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Endoscopic Sinus Surgery Complications

For those who experience chronic sinus infections or who experience trouble breathing and sleeping due to sinus swelling, endoscopic sinus surgery (ESS) may be recommended when conservative treatments fail. Using an endoscope (a thin tube with a camera on the end) inserted through the nose, a surgeon can use slender instruments in order to remove blockages in the sinus cavity. While ESS causes minimal complications in most instances, according to the Baylor College of Medicine), there are risks involved with the surgery.

  1. Bleeding

    • The carotid artery, which is responsible for supplying the head and neck with blood, runs through the sphenoid wall, which runs behind the sinus wall. In rare instances, the carotid artery can be perforated during ESS. This can cause severe bleeding and in some instances, massive hemorrhage. If this occurs during surgery, a surgeon must act quickly to minimize bleeding and repair the artery.

    Spinal Fluid Leakage

    • According to Ehealthmd.com, cerebral spinal fluid leakage is a complication in 2% of ESS surgeries in the United States annually. This can occur when the nervous system's middle turbinate, which is located behind the sphenoid sinus, is cut or nicked during the procedure. If this complication occurs, surgeons are most often able to recognize this immediately and will place a graft or other sealant over the area.

    Optic Nerve Damage

    • Also known as an orbital complication, a surgeon may injure nerves or muscles in the optic nerve during the ESS procedure. During surgery, a surgeon should closely monitor the eyes to observe signs of injury. One of the most severe complications associated with ESS, injury to the optic nerve can result in temporary or permanent blindness.

    Nasolacrimal Duct Stenosis

    • Also known as the tear duct, which provides fluid to the eyes to keep them moist and moving easily, the nasolacrimal duct can be injured during the ESS procedure as it is a mere 3 to 6 mm away from the maxillary sinus cavity, according to the Baylor College of Medicine. This can cause a condition known as epiphora, in which the tear duct does not properly drain, resulting in too many tears.

    Synechiae

    • This condition occurs when the iris sticks to the lens behind it, which is known as adhesion and can occur as a result of inflammation and scar tissue development behind the sinus cavity. An early contributor to glaucoma, if this complication occurs, a surgeon may recommend a stent to ease pressure in this area.

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