A Snapshot of Endoscopic Sinus Surgery in the Western US

Abstract

Objective: Endoscopic sinus surgery is a commonly performed procedure. Despite its prevalence, few data exist regarding the characteristics of the typical endoscopic sinus surgery. At the conclusion of the presentation participants should be able to discuss the following: 1) typical patient characteristics, and 2) types of cases being performed by otolaryngologists. Method: A survey was mailed by The Doctors Company to 500 insured otolaryngologists in the western United States. The survey queried characteristics of the last endoscopic sinus surgery performed. Results: One hundred ninety-six surveys were returned. Chronic sinusitis was the predominant indication for surgery (89%). Revision cases constituted 18% of the cases. Maxillary antrostomies and ethmoidectomies (partial or total) were performed in 94% and 90% of cases, respectively. Powered instrumentation was utilized in 77% of the cases. The majority (71%) did not use image guidance. The surgeon rated the case as technically difficult in 25% of cases. Complications included bleeding (3), septal hematoma (1), check numbness (1), recurrence of polyposis (1), pneumonia (1), and entry into medial orbit (1). Physician reports of technical difficulty did not correlate with reported complications. Conclusion: The present study provides insight into “typical” endoscopic sinus surgery performed in the western United States. The typical patient has chronic sinusitis and is undergoing an initial procedure that involves at least the maxillary and ethmoid sinuses. Further research into practice patterns and risk stratification in endoscopic sinus surgery is warranted.