Wrong-site sinus surgery in otolaryngology.

Area of Science:

• Otolaryngology
• Surgical Safety
• Medical Error Analysis

Background:

• Wrong-site surgery is a significant patient safety concern.
• Sinus surgery carries specific risks due to complex anatomy and imaging interpretation.

Purpose of the Study:

• To determine the prevalence and scope of wrong-site sinus surgery.
• To assess surgeon awareness, concerns, and current practices regarding wrong-site sinus surgery.

Main Methods:

• An electronic mail survey was distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery.
• The survey consisted of 11 items addressing experiences and concerns related to wrong-site sinus surgery.

Main Results:

• A 19.8% response rate yielded 455 participants; 9.3% reported knowledge of wrong-site sinus surgery cases.
• Radiographic error was implicated in 48% of analyzed cases, with the Universal Protocol followed in only one-third.
• A majority of respondents (61%) expressed concern about performing wrong-site sinus surgery, and practices like checklist use (49%) and pre-operative CT review (65%) varied significantly.

Conclusions:

• Around 10% of surveyed otolaryngologists are aware of wrong-site sinus surgery incidents, with most concerned about their own practice.
• Vigilance for inverted computed tomography (CT) images is crucial, suggesting a need for national efforts to address this systems defect.
• Enhanced surgeon training in disclosure and the development of sinus-specific checklists by professional societies are recommended to improve patient safety.