Complications of Frontal Sinus Surgery

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Complications of Frontal Sinus Surgery

• E Hoskison, M Daniel, NS Jones, A Sama
• Department of Otorhinolaryngology Nottingham
  University Hospital

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Introduction

• Frontal sinus surgery is complex
• There is a perceived increased complication rate
  compared with other sinus surgery

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Aim

• To determine the frequency and nature of
  complications occurring in Frontal Sinus surgery
  at a secondary/tertiary centre

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Methods

• Prospective data collection
• All patients undergoing Frontal sinus surgery at
  NUH
• 30th May 1990 26th Sept 2007
• Data collected on demographics, type of
  procedure, major and minor complications

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Results Demographics

• Overall FS surgery 247 patients, 308 procedures
• Complications in 44 (14) procedures in 31
  patients
• Mean age 47.6 years (range 18-75 years)
• 10 ( 32) female
• 26 (84) patients had previous surgery

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Procedures resulting in a complication

• EXTERNAL
• FS oblit. 3
• Riedles 3
• Lothrop 2

ENDOSCOPIC Draf II 7 Draf III 2 Radical FESS
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Major Complications 11 (3.6)

• CSF leak (intra-op) 3
• Periorbital ecchymosis 2
• Epiphoria 2
• Transient diplopia 3
• Permanent diplopia 1

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Minor complications 33 (10.7)

• Infection 11
• (meningism 1, MRSA 1)
• Stenosis 8
• Post operative bleeding 5
• Neuropathic pain 4
• Cosmetic deformity 3
• Adhesions 2

1 cons.
3 packed
1 surg.
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Comparison of complication rates sinus surgery
and FSS
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Conclusion

• 17 year series
• 308 frontal sinus procedures resulted in 44
  complications (14.3)
• Overall major complication rate 3.6, only one
  case (0.3) permanent
• 12 cases (3.9) required further surgical
  intervention
• Restenosis rate 2.5

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Thank you