FESS With or Without Intranasal Desmopressin in Chronic Rhinosinusitis With Nasal Polyps

October 22, 2026 updated by: Daniyal Babar, Services Institute of Medical Sciences, Pakistan

Comparison of Outcomes in Functional Endoscopic Sinus Surgery(FESS) With or Without Preoperative Intranasal Desmopressin in Patients of Chronic Rhinusinusitis With Bilateral Nasal Polyposis

Chronic rhinosinusitis with nasal polyps is a condition that causes long-lasting inflammation and swelling in the nose and sinuses and may lead to nasal blockage, nasal discharge, facial pressure, and reduced sense of smell. Functional Endoscopic Sinus Surgery (FESS) is a surgical treatment used when medical treatment has not adequately controlled the condition.

Bleeding during FESS can make it difficult for the surgeon to see and operate safely. This randomized controlled trial will compare FESS performed with and without preoperative intranasal desmopressin in patients with chronic rhinosinusitis with nasal polyps. Patients will be randomly assigned to one of two groups. The intervention group will receive 20 micrograms of intranasal desmopressin 30-60 minutes before surgery, while the control group will undergo FESS without preoperative desmopressin.

The study will assess intraoperative blood loss, quality of the surgical field, operative time, surgeon satisfaction, and perioperative complications. The study will include patients undergoing elective FESS at the Department of Otorhinolaryngology, Services Hospital, Lahore.

The purpose of this study is to determine whether preoperative intranasal desmopressin can reduce bleeding and improve the surgical field during FESS. The findings may provide local evidence to help inform perioperative management of patients undergoing FESS for chronic rhinosinusitis with nasal polyps.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

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Intervention / Treatment

Intervention / Treatment

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Detailed Description

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a chronic inflammatory condition affecting the nose and paranasal sinuses. Patients may experience persistent nasal obstruction, nasal discharge, facial pressure, and reduced or lost sense of smell. Functional Endoscopic Sinus Surgery (FESS) is performed in patients whose symptoms persist despite appropriate medical treatment.

Intraoperative bleeding is an important consideration during FESS because blood can interfere with visualization of the surgical field and make identification of anatomical structures and surgical dissection more difficult. The study is designed to investigate whether preoperative intranasal desmopressin may influence operative conditions during FESS.

This is a randomized controlled trial to be conducted in the Department of Otorhinolaryngology at Services Hospital, Lahore. Eligible patients with chronic rhinosinusitis with bilateral nasal polyps who are scheduled for elective FESS will be considered for participation. Patients will be randomly allocated into two groups using a computer-generated randomization sequence, with allocation concealment through sequentially numbered opaque sealed envelopes.

Participants assigned to the intervention group will receive 20 μg of intranasal desmopressin, administered as 10 μg in each nostril approximately 30-60 minutes before induction of anesthesia. Participants in the control group will undergo FESS without preoperative intranasal desmopressin. General anesthesia and standardized endoscopic surgical techniques will be used for the procedures.

The study will evaluate intraoperative blood loss and the quality of the surgical field. Blood loss will be estimated using the suction canister volume after accounting for irrigation fluid, together with estimation of blood absorbed by surgical patties and nasal packs. Surgical-field quality will be assessed using the Boezaart Surgical Field Grading Scale. Additional outcomes include operative duration, surgeon satisfaction, nasal packing requirement, postoperative bleeding, and perioperative complications.

The study population will consist of adults aged 18-60 years with chronic rhinosinusitis with bilateral nasal polyps who are planned for elective FESS and meet the specified eligibility criteria. Patients with conditions such as known bleeding disorders, use of anticoagulant or antiplatelet medication, hyponatremia or previous hyponatremia, uncontrolled hypertension, significant cardiovascular disease, fungal rhinosinusitis with polyps, or previous revision FESS will be excluded according to the study protocol.

The collected data will be analyzed using SPSS version 26.0. Continuous and categorical outcomes will be analyzed using statistical tests appropriate to their distribution and measurement characteristics. The study will use a two-sided significance level of p ≤ 0.05.

The study is intended to determine whether the addition of preoperative intranasal desmopressin is associated with differences in operative conditions during FESS for CRSwNP. The findings will provide evidence regarding intraoperative blood loss, surgical-field quality, operative duration, and other perioperative outcomes in the study population.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
174

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

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Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients aged 18-60 years.
  • Diagnosed cases of chronic rhinosinusitis with bilateral nasal polyps.
  • Patients planned for elective Functional Endoscopic Sinus Surgery (FESS).
  • Patients with ASA physical status I or II.

Exclusion Criteria:

  • Known bleeding disorders.
  • Fungal rhinosinusitis with polyps.
  • Use of anticoagulant or antiplatelet drugs.
  • Hyponatremia or history of hyponatremia.
  • Ischemic heart disease or uncontrolled hypertension.
  • Revision FESS.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intervention

Participants will receive intranasal desmopressin 20 μg (10 μg in each nostril) 30-60 minutes before induction of anesthesia, followed by Functional Endoscopic Sinus Surgery (FESS).
Drug: Desmopressin Acetate Nasal, 10 μg/0.1 ml per spray

Intranasal desmopressin 20 μg (10 μg in each nostril) will be administered 30-60 minutes before induction of anesthesia in participants undergoing Functional Endoscopic Sinus Surgery (FESS).
Active Comparator: Control

Participants will undergo Functional Endoscopic Sinus Surgery (FESS) without preoperative intranasal desmopressin.
Procedure: Functional Endoscopic Sinus Surgery

Participants will undergo Functional Endoscopic Sinus Surgery (FESS) without preoperative intranasal desmopressin.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Intraoperative Blood Loss During Functional Endoscopic Sinus Surgery
Time Frame: During surgery (intraoperative period)

Total intraoperative blood loss during FESS, measured in milliliters (mL). Blood loss will be calculated from the volume collected in the suction canister after subtracting the volume of irrigation fluid used during surgery and adding the estimated blood volume absorbed by blood-soaked nasal patties and surgical packs.
During surgery (intraoperative period)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Quality of Surgical Field During FESS
Time Frame: During surgery (intraoperative period)

Quality of the surgical field will be assessed using the Boezaart Surgical Field Grading Scale, ranging from Grade 0 (no bleeding) to Grade 5 (severe bleeding requiring constant suctioning and preventing surgical dissection).
During surgery (intraoperative period)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Services Institute of Medical Sciences, Pakistan

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Daniyal Babar, Services Institute of Medical Sciences, Pakistan

Publications and helpful links

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General Publications

Study record dates

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Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 14, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 14, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 27, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 27, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 2, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 23, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 22, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IRB/2026/1813/SIMS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared with other researchers. Study data will be used by the research team for the purposes of this study and will be maintained confidentially in accordance with applicable ethical and institutional requirements.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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