SYNECHIAE PREVENTION IN ENDOSCOPIC SINUS SURGERY FOR NASAL POLYPS: EVALUATING MICRODEBRIDER-ASSISTED TECHNIQUES

Objective: To evaluate the effectiveness of microdebrider-assisted endoscopic sinus surgery (ESS) in preventing postoperative synechiae formation and improving surgical outcomes in patients with nasal polyps at ---------, Peshawar. Methodology: A retrospective study was conducted from January 2023 to December 2023, including 100 patients divided into two groups: microdebrider-assisted ESS (n=50) and conventional ESS (n=50). Key parameters analyzed included intraoperative blood loss, operative time, synechiae formation, polyp recurrence, and postoperative complications. Statistical analysis was performed using independent t-tests and chi-square tests, with a significance threshold of p<0.05. Results: The microdebrider-assisted ESS group had significantly lower intraoperative blood loss (45.3 ± 15.2 ml vs. 78.6 ± 20.1 ml, p=0.001) and shorter operative time (58.4 ± 10.3 min vs. 91.2 ± 12.7 min, p=0.002). Synechiae formation was observed in 14% of the microdebrider group compared to 32% in the conventional group (p=0.008). The polyp recurrence rate at three months was lower in the microdebrider group (10%) than in the conventional group (26%) (p=0.012). Postoperative infection rates were also lower (6% vs. 18%, p=0.022). Conclusion: Microdebrider-assisted ESS significantly improves surgical outcomes by reducing blood loss, shortening operative time, and minimizing postoperative complications. The findings support the adoption of this technique as a preferred approach for managing nasal polyps.