Indications for and Avoidance of Complications in Endoscopic Sinus Surgery

Abstract

At the Spring Meeting of the American Rhinologic Society in Palm Beach, Fla, Vijay Anand, MD, New York, reviewed his indications and methods for avoidance of complications in endoscopic sinus surgery. His four indications are ethmoiditis, fungal sinusitis, recurrent sinusitis, and biopsy of tumor. Contrasted with this, he recommends not using the procedure for recurrent pansinusitis, tumor resections, and frontal sinus mucocele. To avoid complications, Dr Anand advocates a good preoperative evaluation with a careful diagnostic endoscopic examination. The preoperative planning includes a coronal computed tomographic scan that is reviewed with the radiologist. Special areas of concentration during surgery include local anesthesia and hemostasis. A knowledge of anatomy is absolutely essential. Immediately after the operation, vision and eye movements need to be evaluated. An ophthalmologic consultation is recommended for any eye dysfunction identified. Likewise, if a cerebrospinal fluid leak is suspected, neurosurgical consultation is essential.