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Complications of endoscopic sinus surgery in a residency training program
1Department of Otolaryngology--Head and Neck Surgery, West Virginia University, Morgantown 26506-9200, USA.
The Laryngoscope
|April 1, 1995
Summary
Endoscopic sinus surgery is a safe and effective treatment for chronic sinusitis, with low rates of major complications even when performed by residents. This study found minor complications in 15.1% and major ones in 1.5% of cases.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Medical Procedures
Background:
- Chronic sinusitis is a prevalent condition often managed with medical therapy.
- Endoscopic sinus surgery (ESS) has become a primary surgical intervention for chronic sinusitis.
- Surgical outcomes and complication rates can vary based on surgeon experience and technique.
Purpose of the Study:
- To evaluate the safety and complication rates of endoscopic sinus surgery performed by residents under supervision.
- To identify common minor and major complications associated with ESS.
- To assess the impact of routine partial middle turbinectomy on adhesion rates.
Main Methods:
- A retrospective review of 337 patients who underwent ESS between August 1990 and August 1993.
- Procedures were primarily performed by senior residents with faculty supervision.
- Complication data, including type and frequency, were collected and analyzed.
Main Results:
- Overall, 15.1% of patients experienced minor complications and 1.5% had major complications.
- The most frequent major complication was cerebrospinal fluid leak, successfully managed intraoperatively.
- Common minor complications included middle turbinate adhesions and orbital penetration; routine partial middle turbinectomy did not reduce adhesion rates.
Conclusions:
- Endoscopic sinus surgery demonstrates a favorable safety profile, even when conducted by surgical residents under appropriate faculty guidance.
- Cerebrospinal fluid leaks, though rare, are manageable during surgery.
- Adhesion formation remains a concern, and routine partial middle turbinectomy may not mitigate this issue.