The efficacy and safety of an office-based polypectomy with a vacuum-powered microdebrider.

Background: The waiting time for functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) in the Canadian public healthcare system can be lengthy. Many such patients have significant nasal obstruction resulting in a poor quality of life. A simple and safe office-based polypectomy device to debulk nasal polyps allows immediate alleviation of nasal obstruction and better access for topical medications. The aim of this study is to assess the efficacy, safety, and patient tolerability of a vacuum-powered microdebrider in the outpatient clinic setting.

Methods: The clinical charts of patients with CRSwNP who underwent office polypectomy with a vacuum-powered microdebrider between May 2012 and February 2013 were retrospectively reviewed. These patients were either awaiting surgery or had recurrent polyposis postsurgery that was amenable to office polypectomy. Previously completed procedural and clinical outcomes questionnaires by the patients and surgeon were analyzed.

Results: Sixty-eight patients underwent office polypectomy in this case series. Fifty-nine procedures (87%) were successfully completed. Failed complete polyp resections were due to fibrous polyps (n = 7; 10%), device failure (n = 1; 1.5%), and obstruction from a deviated nasal septum (n = 1; 1.5%). There was a 43% improvement in nasal obstruction score and significant reduction in polyp grade postpolypectomy. Majority of patients (n = 66; 97%) reported a comfort level of "fair" to "excellent." Bleeding was "light" in 61 cases (90%). There were no complications encountered.

Conclusion: The vacuum-powered microdebrider is a safe, effective, and well-tolerated instrument to resect nonfibrous nasal polyps in the outpatient setting.