Subarachnoid hemorrhage: A complication of endoscopic sinus surgery using powered instrumentation☆☆☆★

Berenholz, Leonard P.; Kessler, Alex; Sarfaty, Shlomo; Segal, Samuel

doi:10.1016/s0194-5998(99)70081-1

Cited by 39 publications

(26 citation statements)

References 7 publications

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“…In both cases it was argued that the strong suction of the microdebrider allowed orbital fat or even extra-ocular muscles to be pulled through a relatively small defect in the lamina papyracea. Berenhalz and colleagues [11] described a case of subarachnoid haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Microdebrider Assisted Endoscopic Sinus Surgery and Conventional Endoscopic Sinus Surgery for Nasal Polypi

Singh

Hazarika

Nayak

et al. 2011

Indian J Otolaryngol Head Neck Surg

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Nasal polyposis is often encountered in rhinology practice. Those who fail conservative management, a definitive surgery is essential to achieve sufficient ventilation and drainage of the affected sinuses by using either microdebrider or conventional instruments for functional endoscopic sinus surgery (FESS). A prospective study was conducted on 40 cases of nasal polypi in a tertiary care hospital. 20 cases were operated by conventional endoscopic instruments and 20 using the microdebrider. The study aimed at comparing the intra operative (blood loss, duration of surgery) and post operative results (crusting, scarring, discharge, symptoms, recurrence) between the two groups using LundMackay scoring system and the data was statistically analysed. There was no statistically significant difference in surgical outcome for patients when either conventional endoscopic instruments or microdebrider was used. However, there was a significant symptomatic improvement in cases undergoing microdebrider FESS. Microdebrider assisted polypectomy is precise, relatively bloodless surgery though the precision depends on the surgeon's anatomical knowledge and operative skills. Study substantiates that these instruments are helpful but not a prerequisite for successful outcomes in FESS. The study re-emphasises the utility of the microdebrider to young learning FESS surgeons.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Microdebrider Assisted Endoscopic Sinus Surgery and Conventional Endoscopic Sinus Surgery for Nasal Polypi

Singh

Hazarika

Nayak

et al. 2011

Indian J Otolaryngol Head Neck Surg

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“…On the other hand, diplopia and blindness resulting from extraocular muscle injuries and/or orbital hemorrhage using powered instrumentation have been reported [14] [15]. Furthermore, subarachnoid hemorrhage has been reported as a complication of ESS using powered instruments [16]. Thus, the suction effect from powered dissection can draw in adjacent tissue and produce dramatic postoperative sequelae in a fraction of a second.…”

Section: Discussionmentioning

confidence: 99%

Orbital Injury in Endoscopic Sinus Surgery for Sinonasal Inflammatory Disorders: Juntendo’s Ten-Year Experience

Ikeda¹,

S²,

Homma³

et al. 2017

IJOHNS

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Orbital injury and complications are commonly encountered in endoscopic sinus surgery (ESS) despite advances in techniques and instrumentation. For the recent 10 years, we summarized the experience of the rhinology unit of our department regarding orbital injury and complications of ESS for sinonasal inflammatory disorders. One thousand seventy-three patients (1869 sides) from January 1, 2003 to December 31, 2012 undergoing ESS for sinonasal inflammatory diseases were enrolled in the present study. The age of the patients ranged from 8 to 81 years, mean age 49 years. Orbital injury and complications were observed in 13 patients (13 sides), which corresponded to 0.7% of the operated sides and 1.2% of the patients. Eight patients showed herniation of orbital fat alone through the injury of the lamina papyracea. The protruding orbital fat was snipped and cut using forceps in 2 patients. Removal of exposed orbital fat using powered instruments was performed in 3 patients, two of whom transiently showed periorbital edema postoperatively. No permanent complications were observed. Meticulous preoperative and perioperative planning is critical to prevent orbital complications. Especially, exposure of the periorbit and herniation of orbital fat after lamina injury with powered instrumentation dramatically increases the potential for more severe complications.

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“…Daha ince, hafif ve eğimli uçlar kullanmakla taktil duyu kazanımı ve görüş alanının artırılması komplikasyon riskini azaltılabilir. [12] Yine debrider ucunun maksiller sinüs ostiyumundan uzakta ve aşağıda tutulması, unsinat çıkıntının lamina papyraceaya yapıştığı yerin debrider ile rezeke edilmemesi, debrider ucunun lamina papyraceanın aksi yönüne 90 derecede tutulması, hareketlerin bu bölgeden uzağa doğru yapılması, aynı yönte-min kafa tabanına da uygulanması önerilir. [13] Debrider kullanımı sırasında mutlaka lamina papyracea'nın ve kafa tabanının nerede olduğu belirlenmeli aksi takdirde sadece poliplerin genel hacmini azaltma amacı ile kullanımını sınırlandırmalıdır.…”

Section: Yeterli Dikkatli Eksizyon Ve Düzgün Ameliyat Sonrası Bakım unclassified

Complications in endoscopic sinus surgery

Kaytaz¹

2014

Praxis of ORL

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Son 25-30 yılda popülerliği artan endoskopik sinüs cerrahisi (ESC) artmış komplikasyon oranlarını da beraberinde getirmiştir. Ülkemizde de zaman zaman majör komplikasyonlar görmekteyiz. Komplikasyonlar genellikle yetersiz bilgi ve beceriye sahip deneyimsiz cerrahtan kaynaklanır. Endoskopik sinüs cerrahisi, çok önemli hayati yapılarla çevrili ve kısıtlı aydınlatmaya sahip bir alanda, deneyimli ve eğitimli bir cerrahın varlığını gerektirir. Kapasiteli bir cerrah, hassas bir anatomiye sahip bu bölgede çevre yapılara zarar vermeden hasta dokuları diseke edebilmelidir. Cerrah aynı zamanda problemli faktörleri azaltmak için ameliyat öncesi dönemde hastayı dikkatlice değerlendirmeli ve hazırlamalıdır. Beklenmeyen, aberan anatomi ve yetersiz aletlerin kullanılması komplikasyon oranını artıran ek faktörlerdir. Bu yazıda ESC sırasında komplikasyonlardan kaçınmak için cerrahın alacağı önlemler üzerinde durulmuştur.Anahtar Sözcükler: Endoskopik sinüs cerrahisi; komplikasyon; rinosinüzit.With an increased popularity in the recent 25-30 years, endoscopic sinus surgery has (ESC) brought an increased complication rate. We occasionally witness major complications in Turkey as well. The complications usually arise from the inexperienced surgeon with insufficient skills and knowledge. Endoscopic sinus surgery necessitates an experienced and educated surgeon in a field with limited illumination and surrounded by vital structures of utmost importance. A capable surgeon should dissect the diseased tissues within delicate anatomy without any harm to the surrounding structures. The surgeon should also evaluate and prepare the patient thoroughly in the preoperative period to decrease additive problematic factors. Unexpected, aberrant anatomy and insufficient instrumentation are the additive factors to increase complication rate. In this article, the measures to be taken by the surgeon during ESC to prevent complications are reviewed. 1980'li yılların ortalarından itibaren bütün dünyada ve ülkemizde sinüs cerrahisinde endoskopların kullanı-ma girmesi ile yeni bir dönem başlamış, yeni dönemin başlaması da yepyeni sorunları gündeme getirmiştir. Her türlü cerrahi girişimin kaçınılmaz sonuçlarından biri olan komplikasyon oluşumu, endoskopik sinüs cerrahisinde (ESC) de başlangıçta sıkça görülmüş ama eğitim, teknoloji ve cerrahi teknikteki gelişmeler sonucunda hızla azalmaya yüz tutmuştur. Sinüsler gibi kafa içi, orbita ve büyük damar ve sinirler ile yakın ilişkili, çok değişken bir anatomiye sahip bir bölgede distorsiyon, aydınlatma ve rezolüsyon sorunları olan bir enstrümantasyon grubu (endoskop, kamera vs.) ile ameliyat yapmak kaçınılmaz olarak ciddi komplikasyonların ortaya çıkmasına yol açacaktır. Yirmi -yirmi beş yıl önceki yayınlara, dünyadaki ilk ESC serilerinin sonuçlarına bakıldığında komplikasyon oranları-nın %25'lere vardığı, ardından, deneyim arttıkça bu oranın %1'lere kadar düştüğü görülmektedir.[1,2] Ama hala zaman zaman majör ve minör, kraniyal, orbital veya sinonazal komplikasyonlar ile karşılaşmaktayız. Ülkemizde ESC komplika...

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Subarachnoid hemorrhage: A complication of endoscopic sinus surgery using powered instrumentation☆☆☆★

Cited by 39 publications

References 7 publications

A Comparison of Microdebrider Assisted Endoscopic Sinus Surgery and Conventional Endoscopic Sinus Surgery for Nasal Polypi

A Comparison of Microdebrider Assisted Endoscopic Sinus Surgery and Conventional Endoscopic Sinus Surgery for Nasal Polypi

Orbital Injury in Endoscopic Sinus Surgery for Sinonasal Inflammatory Disorders: Juntendo’s Ten-Year Experience

Complications in endoscopic sinus surgery

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