Correlation of Complications during Endoscopic Sinus Surgery with Surgeon Skill Level and Extent of Surgery

2005 ◽  
Vol 19 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Michael B. Soyka ◽  
David Holzmann
Keyword(s):  
Complication Rate ◽  
Retrospective Review ◽  
Classification System ◽  
Endoscopic Sinus Surgery ◽  
Skill Level ◽  
Point Of View ◽  
Sinus Surgery ◽  
New Classification ◽  
Great Range ◽  
Extent Of Surgery

Background Endoscopic sinus surgery (ESS) produces a great range of potential complications. Rough segregation into “minor” and “major” complications seems insufficient. This study uses a recently published new classification system that is based more on the patient's point of view, with a greater variety of options. Methods A retrospective review was undertaken of 421 ESS procedures. Both, the surgeon's experience and the extent of surgery were correlated with the complication rate. Results The overall complication rate was 39.7% (grades A–D) and did not correlate significantly with either the experience of the surgeon or with the extent of surgery. Conclusion The new classification is simple, precise, and takes complications into account that used to be neglected. ESS is even safe in the hands of less skilled surgeons as long as the degree of difficulty stays highly adapted to his/her ability. Some complications (grade A) seem to be inherent to the procedure.

The Effect of FloSeal on Mucosal Healing after Endoscopic Sinus Surgery: A Comparison with Thrombin-Soaked Gelatin Foam

2003 ◽  
Vol 17 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Rakesh K. Chandra ◽  
David B. Conley ◽  
Robert C. Kern
Keyword(s):  
Granulation Tissue ◽  
Endoscopic Sinus Surgery ◽  
Adhesion Formation ◽  
Mucosal Healing ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Patient Comfort ◽  
Rapid Healing ◽  
Extent Of Surgery ◽  
High Degree

Background The optimal form of nasal packing after endoscopic sinus surgery (ESS) still has not been established. Although wide variations exist among sinus surgeons, the goals are adequate hemostasis, rapid healing, and patient comfort. Preliminary studies indicated that FloSeal (FS), a novel absorbable hemostatic paste used as a nasal pack, was associated with minimal postoperative discomfort and effective hemostasis. This study was designed to evaluate the effects of this agent on mucosal healing in ESS. Methods Twenty consecutive patients underwent bilateral ESS. For each patient, one ethmoid cavity was randomized to receive FS and the other received thrombin-soaked gelatin foam. The extent of granulation tissue and adhesion formation was evaluated at 6–8 weeks after surgery. Results No significant differences were observed between the FS and the thrombin-soaked gelatin foam groups with respect to the preoperative Lund-Mackay score, extent of surgery performed, or need for additional nasal packing. However, the FS group showed clear trends toward increased granulation tissue (p = 0.007) and adhesion (p = 0.006) formation. Conclusion: Absorbable hemostatic agents are associated with a high degree of patient comfort and provide hemostasis comparable with traditional techniques. Different materials may induce differential patterns of mucosal healing, potentially affecting the ultimate result of ESS.

APPROACH TO UNCINECTOMY BY SWING DOOR TECHNIQUE VS STANDARD TECHNIQUE – A COMPARATIVE STUDY

2021 ◽  
pp. 37-39
Author(s):  
Praveen Singh ◽  
Tarun Ojha ◽  
Shreya Prasad
Keyword(s):  
Complication Rate ◽  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Tertiary Care ◽  
Standard Technique ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Minor Complication ◽  
Tertiary Care Centre ◽  
Group B

Introduction: Uncinectomy is the most important step in endoscopic sinus surgery which can be performed by various methods. The present study aimed to compare the results and complications of performing uncinectomy and middle meatus antrostomy using the standard and swing door techniques during FESS. Methods: In this study, 50 patients of both gender (aged 18–50 years) suffering from chronic maxillary sinusitis underwent functional endoscopic sinus surgery (FESS) from January 2019 to December 2019 at a tertiary care centre. The patients were divided on random basis into two groups of 25. Group Apatients underwent uncinectomy using standard technique while Group B underwent uncinectomy using swing door technique. Results:The mean VAS scores for Group Aand Group B were 78.50 ± 16.63 and 80.58 ± 14.34, respectively, suggesting that Group B patients have better symptomatic improvement. No major complications were observed in both groups. At the end of Week 2, minor complications were observed in 8 (26.7%) of the patients from Group Aand 2 (6.7%) from Group B. By the sixth week, the minor complication rate was 1 (3.3%) and 0 in Group A and Group B, respectively. When compared statistically during the second week using chi-square test, the difference in minor complication rate was found to be statistically signicant (p < 0.05, 2 = 4.81), with lower incidence of complications in Group B. Conclusion: Uncinectomy performed by swing door technique produces better postoperative results, with lesser complications, when compared to the standard technique.

Factors Associated with Revision Surgery after Balloon Sinuplasty

2018 ◽  
Vol 160 (4) ◽  
pp. 734-739 ◽  
Author(s):  
Matthew Cooper ◽  
Tracy Cheng ◽  
Tracy Truong ◽  
Maragatha Kuchibhatla ◽  
Ralph Abi Hachem ◽  
...  
Keyword(s):  
Health System ◽  
Retrospective Review ◽  
Endoscopic Sinus Surgery ◽  
Odds Ratio ◽  
Selection Procedure ◽  
Senior Author ◽  
Sinus Surgery ◽  
Radiographic Findings ◽  
Balloon Sinuplasty ◽  
Univariate Analyses

Objective Although balloon sinuplasty (BSP) is increasing in popularity, little is known about which patients are the ideal candidates. The objective of this study is to investigate factors that may be associated with BSP failure. Study Design Retrospective review. Setting Academic center. Subjects and Methods This is a 6-year (July 2011-June 2017) retrospective review of patients who underwent BSP or revision endoscopic sinus surgery (rESS) after BSP within a single tertiary health system. Demographics, clinical findings, and radiographic findings were investigated for association with rESS via univariate analyses and a multivariable backward elimination selection procedure. Results A total of 154 patients were identified (median age, 53 years): 146 patients underwent BSP at a single health system, with 16 (11%) undergoing rESS; 8 patients underwent BSP at an outside institution and underwent rESS with the senior author. Mean ± SD follow-up was 12.8 ± 16.6 months. Univariate analyses revealed that prior endoscopic sinus surgery, polyps, allergic rhinitis, and gram-negative infection were significantly associated with rESS. As for radiographic findings, a higher Lund-Mackay score, neo-osteogenesis, moderate or complete opacification, and hyperdensities were associated with rESS. The final model after multivariable selection showed that higher radiographic scores (odds ratio, 1.08; 95% CI, 1.01-1.17) and neo-osteogenesis (odds ratio, 5.25; 95% CI, 1.68-16.42) were associated with higher odds for rESS. Conclusions This study identifies several clinical and radiographic factors that may be associated with the need for rESS after BSP. Surgeons can take these factors into consideration when deciding whether a patient should forego BSP and undergo conventional FESS.

Endoscopic Sinus Surgery with Middle Turbinate Resection: Results and Complications

1993 ◽  
Vol 72 (5) ◽  
pp. 351-355 ◽  
Author(s):  
John F. Biedlingmaier
Keyword(s):  
Success Rate ◽  
Retrospective Review ◽  
Endoscopic Sinus Surgery ◽  
Patency Rate ◽  
Middle Turbinate ◽  
Partial Resection ◽  
Sinus Surgery

Numerous articles have been published on the techniques of endoscopic sinus surgery. Fewer articles are available regarding the effectiveness of these procedures in curing the patient's symptoms. A retrospective review of eighty patients was performed to outline their symptoms and determine the success of the surgery. Partial middle turbinate resection was performed in all patients. The high overall success rate of 93.5% and the high antrostomy patency rate of 94.8% demonstrates the benefits of partial resection.

Local and Regional Anesthesia for Functional Endoscopic Sinus Surgery

1997 ◽  
Vol 106 (9) ◽  
pp. 767-769 ◽  
Author(s):  
Wai Chung Lee ◽  
Tilak R. Kapur ◽  
Walter N. Ramsden
Keyword(s):  
Regional Anesthesia ◽  
Complication Rate ◽  
Endoscopic Sinus Surgery ◽  
Surgical Complication ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Anesthetic Technique ◽  
Anesthetic Complications ◽  
Regional Anesthetic

An effective topical and regional anesthetic technique using 25% cocaine paste combined with intravenous midazolam hydrochloride was used in 554 patients undergoing functional endoscopic sinus surgery. The operative fields were excellent and all procedures were completed with little patient disturbance. Patients recovered rapidly from sedation and were usually fit for discharge on the same day. There were no anesthetic complications. The major surgical complication rate was 0.5%.

Postoperative Hemorrhage after Endoscopic Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P80-P80
Author(s):  
Troy D. Woodard ◽  
James A Stankiewicz
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Tertiary Care ◽  
Care Facility ◽  
Postoperative Hemorrhage ◽  
Sinus Surgery ◽  
Complication Rates ◽  
Tertiary Care Facility ◽  
Significant Difference ◽  
Extent Of Surgery ◽  
The Mean

Objective 1) Identify complication rates of patients that underwent endoscopic sinus surgery and developed postoperative hemorrhage. 2) Determine if there is a correlation of preoperative variables with the development of this complication. Methods Retrospectively review patients who had functional endoscopic sinus surgery and developed postoperative hemorrhage from 1987 to 2007 in an university tertiary care facility. Analyze baseline characteristics and preoperative clinical variables for significant correlations. Results 29 of 5000 endoscopic cases resulted in postoperative hemorrhage (.58% complication rate). The mean age of the patients was 50 years old and there were equal proportions of male and female patients. While the extent of surgery demonstrated no significant difference among the patients, hemorrhage was most likely to occur in patients with previous surgery. An overwhelming majority of patients required a surgical procedure to control the bleeding. Hemorrhage was primarily isolated on the patient's right side and involved the sphenopalatine or posterior septal arteries. Conclusions Endoscopic sinus surgery has vastly increased in popularity. However, there still is a paucity of information in the literature on complications associated with endoscopic sinus surgery, particularly postoperative hemorrhage. The results from this study provide identifying characteristics that predispose patients to develop this complication and what methods can be successfully utilized to treat this complication.

The Amsterdam Classification of Completeness of Endoscopic Sinus Surgery (ACCESS): a new CT-based scoring system grading the extent of surgery

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
S. Reitsma ◽  
G.F.J.P.M. Adriaensen ◽  
M.E. Cornet ◽  
R.M. van Haastert ◽  
M.H. Raftopulos ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Scoring System ◽  
Sinus Surgery ◽  
Extent Of Surgery

scholarly journals Effectiveness of Functional Endoscopic Sinus Surgery in Surgical Management of Ethmoid Polyps

2022 ◽  
Vol 8 (1) ◽  
pp. 38-42
Author(s):  
Kumari Radha M. N ◽  
Anju Unnikrishnan ◽  
Manju N
Keyword(s):  
Ct Scan ◽  
Surgical Management ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Frontal Recess ◽  
Extent Of Surgery ◽  
Middle Meatus Antrostomy

Background: Aim: To assess efficacy of functional endoscopic sinus surgery in surgical management of ethmoid polyps.Methods:One hundred twelve adult patients age ranged 18- 38 years of either gender with ethmoid polyps underwent FESS under general anesthesia. The extent of surgery was decided based on the findings in pre-operative CT scan of paranasal sinuses. Anterior ethmoidectomy, posterior ethmoidectomy, middle meatus antrostomy and clearance of frontal recess were performed in all the patients. Five functional criteria were evaluated as nasalobstruction , anosmia, rhinorrhea, post nasal drip, head ache and facial pain.Results:Pre- operative nasal obstruction percentage was 3.42 and post- operative ercentage was 2.10, Anosmia percentage was 2.14 and 1.15, Rhinorrhea percentage was 3.56 and 2.08 and ocular problem in 1 and synechia in 4 cases.Conclusions:Functional endoscopic sinus surgery found to be effective in management of ethmoid polyps and hence can be the treatment of choice.

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