Clinical analysis of the cranial complications of endoscopic sinus surgery

Acta Otolaryngol. 2013 Jul;133(7):739-43. doi: 10.3109/00016489.2013.767986. Epub 2013 Feb 19.

Abstract

Conclusions: The most frequently affected sites of cranial complications of endoscopic sinus surgery (ESS) are the boundary between the anterior and posterior ethmoid roof, the frontal recess, and the cribriform plate. Being aware of cranial complications in time and provision of appropriate treatment may minimize the serious consequences.

Objectives: To investigate the reasons for cranial complications secondary to ESS and to find optimal prevention of cranial complications of ESS.

Methods: The cranial complications of 19 patients were retrospectively reviewed. Eight patients underwent surgery in our hospital and the others underwent surgery in eight other hospitals, and were then transferred to our hospital for further examination and management of their complications.

Results: The type of cranial complications involved defects of the skull base (n = 19), cerebrospinal fluid leak (n = 14), frontal lobe injury (n = 3), subarachnoid hemorrhage (n = 1), meningitis (n = 2), and concomitant pneumocephalus (n = 3). In 10 cases, the boundary between the anterior and posterior ethmoid roof was damaged. The frontal recess was involved in five cases and the cribriform plate was damaged in three patients. All of the complications resolved completely after treatment.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Cerebrospinal Fluid Rhinorrhea / epidemiology
  • Cerebrospinal Fluid Rhinorrhea / etiology
  • Cohort Studies
  • Endoscopy / adverse effects*
  • Endoscopy / methods
  • Ethmoid Bone / injuries
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Meningitis / epidemiology
  • Meningitis / etiology
  • Middle Aged
  • Nasal Polyps / diagnosis
  • Nasal Polyps / surgery
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / surgery*
  • Pneumocephalus / epidemiology
  • Pneumocephalus / etiology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology*
  • Radiography
  • Retrospective Studies
  • Rhinitis / diagnosis
  • Rhinitis / surgery
  • Risk Assessment
  • Sinusitis / diagnosis
  • Sinusitis / surgery
  • Skull Base / diagnostic imaging
  • Skull Base / injuries
  • Subarachnoid Hemorrhage / epidemiology
  • Subarachnoid Hemorrhage / etiology
  • Young Adult