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Related Experiment Video

Updated: Feb 27, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Published on: June 20, 2018

Evaluating Surgeon-Specific Performance for Endoscopic Sinus Surgery.

Luke Rudmik¹, Yuan Xu², Jeremiah A Alt³

¹Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.

JAMA Otolaryngology-- Head & Neck Surgery

|June 28, 2017

Summary

This summary is machine-generated.

Quality of endoscopic sinus surgery (ESS) varies, with 16% of surgeons showing lower-than-expected revision rates. This study highlights the need for surgeon-specific performance evaluation to improve ESS quality of care for chronic rhinosinusitis (CRS).

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Area of Science:

Otolaryngology
Surgical Quality Improvement
Health Services Research

Background:

Endoscopic sinus surgery (ESS) quality is questioned due to geographic variations, unclear indications, and lack of specific metrics.
High complication risks make ESS a target for quality improvement initiatives.

Purpose of the Study:

To assess surgeon-specific performance in ESS using a risk-adjusted, 5-year revision rate as a quality indicator.
Identify factors influencing ESS outcomes to guide quality enhancement.

Main Methods:

Retrospective analysis of a population-based administrative database in Alberta, Canada (2007-2010).
Included adults (≥18) with chronic rhinosinusitis (CRS) undergoing primary ESS.
Utilized logistic regression to develop a risk adjustment model for the 5-year ESS revision rate.

Main Results:

43 surgeons performed primary ESS on 2168 patients; 10.6% required revision surgery within 5 years.
Risk-adjusted analysis revealed 16% of surgeons had lower-than-expected performance.
Nasal polyps, systemic corticosteroid use, and concurrent septoplasty were associated with revision rates.

Conclusions:

Surgeon-specific performance evaluation in ESS can inform quality improvement efforts.
While most surgeons performed comparably, a significant minority showed lower performance, indicating room for care quality enhancement.
Further research is needed to validate risk adjustment models and explore additional surgeon-specific variables for feedback.