A national audit of sinus surgery. Results of the Royal College of Surgeons of England comparative audit of ENT surgery

Abstract

The results of a national audit of sinus surgery are presented. Forty-six consultant ENT surgeons reported on over 2500 sinus procedures. There has been an exponential rise in the number of surgeons in England and Wales performing functional endoscopic sinus surgery (FESS) in recent years. Sixty-five per cent of surgeons in our study used the FESS technique and 81% had formal or other training. Outpatient sinus endoscopy and CT scans have become more routine pre-operative investigations, whilst the use of plain films has waned. There was a wide variation in the numbers of FESS procedures performed by individual surgeons in the 6-month period (between 5 and 85). The overall complication rate was 0.75% for conventional surgery and 1.41% for functional surgery but no major complications were recorded. The primary symptom of blockage was most successfully treated by both conventional and functional surgery (70% and 84% asymptomatic or improved at 6 months). Pain was relieved in 75% of functional procedures and 47% of conventional procedures and discharge relieved in 76% of FESS procedures and 47% of conventional procedures.

A 5-Year Audit of Rhinology Procedures Carried Out in a District General Hospital

“…No serious complications such as CSF rhinorrhea, orbital damage or meningitis were reported. This is comparable to a quoted rate of 1.41%, 3 from a study undertaken by The Royal College of Surgeons of England in 1994, and a Dutch study 4 on endoscopic sinus surgery quoting rates of 4.2% for minor complications and 0.3% for serious complications. A French study 8 further quoted rates of 2.2% for major and 13.4% for minor complications.…”

“…Although there have been many studies quoting ENT and rhinology complications, [1][2][3][4][5][6][7][8][9] there have been none looking at the complication rates of one department with a single specialist rhinologist over a 5-year period with the information collected in a prospective manner. From this study, we can conclude that, in the hands of a specialist surgeon in a DGH, rhinological procedures are safe surgical procedures with few complications.…”

“…Although there have been several studies auditing ENT procedures and their complications, [1][2][3] there have been none in the literature involving a single ENT department monitored prospectively over a 5-year period. We looked initially at the total number of procedures undertaken within the ENT department over a 5-year period and then, more specifically, at the number of procedures in rhinology, which were mostly undertaken by one specialist surgeon over this period.…”

Long-term results of FESS — a random survey

“…As the presentations of these conditions are similar it was logical to group these together in analysis. Literature has also proved that symptoms do not correlate with objective signs; therefore we looked at patient satisfaction scores [2]. Emphasis was given towards long-term results as symptoms following nasal surgery vary with time [1].…”

“…Functional endoscopic sinus surgery (FESS) is a relatively new concept but is increasingly becoming popular with the majority of ENT surgeons [2]. Like any other procedures it is coming under close scrutiny with relation to evidence-based efficacy.…”