Reporting results of sinus surgery: A classification system

Abstract

Because various systems are in current use to report the outcome, including complications, of sinus surgery, it is impossible to evaluate the relative success of various procedures. The published literature shows lack of agreement even as to what adverse surgical events constitute complications, as well as whether these complications are major or minor. This article presents a reporting system that takes into account (1) the severity of disease preoperatively, as determined by results of endoscopic examination and findings on computed tomography (CT); (2) history of previous sinus surgery; (3) grading of relief of sinus disease symptoms postoperatively; and (4) results at various follow-up times. A classification system for complications is also included, based on whether an adverse event is major or minor and whether it can be corrected. The classification system presented should serve as a starting point for discussion among sinus surgeons of a uniform reporting system, the adoption of which would make possible the statistical comparison of the success of various procedures. Because various systems are in current use to report the outcome, including complications, of sinus surgery, it is impossible to evaluate the relative success of various procedures. The published literature shows lack of agreement even as to what adverse surgical events constitute complications, as well as whether these complications are major or minor. This article presents a reporting system that takes into account (1) the severity of disease preoperatively, as determined by results of endoscopic examination and findings on computed tomography (CT); (2) history of previous sinus surgery; (3) grading of relief of sinus disease symptoms postoperatively; and (4) results at various follow-up times. A classification system for complications is also included, based on whether an adverse event is major or minor and whether it can be corrected. The classification system presented should serve as a starting point for discussion among sinus surgeons of a uniform reporting system, the adoption of which would make possible the statistical comparison of the success of various procedures.