Endocranial Complications of Endoscopic Sinus Surgery: Learning from Experience

Miguel Armengot-Carceller^1*, Rosa Hernandez-Sandemetrio²

¹ENT Department, Surgery Department, Valencia University, General and University Hospital, Valencia, Spain.
²ENT Department, General and University Hospital, Valencia, Spain.

DOI: 10.4236/ijohns.2014.35053                

Abstract

Objectives: We critically reviewed our experiences in endocranial complications with Functional Endoscopic Sinus Surgery, and investigated the causes, prevention strategies and management. Methods: We conducted a retrospective study of endocranial complications with Functional Endoscopic Sinus Surgery performed during last 10 years in our ENT department. We analyzed endocranial complications, their causes, consequences, treatments and outcomes. Management was performed in collaboration with neurosurgeons and infectious diseases specialists. Results: Of 763 Functional Endoscopic Sinus Surgery procedures, we identified three cases with endocranial complications (0.393%). These complications included: a case of postoperative severe cerebrospinal fluid leak in a patient treated for severe polyposis; a case of cerebral-frontal abscess with delayed clinical manifestation (4 weeks post-surgery) in a patient treated for chronic pansinusitis who experienced difficult surgery for septal spur; and a case of pneumocephalus in a patient treated for allergic fungal sinusitis. The clinical outcome was favorable in all cases. Conclusions: Intra-operative cerebrospinal fluid leak, anatomical deformities (even minimal deformities) and massive inflammatory sinus disease are predisposing factors for endocranial complications with Functional Endoscopic Sinus Surgery. Prognosis can be favorable when therapeutic management is carried out in collaboration with neurosurgeons and infectious disease specialists.

Keywords

Cerebral Abscess, Cerebrospinal Fluid Leak, Inflammatory Sinus Disease, Pneumocephalus, Polyposis

Conflicts of Interest

The authors declare no conflicts of interest.

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