Tissue model and preliminary analysis of microdebriders used in endoscopic sinus surgery

Abstract

Objectives: In 1999, Ferguson reported the first and only quantitative analysis of microdebriders used in ESS. The purpose of our study was to establish a standardized in vitro model and compare the newer “next-generation” microdebriders to determine which device and combination of tissue type, blade, and suction strength was most efficient for this model. Methods: The Gyrus-Diego-Powered-Dissector and Xomed-XPS-3000-Powered-ENT-System were compared using a soft tissue model consisting of raw oysters (nasal polyps) and a firm-tissue model consisting of scallops mixed with eggshells (nasal/sinus tissue). In addition, the effect of blade type (straight/60) and suction strength (wall-suction/liposuction) on aspiration efficiency was evaluated. Aspiration efficiency was quantified by 3 outcomes (tissue aspiration, clog-frequency, and clearance time). Results: For the “head-to-head” comparison, Xomed was statistically superior for soft tissue/oyster aspiration when using the straight blade regardless of suction strength and when using the angled blade with liposuction. Although not statistically significant, several trends were observed in our analysis. First, Gyrus appeared to be superior to Xomed for firm-tissue/scallop aspiration, clog-frequency, and clearance time. In addition, straight blades appeared to be superior to angled blades for overall tissue aspiration, clog frequency, and clearance time. Finally, liposuction appeared to be superior for both soft tissue/oyster and firm tissue/scallop aspiration, but wall-suction demonstrated less clogging and clearance time. Conclusion: The tissue model presented appears to be both reliable and reproducible. Only 2 statistically significant results were observed, however, several trends toward significance were noted. A second study with a larger sample size and more advanced statistical analysis is needed to better delineate these trends.