Complications in Sinus Surgery and New Classification Proposal

Abstract

Complication overviews may lead to measures directed toward quality improvement and to better information for patients. When evaluating the rhinological literature from 1979 to 1999, a detailed comparison could not be made because of differences in reporting. With the advent of electronically stored medical data, events can be registered better than before. To be able to compile very diverse data from electronic dossiers into concise overviews for feedback, a simple general scale with broad categories is needed. These feedback overviews enable insight in the complication rates of different kinds of sinus surgery and monitoring of changing trends in sinus surgery. An example of a general classification based on severity is presented for use when electronically storing medical data. This scale varies from adverse events (grade A) to death (grade D). A consensus on categorization of complications is a prerequisite for a valid comparison with other clinics. To instigate a discussion about consensus, this classification is presented as an example. Our proposal is presented together with an overview of sinus surgery complications in recent literature for reference.

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…After reporting on an initial incidence of complications, Stankiewicz 1355 demonstrated that after the experience of an additional 300 ethmoidectomies, the overall complication rate went from 29% down to 9.3%, suggesting that as experience with the procedure increased, the likelihood of complications decreased. Using the Rombout and de Vries 1357 criteria, Soyka and Holzmann 1356 retrospectively evaluated 421 endoscopic procedures of varied complexity as performed by surgeons of varied skill levels and found that there was an overall complication rate of 39.7%, which included both minor and major complications. However, there was no significant correlation between the experience of the surgeon and the incidence of complications.…”

Catheter in Antrochoanal Polyp: Functions Intact

“…Sphenopalatine artery, ethmoidal artery, and internal carotid artery are always at danger during Endoscopic sinus surgery leading to catastrophic complications. Injury to the Optic nerve in sphenoid sinus can cause permanent blindness [8]. All the above mentioned complications can be avoided by our method of using rubber catheter for AC Polyp resection.…”

Complications of hyoid suspension in the treatment of obstructive sleep apnea syndrome

“…We divided complications in (a) adverse events (spontaneous recovery), (b) minor complications (intervention needed, but without residual problems), (c) major complications (persistent problems) and (d) death [27].…”