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[内镜鼻窦手术危险点、并发症及法医学方面的综合综述]

[Comprehensive review on danger points, complications and medico-legal aspects in endoscopic sinus surgery].

作者信息

Hosemann W

机构信息

Klinik für Hals-, Nasen-, Ohrenkrankheiten, Kopf- und Hals-Chirurgie, Universitätsmedizin Greifswald, Greifswald.

出版信息

Laryngorhinootologie. 2013 Apr;92 Suppl 1:S88-136. doi: 10.1055/s-0033-1337908. Epub 2013 Apr 26.

Abstract

Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5-1%.A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.

摘要

鼻内镜鼻窦手术是慢性鼻窦炎普遍接受的手术治疗方式。尽管质量标准不断提高且仍在发展,但进行常规内镜手术的外科医生面临5%的轻微并发症和0.5 - 1%的严重并发症。本文全面综述了鼻内镜鼻窦手术以及前颅底手术的所有轻微和严重并发症,并列出了相关科学文献。回顾了每种并发症的发病机制、体征和症状,并根据实际发表的参考文献详细讨论了治疗方案。阐述了潜在的医疗法律问题,并提及了最新的避免并发症的方法,同时考虑了手术培训和教育方面的选择。

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