Functional Endoscopic Sinus Surgery: Key Points for Safer Surgery

Area of Science:

• Otolaryngology
• Surgical Innovation
• Medical Imaging

Background:

• Functional endoscopic sinus surgery (FESS) is a common procedure for inflammatory and infectious sinus diseases.
• Minimizing complications and enhancing surgical safety are paramount in FESS.
• Image-guided surgery offers potential benefits for complex sinus procedures.

Purpose of the Study:

• To review current measures and strategies for improving the safety of functional endoscopic sinus surgery.
• To identify key factors influencing complication rates in FESS.
• To evaluate the role of image guidance in enhancing FESS safety.

Main Methods:

• A comprehensive literature review was conducted using multiple databases (PubMed, EBSCO, UpToDate, Google Scholar).
• Keywords included "functional endoscopic sinus surgery," "FESS," "Safety," "Image-Guided," and "complications" from 2000 to 2024.
• Analysis focused on identifying common FESS techniques, complication rates, and safety-enhancing technologies.

Main Results:

• FESS has low rates of significant complications (0-1.5%) but higher rates of minor issues (1.12-20.8%).
• Preoperative preparation and surgical expertise are crucial for improving outcomes and avoiding problems.
• Image-guided surgery allows real-time tool positioning, significantly aiding anatomical navigation and potentially reducing risks.

Conclusions:

• Accurate CT scans, thorough patient preparation, and robust surgical training are essential for safer FESS.
• Image guidance is a valuable tool for enhancing precision and safety during endoscopic sinus surgery.
• Proactive management of intraoperative events like CSF leaks is critical to prevent increased infection risk and prolonged hospital stays.