Complications in endoscopic intranasal ethmoidectomy: An update

TLDR

Endoscopic intranasal ethmoidectomy has historically shown higher complication rates, with a prior study reporting 29% overall and 17% in 150 procedures, far exceeding the 2.7–3.7% rate for traditional approaches. The study presents complication outcomes from 300 ethmoidectomies performed on 180 patients. The authors discuss methods and techniques that have led to a reduction in complications. The updated series shows a reduced overall complication rate of 9.3%, with only a cerebrospinal fluid leak and subcutaneous emphysema reported, confirming that endoscopic ethmoidectomy is a safe procedure when performed by experienced surgeons.

Abstract

A previous publication by this author discussing complications of endoscopic intranasal ethmoidectomy indicated an overall complication rate of 29% in 90 patients (17% in 150 ethmoidectomies). Compared to published complications rates for traditional intranasal ethmoidectomy (2.7% to 3.7%), 17% is alarming and of concern. The complication results in 300 ethmoidectomies performed on 180 patients are presented. The overall complication rate was 9.3%. Only two further complications have occurred since the first reported series: a cerebrospinal fluid leak and one case of subcutaneous emphysema. Methods and techniques that have led to the reduction of complications are briefly discussed. Endoscopic ethmoidectomy is a valid, safe procedure in experienced hands.