in this study. They were randomly assigned in two groups of 50 patients each. The first group was operated by intra-nasal ethmoidectomy by conventional method while the second group was operated by endoscopic sinus surgery. Post-operatively patients were seen weekly for 1 month and then at 1, 3 and 6 months. The recurrence of polyp was noted after 6 months. All complications were less in the group that underwent endoscopic sinus surgery compared to the group of intranasal ethmoidectomy. However the most significant difference was in post-operative crusting and recurrence after 6 months, where P-values were highly significant in favour of endoscopic sinus surgery. Endoscopic sinus surgery is a much superior and safe procedure compared to conventional intranasal ethmoidectomy for surgical management of nasal polyposis. There is overall decrease in complication rate especially postoperative crusting. Recurrence rate of nasal polyposis is also significantly reduced