Prevention and treatment of functional endoscopic sinus surgery complications: Knowledge from cadaveric dissection and literature revision
DOI:
https://doi.org/10.34631/sporl.116Keywords:
functional endoscopic sinus surgery, complications, prevention, treatment, cadaveric dissection, review, orbital hematoma, CSF leakAbstract
Introduction: Since its introduction in the 1980s, functional endoscopic sinus surgery (FESS) met a great development and expansion to other surgical areas. Nevertheless, the modern technique did not overcome the risks and dangerousness of FESS, and its complications are still the number one reason for malpractice claims in otorhinolaryngology and head and neck surgery in the US. The objective of this work is to present practical attitudes to prevent and treat FESS complications, based on clinical experience, cadaveric training and literature revision.
Methods: Experience and iconographic presentation from:
1) cadaveric training dissection;
2) postgraduate endoscopic sinus surgery courses organized by the Department of Otorhinolaryngology of the Egas Moniz Universitary Hospital; and
3) clinical cases from the same department. Literature revision about practical attitudes for prevention and management of FESS complications.
FESS complications are classified based on the organ injured (orbital, vascular and intracranial) and severity (major and minor). The preventive and therapeutic attitudes for each complication are presented in a systematic and documented manner mainly based on work from residents.
Conclusions: FESS complications will always happen independently of surgeon experience, and is his obligation to prevent and treat them when they occur. Up-to-date knowledge of FESS complications allied with cadaveric training, allows a safer and faster learning curve with lower complications rate.
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