Abstract
OBJECTIVE
Frontal sinus surgery is complex, technically challenging and therefore is associated with an increased complication rate compared to other types of sinus surgery. The aim of this study was to characterize the complications that occur in endoscopic frontal sinus surgery.
METHOD
Prospective data collection on all patients undergoing endoscopic frontal sinus surgery at our institution between 30th May 1990 and 26th September 2007.
RESULTS
235 patients underwent 298 frontal sinus procedures. In 28 procedures 30 complications occurred (10.1%) with 2.7% being major and 7.4% being minor. The majority (83%) presented in the immediate postoperative period. Only one case had long term morbidity (diplopia). The lowest complication rates were seen when the indications for surgery were fungal sinus disease, nasal polyposis, chronic rhinosinusitis and with the highest being seen in mucocele and inverted papilloma. There was an increase in complication rate from primary frontal sinus surgery (6.0%) to revision procedures (12.1%) and with increasing size of the frontal sinusotomy from Draf I procedures (7.0%) to Draf III (20.0%).
CONCLUSION
In our series the major complication rate of endoscopic sinus surgery involving the frontal sinus is 2.7%. Surgeons should be aware that if endoscopic sinus surgery is to extend beyond the frontal recess, the risks of complications are higher and this should be reflected in the consent process.