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Medical and Surgical Complications in the Treatment of Chronic Rhinosinusitis, An Issue of Otolaryngologic Clinics of North America, E-Book

Medical and Surgical Complications in the Treatment of Chronic Rhinosinusitis, An Issue of Otolaryngologic Clinics of North America, E-Book

James A. Stankiewicz

(2016)

Additional Information

Abstract

The small nasal anatomic area can offer challenges and complications to surgeons and physicians treating chronic rhinosinusitis. This compact, focused publication on Medical and Surgical Complications in Chronic Rhinosinusitis offers clinicians a current source of information to avoid complications and to address them when they arise. Sinus surgery expert and patient champion James Stankiewicz leads this issue with authors who are expert in various aspects of sinus treatment and surgery.
Topics include: Overview of complications;  Anatomy of the sinus and complications; Orbital complications and treatment; Neurologic complications and treatment;  Vascular complications and treatment; Smell loss and sinus surgery; Radiology for cases of higher risk of complications; Medication related complications and side effects; Medical-legal issues and complications; Does image guided surgery reduce complications?; Avoiding complications: overriding principles.  Especially dedicated to Residents, Fellows and those in early practice is presentation of External Sinus Surgery and Procedures & Complications; when endoscopic procedures are the norm, how does one handle reversion to an open procedure, which often takes place in emergency situations.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Medical and SurgicalComplications in theTreatment of ChronicRhinosinusitis i
Copyright\r ii
PROGRAM OBJECTIVE iii
LEARNING OBJECTIVES iii
ACCREDITATION iii
DISCLOSURE OF CONFLICTS OF INTEREST iii
UNAPPROVED/OFF-LABEL USE DISCLOSURE iii
TO ENROLL iv
METHOD OF PARTICIPATION iv
CME INQUIRIES/SPECIAL NEEDS iv
Contributors v
EDITOR v
AUTHORS v
Contents ix
Preface: Medical and Surgical Complications in the Treatment of Chronic Rhinosinusitis\r ix
Pitfalls in Sinus Surgery: An Overview of Complications\r ix
Anatomy and Complications: Safe Sinus\r ix
Orbital Complications Associated with the Treatment of Chronic Rhinosinusitis\r ix
Neurologic Complications and Treatment\r ix
Hemorrhagic Complications of Endoscopic Sinus Surgery\r x
Olfaction in Endoscopic Sinus and Skull Base Surgery\r x
Imaging of the Paranasal Sinuses: Mitigation, Identification, and Workup of Functional Endoscopic Surgery Complications\r x
Medicolegal Implications of Common Rhinologic Medications\r x
Medicolegal Issues in Endoscopic Sinus Surgery and Complications\r xi
Early Practice: External Sinus Surgery and Procedures and Complications\r xi
Does Image-Guided Surgery Reduce Complications?\r xi
Rare and Other Notable Complications in Endoscopic Sinus Surgery\r xi
Avoiding Complications in Endoscopic Sinus Surgery\r xi
OTOLARYNGOLOGIC CLINICS\rOF NORTH AMERICA\r xiii
FORTHCOMING ISSUES xiii
December 2015 xiii
February 2016 xiii
April 2016 xiii
RECENT ISSUES xiii
August 2015 xiii
June 2015 xiii
April 2015 xiii
Preface\r xv
REFERENCES xvi
Pitfalls in Sinus Surgery 725
Key points 725
COMPLICATIONS OF SURGICAL THERAPY 726
Orbital Complications 726
Neurologic and Intracranial Complications 730
Anosmia and Endoscopic Sinus Surgery 731
Other Vascular Injuries 732
COMPLICATIONS OF MEDICAL THERAPY 732
Medicolegal Considerations 733
SUMMARY 734
REFERENCES 735
Anatomy and Complications 739
Key points 739
INTRODUCTION OR OVERVIEW: NATURE OF THE PROBLEM 739
SAFE SINUS SURGERY: SINUS ANATOMY 739
Middle Turbinate 740
Uncinate 740
Maxillary Antrostomy 741
Anterior Ethmoid 742
Posterior Ethmoid 743
Ethmoid Roof 744
Sphenoid Sinus 745
Frontal Sinus 746
SUMMARY 747
REFERENCES 747
Orbital Complications Associated with the Treatment of Chronic Rhinosinusitis 749
Key points 749
INTRODUCTION 749
INCIDENCE OF ORBITAL COMPLICATIONS IN ENDOSCOPIC SINUS SURGERY 750
AVOIDANCE OF ORBITAL COMPLICATIONS 750
Preoperative Planning 750
Intraoperative Considerations 751
Computed Tomographic Review 751
Postoperative Considerations 753
MANAGEMENT OF SPECIFIC ORBITAL INJURIES 754
Nasolacrimal Duct Injury and Epiphora 754
Orbital Penetration Due to Lamina Papyracea Breach 755
Subcutaneous Emphysema and Ecchymosis 756
Orbital Hematoma 757
Orbital Hematoma Management in the Postoperative Period 760
Extraocular Muscle Injury and Diplopia 760
Blindness 761
Hemorrhage, Stroke, and Death 761
Infraorbital Nerve Numbness 764
Cosmetic Deformity 764
PHARMACOLOGIC COMPLICATIONS 766
SUMMARY 766
REFERENCES 766
Neurologic Complications and Treatment 769
Key points 769
INTRODUCTION 769
COMPLICATIONS 769
Specific: Cerebrospinal Fluid Leak 770
COMPLICATION AVOIDANCE 771
COMPLICATIONS MANAGEMENT 777
SUMMARY 780
REFERENCES 780
Hemorrhagic Complications of Endoscopic Sinus Surgery 783
Key points 783
INTRODUCTION 783
VASCULAR ANATOMY OF THE NOSE AND SINUSES 784
SETTING UP FOR SUCCESS 788
Preoperative 788
Intraoperative 788
Postoperative 790
SUMMARY 791
REFERENCES 791
Olfaction in Endoscopic Sinus and Skull Base Surgery 795
Key points 795
INTRODUCTION 795
OLFACTION ANATOMY AND PHYSIOLOGY 796
OLFACTORY TESTING 796
CONDUCTIVE OLFACTORY LOSS 797
INFLAMMATORY CHANGES TO THE OLFACTORY EPITHELIUM IN CHRONIC RHINOSINUSITIS 798
IMPACT OF ENDOSCOPIC SINUS SURGERY ON OLFACTION IN CHRONIC RHINOSINUSITIS 798
PERIOPERATIVE CONSIDERATIONS FOR OLFACTORY PRESERVATION DURING ENDOSCOPIC SINUS SURGERY FOR CHRONIC RHINOSINUSITIS 799
PERIOPERATIVE CONSIDERATIONS IN THE ENDONASAL APPROACH TO THE SKULL BASE 800
POSTOPERATIVE CONSIDERATIONS FOR SMELL LOSS 801
SUMMARY 801
REFERENCES 802
Imaging of the Paranasal Sinuses 805
Key points 805
APPLICATION OF IMAGING TO REDUCE FUNCTIONAL ENDOSCOPIC SURGERY COMPLICATIONS 806
Introduction 806
Complications 807
RADIOGRAPHIC EVALUATION OF COMPLICATIONS IN FUNCTIONAL ENDOSCOPIC SURGERY 807
SUMMARY 812
REFERENCES 813
Medicolegal Implications of Common Rhinologic Medications 817
Key points 817
INTRODUCTION 817
ANTIBIOTICS 818
Complications of Antibiotic Use 818
Allergy 818
Antibiotic-associated diarrhea 818
Fluoroquinolone-induced tendon damage 819
Others 820
CORTICOSTEROIDS 820
Complications of Steroid Use 820
NARCOTICS 820
SCOPE OF LITIGATION 821
INFORMED CONSENT IN THE PRESCRIPTION OF MEDICATIONS 823
PREVENTING COMPLICATIONS AND LITIGATION 824
SUMMARY 825
REFERENCES 825
Medicolegal Issues in Endoscopic Sinus Surgery and Complications 827
Key points 827
INTRODUCTION 827
PREOPERATIVE 827
OPERATIVE MEDICOLEGAL CONCERNS 832
POSTOPERATIVE MEDICOLEGAL ISSUES 836
SUMMARY 837
REFERENCES 837
Early Practice 839
Key points 839
INTRODUCTION 839
MAXILLARY SINUS 839
ETHMOID SINUS 841
Frontal Recess 844
FRONTAL SINUS 844
Frontal Sinus Trephination 844
Frontal Osteoplastic Flap 846
SUMMARY 849
REFERENCES 850
Does Image-Guided Surgery Reduce Complications? 851
Key points 851
INTRODUCTION 851
CURRENT TECHNOLOGY AND USE 852
CURRENT APPLICATIONS OF TECHNOLOGY 853
IMPACT ON THE SURGEON, SURGICAL APPROACH, AND DECISION MAKING 854
REPORTED IMPACT ON COMPLICATIONS 856
MEDICOLEGAL IMPLICATIONS 856
SUMMARY 857
REFERENCES 857
Rare and Other Notable Complications in Endoscopic Sinus Surgery 861
Key points 861
INTRODUCTION 861
RARE VASCULAR COMPLICATIONS 862
Internal Carotid Artery Injury 862
Sphenopalatine Pseudoaneurysm 863
RARE ORBITAL COMPLICATIONS 863
Sclerosing Lipogranuloma 863
Rare Causes of Blindness 864
RARE NEUROLOGIC COMPLICATIONS 865
Peripheral Nerve Injury and Numbness 865
Tension Pneumocephalus 865
OTHER COMPLICATIONS 865
Toxic Shock Syndrome 865
Myospherulosis 866
Secondary Atrophic Rhinitis and Empty Nose Syndrome 866
MEDICAL AND CARDIOPULMONARY COMPLICATIONS 866
Cardiac Spasm or Injury 866
Pulmonary Embolism and Deep Vein Thrombosis 866
Electrocardiographic Artifact with Microdebrider Use 867
RARE BALLOON SINUPLASTY COMPLICATIONS 867
SUMMARY 867
REFERENCES 867
Avoiding Complications in Endoscopic Sinus Surgery 871
Key points 871
INTRODUCTION 871
RISK IDENTIFICATION AND COMPLICATION AVOIDANCE 872
Preoperative Phase 872
Intraoperative Phase 874
Postoperative Phase 878
SUMMARY 878
REFERENCES 879
Index 883