Preventing and Managing Complications in Frontal Sinus Surgery

Eloy, Jean Anderson; Svider, Peter F.; Setzen, Michael

doi:10.1016/j.otc.2016.03.019

Cited by 10 publications

(11 citation statements)

References 61 publications

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“…In contrast, the performance of BD procedures increased significantly more for the time period from 2011 through 2015 for every sinus cavity, frontal sinusotomy (4.7-fold, vs. 1.13fold), sphenoidotomy (7.0-fold vs. 1.1-fold), and maxillary antrostomy (5.0-fold vs. 1.01-fold) (Figs. [2][3][4].…”

Section: Resultsmentioning

confidence: 99%

“…Our findings (Figs. [1][2][3][4] suggest that there has been a considerable increase in the number of sinus procedures performed on the Medicare population, driven by an increase in the use of BD; hence, BDs may not be replacing ESS but rather are being performed in addition to the stable baseline number of ESS. Importantly, ESS rose 5.2% during this study period, whereas Medicare enrollment rose 13.4%.…”

Section: Discussionmentioning

confidence: 99%

“…Critics also note that although BD addresses ostial occlusion, it may not adequately address factors related to inflammation, microbial colonization, and mucociliary dysfunction. Concerns also have been raised that otolaryngologists should avoid pursuing BD simply because it represents a technically “easier” approach in situations with complicated anatomy requiring more complex intervention, which can lead to undesirable consequences …”

Section: Introductionmentioning

confidence: 99%

“…Concerns also have been raised that otolaryngologists should avoid pursuing BD simply because it represents a technically "easier" approach in situations with complicated anatomy requiring more complex intervention, which can lead to undesirable consequences. 4 Although the body of literature examining considerations and outcomes related to BD has increased significantly in recent years, there has been little study into nationwide practice patterns, an issue that may be important for physicians, policymakers, and the general public. Distinct BD Current Procedural Terminology (CPT) codes were not introduced until 2011, making analysis of population-based trends difficult until recently.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

Svider¹,

Darlin²,

Bobian³

et al. 2017

The Laryngoscope

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

Svider¹,

Darlin²,

Bobian³

et al. 2017

The Laryngoscope

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“…One recent study examining temporal trends in various frontal sinus procedures reported a steady increase in endoscopic approaches between 2001 and 2011 . In the wake of this new trend, some consider open frontal procedures a “lost art.” Increases in the adoption of endoscopic approaches to the frontal sinus may be due in part to the popularization and availability of balloon dilation systems …”

Section: Discussionmentioning

confidence: 99%

Endoscopic and external approaches for orbital decompression: an analysis of trends from a U.S. perspective

Svider

Arianpour

Nguyen

et al. 2018

Int Forum Allergy Rhinol.

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There has not been a clear movement toward the endoscopic approach for orbital decompression, with modest growth when compared with external approaches. Potential explanations include the specialty-exclusive nature of approaches, as well as a lack of consensus; the latter idea is further reinforced by geographic variation. High-quality prospective trials may clarify the role of endoscopic approaches in these patients.

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Frontal sinus “mega‐trephination” in a tertiary rhinology practice

Geltzeiler¹,

Mowery²,

Detwiller³

et al. 2019

Int Forum Allergy Rhinol

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BackgroundFrontal sinus trephination is traditionally performed through a small cutaneous incision and osteotomy, allowing irrigation of the frontal sinus. Utilizing the trephination osteotomy for endoscopic visualization and surgical manipulation requires a larger opening. This “mega‐trephination” is thought to carry an increased risk of cosmetic deformity given the increased bony removal at the anterior table. The purpose of our study was to clarify the risks of frontal sinus mega‐trephination and examine how this technique is incorporated into a modern, tertiary care rhinology practice.MethodsPatients were identified through billing records and confirmed by retrospective chart review. All patients underwent frontal sinus mega‐trephination, which is defined as an osteotomy large enough for insertion of a 4‐mm endoscope and an operative instrument simultaneously. All patients had at least 2 years of follow‐up. The primary outcome was complication rate, including cosmetic deformity.ResultsSixty‐four patients underwent frontal sinus mega‐trephination from 2006 to 2016. The most common surgical indications were chronic sinusitis (34%), mucocele (19%), osteoma (17%), acute sinusitis (11%), and inverting papilloma (9%). Ten patients (16%) underwent mega‐trephination alone, whereas the others had mega‐trephination with endoscopic sinus surgery. Twenty‐one patients (33%) had minor complications. The most common complications were self‐limited paresthesia (11%), infection (8%), and epistaxis (3%). No patient complained of permanent cosmetic deformity or required revision surgery for cosmesis.ConclusionFrontal sinus mega‐trephination is a useful tool to augment the rhinologist's armamentarium in complex frontal sinus anatomy and pathology. This procedure is well tolerated, safe, and not associated with long‐term cosmetic deformity.

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Preventing and Managing Complications in Frontal Sinus Surgery

Cited by 10 publications

References 61 publications

Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

Endoscopic and external approaches for orbital decompression: an analysis of trends from a U.S. perspective

Frontal sinus “mega‐trephination” in a tertiary rhinology practice

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