Perioperative and postoperative management of orbital complications in functional endoscopic sinus surgery

1995 ◽  
Vol 6 (3) ◽  
pp. 231-236 ◽  
Author(s):  
Andrew B. Silva ◽  
James A. Stankiewicz
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Complications

Orbital Complications in Functional Endoscopic Sinus Surgery

1993 ◽  
Vol 109 (5) ◽  
pp. 814-820 ◽  
Author(s):  
Jacquelynne P. Corey ◽  
Robert Bumsted ◽  
William Panje ◽  
Ari Namon
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Nasolacrimal Duct ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Previous Surgery ◽  
Steroid Use ◽  
Orbital Complications ◽  
Lateral Canthotomy

Endoscopic sinus surgery can result in both minor and major complications. Among these, orbital complications—including retroorbital hematoma—are among the most feared. Injuries can be direct or indirect from pulling on diseased structures. A retrospective chart review of 616 endoscopic sinus procedures revealed eight orbital complications in seven patients. These included two medial rectus injuries, five orbital hemorrhages, and one nasolacrimal duct injury. Predisposing factors may include hypertension, lamina papyracia dehiscences, extensive polypoid disease, previous surgery, inability to visualize the maxillary ostia, violent coughing or sneezing, and chronic steroid use. Suggested management in the literature includes lateral canthotomy, steroids, and mannitol with ophthalmologic consultation. Opening of the wound by means of an external ethmoidectomy incision has also been suggested. We suggest that adding orbital decompression by means of multiple incisions into the periorbita should be added for fully effective relief. A “management” tree of decision parameters relevant to orbital complications is presented.

scholarly journals Diagnosis and Management of Orbital Fat Exposure During Endoscopic Sinus Surgery

2021 ◽  
pp. 014556132110154
Author(s):  
Edward Westfall ◽  
Zachary Fridirici ◽  
Nadeem El-Kouri ◽  
Ryan McSpadden ◽  
Mike Loochtan ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Sinus Surgery ◽  
Postanesthesia Care Unit ◽  
Orbital Fat ◽  
Diagnosis And Management ◽  
Muscle Trauma ◽  
Intraoperative Management ◽  
Orbital Complications ◽  
Orbital Hematoma

Background: The orbital complication rate during endoscopic sinus surgery (ESS) is <1%. Orbital fat exposure during ESS can herald orbital complications including orbital hematoma, extraocular muscle trauma, optic nerve injury, or blindness. The objective of this study was to evaluate the current consensus regarding diagnosis and management of orbital fat exposure during ESS. Methods: A 24-point survey focused on orbital fat exposure during ESS was distributed to American Rhinologic Society members. Also, a retrospective review of 25 cases of orbital fat exposure drawn from the principal investigator’s 30-year experience was performed. Results: Over 10 000 surgical cases of the principal investigator were reviewed. Twenty-five patients had orbital fat exposure. Five developed minor complications while 2 were major (ie, temporary vision changes). Two hundred thirty-six surgeons responded to the survey; 93% had encountered orbital fat during ESS; 88% of surgeons identify orbital fat by either its appearance endoscopically or the “bulb press” test. Almost every responding surgeon will cautiously avoid further manipulation in the area of orbital fat exposure. Nearly half will immediately curtail the extent of surgery. Surgeons do not significantly change postoperative management. Considerations regarding observation in postanesthesia care unit, close follow-up, and strict nose blowing precautions are common. Conclusion: Orbital fat exposure during ESS is a rarely discussed, but clinically important. Orbital fat exposure can be a harbinger for major orbital complications that should be recognized by endoscopic appearance and confirmed with the bulb press test. Caution with “no further manipulation” of orbital fat is the guiding principle for intraoperative management, while postoperative management is generally expectant. Level 4 Evidence

Outcomes of Early Functional Endoscopic Sinus Surgery for Orbital Complications of Acute Rhinosinusitis

2020 ◽  
Author(s):  
Saangyoung E. Lee ◽  
Mark W. Gelpi ◽  
William C. Brown ◽  
Adam M. Zanation ◽  
Brent A. Senior ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Acute Rhinosinusitis ◽  
Orbital Complications

One-way Valve Bottle Contamination Rates in the Immediate Post–functional Endoscopic Sinus Surgery Period

2011 ◽  
Vol 25 (6) ◽  
pp. 393-396 ◽  
Author(s):  
Jennifer M. Kofonow ◽  
Aditi Bhuskute ◽  
Laurel Doghramji ◽  
James N. Palmer ◽  
Noam A. Cohen ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Positive Culture ◽  
Postoperative Management ◽  
Delivery Systems ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Saline Irrigation ◽  
Time Of Surgery ◽  
Accepted Practice ◽  
Alternative Delivery

Background Sinonasal saline irrigation has become an accepted practice in the immediate postoperative management of functional endoscopic sinus surgery (FESS) patients. Recent studies have found that valveless delivery systems of sinonasal irrigation are colonized with bacteria. An alternative delivery system uses a one-way valve to reduce saline backflow and may limit bottle contamination. Our sole objective was to determine whether this system in post-FESS patients eliminates microbial bottle contamination. Methods Eight patients undergoing FESS were given one-way valve irrigation bottles to use immediately after surgery. Bottles were collected after 1 week of use and another set of bottles after an additional week. Endoscopic-directed cultures of the middle meatus were performed at the time of surgery. Returned used bottles were swabbed for bacteria and the valve system of the bottle was analyzed under scanning electron microscopy (SEM) for the presence of bacteria. Results All sinus swabs collected at the time of surgery grew bacteria with Staphylococcus sp. present in all samples. After the 1st week of use, 5/8 bottles grew bacterial cultures and showed bacterial presence on the valves by SEM. After the 2nd week, 4/5 bottles had positive culture results and also showed bacterial presence on the valves by SEM. Conclusion Despite commercial claims that the use of valves and limit of backflow into the bottle will eliminate contamination, our study showed that one-way valve delivery systems become contaminated with bacteria after 1 week of use. We also showed that the bottle valves themselves harbor bacteria after 1 week of use.

Orbital Complications of Functional Endoscopic Sinus Surgery at King Hussein Medical Center

2018 ◽  
Vol 25 (2) ◽  
pp. 79-82
Author(s):  
Ahmed Khatatbeh ◽  
Khaled Hamasha ◽  
Hisham Rashdan ◽  
Khaldoun Al-Shugran ◽  
Haifaa Obedat
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Medical Center ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Complications
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