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Prospective, randomised controlled trial comparing intense endoscopic cleaning versus minimal intervention in the early post-operative period following functional endoscopic sinus surgery

  • J M Fishman (a1), S Sood (a1), M Chaudhari (a1), P Martinez-Devesa (a1), L Orr (a1) and D Gupta (a1)...



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.

Study design:

Prospective, randomised controlled, single-blinded, within-subject trial involving 24 patients with bilateral chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery.

Main outcome measure:

The primary outcome measure was ethmoid cavity healing, based on endoscopic appearance, graded using a modified Lund–MacKay endoscopic score.

Secondary outcome measure:

Lund–MacKay symptom score before and after surgery.


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.


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.


Corresponding author

Address for correspondence: Mr Jonathan Fishman, ENT Registrar & Royal College of Surgeons of England Surgical Research Fellow, Department of Otolaryngology, The Great Western Hospital, Swindon, Wiltshire SN3 6BB, UK E-mail:


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Presented and awarded first prize for best oral presentation at the 8th Annual Meeting of the British Rhinological Society, 15 May 2009, Cheltenham, UK



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