Ethmoid Surgery Complications and Their Avoidance

The purpose of this report is to review the complications that two experienced operators have encountered during the past 20 years. The techniques employed by the authors are similar. Three thousand intranasal nonendoscopic procedures accumulated between the coauthors were further evaluated to explain why complications could occur. There were five dural injuries in this series that were managed conservatively. Periorbital ecchymoses were seen in 9% of the cases with no permanent adverse sequelae. Approximately 0.5% of the patients had postoperative bleeding. Conclusions that the authors reached were as follows. 1) A complication as a result of ethmoid sinus surgery can occur with any technique and in the hands of any surgeon. 2) Training and experience plus knowledge of the ethmoid anatomy may help reduce the absolute number of complications. 3) Early recognition of a complication and its appropriate management can help decrease the relative severity of the complication. 4) The surgeon should terminate a procedure when visualization and localization are compromised.