The role of diode laser assistance in functional endoscopic sinus surgery to reduce perioperative morbidity.

Abstract

Objectives: To compare the mean duration of hospital stay and frequency of postoperative haemorrhage in patients undergoing FESS with or without Diode laser-assistance. Study Design: Single-blinded Randomized Controlled Trial. Setting: Department of ENT and Head & Neck Surgery, KRL Hospital Islamabad. Period: 01.03.2024 to 30.11.2024. Methods: No data has been published on the efficacy of Diode lasers as an adjunct to FESS for inflammatory sinonasal disease. Therefore, after Ethical Committee approval, a pilot study was first conducted to evaluate the feasibility of proposed project. Sample size calculated using WHO calculator was sixty. Using simple random sampling technique, thirty patients had laser-assisted surgery and the other thirty did not have laser-assistance employed. The comparative outcome was measured by recording the post-operative duration of hospital stay and the incidence of postoperative haemorrhage in both groups. Comparative data analysis was done using SPSS version 23. Results: Regarding postoperative duration of hospital stay, mean±SD compared were significantly different in the Laser-assisted and control groups (1.23±0.43 vs 1.87±0.78 days, p-value=0.0002). The parameter of postoperative haemorrhage, too, showed significant difference between the laser-assisted and control groups i.e. an incidence of 6.67% vs 26.67% respectively, giving p-value=0.04. Conclusion: This study revealed that per-operative defocused laser irradiation of the raw cut edges of mucosa following FESS has proven very beneficial as it leads to significant reduction in hospital stay, reduced chance of bleeding, expedited recovery and enhanced patient satisfaction.