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

Pharmacological pupil dilatation after sinus surgery

2021 ◽  
Vol 14 (1) ◽  
pp. e236666
Author(s):  
Bassem Mettias ◽  
Tahir Islam ◽  
Theodoros Valsamakis
Keyword(s):  
Case Report ◽  
Endoscopic Sinus Surgery ◽  
Rare Case ◽  
Sinus Surgery ◽  
Lacrimal Duct ◽  
Postoperative Assessment ◽  
Rare Case Report ◽  
High Concern ◽  
Flow Through ◽  
Orbital Complications

Orbital complications after endoscopic sinus surgery are serious problems. Inadvertent contamination of the eye by pharmacological solution can lead to early postoperative anxiety to patients and high concern to surgeons. This is a rare case report of retrograde epinephrine flow through lacrimal duct in sinus surgery with learning tips during postoperative assessment for reassurance in temporary pharmacological effect rather than serious complication.

The early history and development of functional endoscopic sinus surgery

2019 ◽  
Vol 134 (1) ◽  
pp. 8-13
Author(s):  
K J Kane
Keyword(s):  
Twentieth Century ◽  
Nasal Cavity ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Early History ◽  
Sinus Surgery ◽  
Diagnosis And Management ◽  
The World ◽  
English Speaking

AbstractBackgroundThe concept of endoscopic diagnosis and procedures on the nasal cavity had been investigated for several decades in Europe in the early part of the twentieth century. It was Prof Walter Messerklinger and his assistant, Heinz Stammberger, with US colleague, David Kennedy, who brought the science and technique of functional endoscopic sinus surgery to the wider world.MethodsThe author, an English-speaking surgeon, was present at this movement from the commencement of its propagation, and has recorded the remarkable ascendency of this technique throughout the world.ConclusionThe technique revolutionised the diagnosis and management of intranasal, sinus and intracranial conditions.

Postoperative management of endoscopic sinus surgery

2002 ◽  
Vol 10 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Rodney J. Schlosser ◽  
Stilianos Kountakis ◽  
Charles W. Gross
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Sinus Surgery

Effect of Microporous Polysaccharide Hemospheres (MPH) on Bleeding after Endoscopic Sinus Surgery

2009 ◽  
Vol 141 (3) ◽  
pp. 353-357 ◽  
Author(s):  
Jastin L. Antisdel ◽  
Jackie L. West-Denning ◽  
Raj Sindwani
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Postoperative Recovery ◽  
Early Postoperative Period ◽  
University Hospital ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Visual Analog Scales ◽  
Microporous Polysaccharide Hemospheres ◽  
Bleeding Score

OBJECTIVES: Absorbable hemostatic agents are commonly used after endoscopic sinus surgery (ESS). MPH (microporous polysaccharide hemospheres) is a novel hemostatic powder that is rapidly absorbed. The goal of this study was to examine the effects of MPH on bleeding after ESS. STUDY DESIGN: Randomized, controlled, single-blinded. SETTING: Tertiary university hospital. SUBJECTS AND METHODS: Patients undergoing bilateral (symmetric) ESS for CRS by the same surgeon were randomized to unilateral treatment with MPH at surgical conclusion. The untreated opposite side served as a control. All patients received standard postoperative management. Patients completed symptom diaries using visual analog scales (VAS, scored out of 100) at baseline and through postoperative day (POD) 30. Outcomes including bleeding, pain, obstruction, and nasal discharge were recorded separately for left and right sides. RESULTS: Forty patients (19 men, 21 women) with an average age of 48.3 years were included. There were no complications, and all patients were discharged home the same day. The mean bleeding score on POD one for MPH-treated sides was 22.5 vs 39.0 for untreated controls (mean reduction 16.5, P < 0.0001, 95% CI −23.2 to −9.7). The scores for bleeding at baseline and at all other post-treatment days were not significantly different ( P > 0.05). There were no other significant differences between MPH-treated and control sides in any other variables measured. CONCLUSION: The use of MPH after ESS results in significantly less bleeding in the early postoperative period with no increase in pain, obstruction, or nasal discharge. Patients treated with MPH follow a normal postoperative recovery otherwise.

scholarly journals Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

2019 ◽  
Vol 47 (2) ◽  
pp. E12 ◽  
Author(s):  
Megumi Koizumi ◽  
Miho Ishimaru ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Tatsuya Yamasoba ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Length Of Stay ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Neurosurgical Procedures ◽  
Fungal Sinusitis ◽  
Intracranial Abscess ◽  
Diagnosis Procedure Combination ◽  
Intracranial Complications ◽  
Orbital Complications

OBJECTIVEAlthough sinusitis-induced intracranial complications rarely occur in the current era of antibiotics, they can induce neurological symptoms or death. The authors of this study investigated the association between endoscopic sinus surgery (ESS) and outcomes in patients who had undergone neurosurgical procedures for sinusitis-induced intracranial abscess.METHODSThe authors obtained data on patients with sinusitis-induced intracranial abscess from the Japanese Diagnosis Procedure Combination inpatient data for the period from 2010 to 2017. They excluded patients with fungal sinusitis, orbital complications, immunodeficiency, and malignant disease. They also excluded patients who had received antifungal agents, chemotherapy, immunosuppressants, and antidiabetic drugs. Eligible patients were divided into those with and those without neurosurgical procedures. Propensity score–adjusted regression analyses were performed to examine the association between ESS within the same hospitalization and outcomes (mortality, blood transfusion, readmission, revision neurosurgery, and length of stay).RESULTSOf the 552 potentially eligible patients, 255 were treated with neurosurgical procedures, including 104 who underwent ESS within the same hospitalization and 151 who did not. ESS was not significantly associated with mortality (OR 0.54, 95% CI 0.05–5.81, p = 0.61), blood transfusion (OR 1.95, 95% CI 0.84–4.51, p = 0.12), readmission (OR 0.86, 95% CI 0.34–2.16, p = 0.75), revision neurosurgery (OR 0.65, 95% CI 0.24–1.74, p = 0.39), or length of stay (percent difference −10.8%, 95% CI −24.4% to 5.1%, p = 0.18).CONCLUSIONSThe present study suggests that ESS may not have significant benefits with respect to reducing mortality, blood transfusion, readmission, revision neurosurgery, or length of stay.

Sign in / Sign up

Export Citation Format

Share Document