The Potential Pitfalls of Concurrent Rhinoplasty and Endoscopic Sinus Surgery

Millman, Brad; Smith, Raymond L.

doi:10.1097/00005537-200207000-00009

Cited by 30 publications

(24 citation statements)

References 18 publications

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“…Additionally, they felt that postoperative edema was greater in patients undergoing surgery of the frontal or sphenoid sinuses. Millman and Smith,5 however, described a patient referred after developing bacteremia, myocarditis, and delayed superficial frontal abscess after combined ESS/CR, although they noted no complications in 11 patients undergoing combined ESS/CR at their own institution over a 5‐year period. Mazzola and Felisati6 described 72 rhinoplasty patients who underwent additional rhinologic procedures; however, of these only 17 patients underwent “selective ethmoidectomy,” with one patient each undergoing additional antrostomy or sphenoidotomy.…”

Section: Discussionmentioning

confidence: 99%

“…These studies together report a total of 329 patients who underwent combined ESS/CR. Of those studies that described the sinus surgery,1, 2, 5, 6, 8 the average maximal Lund surgical scores ranged no more than 3–7.78 (calculated based on reported data, assuming all patients had uncinectomies and all procedures were performed bilaterally and likely overestimating the severity of disease (Table XV). The total rate of complications in these studies was 6.7%; extra sinus infections were noted in 2.4% of patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Triological thesis: concurrent endoscopic sinus surgery and cosmetic rhinoplasty: Rationale, risks, rewards, and reality

Sclafani¹,

Schaefer²

2009

The Laryngoscope

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While our data supports concurrent ESS and CR as safe, our findings suggest that the presence and treatment of concurrent sinonasal disease prolongs the patients' recovery from CR. This may be due to the effects of sinus pathology and manipulation of sinonasal venous and lymphatic drainage patterns or could be due to subclinical infectious soiling of rhinoplasty tissue planes. We recommend a two-team approach to promote excellent surgical technique, avoid surgeon fatigue, and enhance patient care. We recommend adequate medical management of chronic sinusitis prior to surgery, pre, intra and postoperative antibiotic coverage, appropriate postoperative sinus toilet beginning 1 week after surgery and careful and close patient follow-up to optimize results. Most importantly, we advocate close coordination of sinonasal and rhinoplastic care in a two-team approach to maximize care.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Triological thesis: concurrent endoscopic sinus surgery and cosmetic rhinoplasty: Rationale, risks, rewards, and reality

Sclafani¹,

Schaefer²

2009

The Laryngoscope

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show abstract

“…Intracranial infection complications after rhinoplasty, such as cavernous sinus thrombosis, are exceedingly uncommon in the antibiotic era, yet it must be remembered that cavernous sinus thrombosis, when it occurs, carries a mortality rate of nearly 20%. 10,11 It is difficult to ascertain precisely the influence that autogenous cartilage grafts placed for support or contour plays in the development of infections following nasal surgery. The incidence of infections associated with cartilage and bone graft use in nasal surgery averages 1% to 5%, occurring with increased frequency in major nasal reconstructions, multiple prior surgeries, scarring, or radiation as compared with primary rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

Salvage of Infected Cartilage Grafts for Nasal Reconstruction With a Through-and-Through Irrigation System

Walton

Beahm

2005

Annals of Plastic Surgery

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Development of a wound infection after nasal reconstruction can place the entire reconstructive effort in jeopardy. The approach to management in these cases has traditionally entailed wound drainage, removal of involved graft material, and debridement of nonvital tissue. Following adequate wound healing, delayed reconstruction is then performed, with the final result often compromised in form and function. We present a case of a postoperative wound infection following reconstruction of a traumatic nasal deformity utilizing autologous cartilage grafts. Treatment consisted of hospitalization with administration of culture-specific parenteral antibiotics and continuous through-and-through antibiotic irrigation of the wound via an indwelling catheter. The infection was completely eradicated and all cartilage grafts were salvaged utilizing this technique. At 3 years postoperatively, the patient has maintained the shape and quality of her reconstruction, without evidence of recurrent infection.

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“…50 Toffel 51 observed a low overall individualized preoperative assessment to determine the appropriate osteotomy for each patient.…”

Section: Combination Of Septorhinoplasty and Functional Endoscopic Simentioning

confidence: 99%

32 Rhinology in Rhinoplasty

Papel¹,

Frodel²,

Holt³

et al. 2016

Facial Plastic and Reconstructive Surgery

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The Potential Pitfalls of Concurrent Rhinoplasty and Endoscopic Sinus Surgery

Abstract: We conclude and agree with the literature that concurrent surgery is safe and effective.

Cited by 30 publications

References 18 publications

Triological thesis: concurrent endoscopic sinus surgery and cosmetic rhinoplasty: Rationale, risks, rewards, and reality

Triological thesis: concurrent endoscopic sinus surgery and cosmetic rhinoplasty: Rationale, risks, rewards, and reality

Salvage of Infected Cartilage Grafts for Nasal Reconstruction With a Through-and-Through Irrigation System

32 Rhinology in Rhinoplasty

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