Informed consent in functional endoscopic sinus surgery.
OBJECTIVE
Functional endoscopic sinus surgery (FESS) is one of the more common procedures performed by otolaryngologists. Before performing FESS, surgeons are obligated to discuss the procedure and its risks through the process of informed patient consent. The study identifies current practices in informed consent for FESS and formulates guidelines for informed consent for FESS.


METHODS
Survey.


METHODS
Surveys were sent to 1000 American Academy of Otolaryngology-Head and Neck Surgery members in the United States. Surveys inquired about current informed consent practices related to FESS.


RESULTS
Three hundred forty-six surveys were returned. Nearly 60% of respondents thought that 1% incidence of a complication warrants a discussion with patients. The percentage of respondents who discuss specific risks were as follows: bleeding, 96.7%; infection, 84.8%; cerebrospinal fluid leak, 99.1%; orbital injury, 96.7%; smell changes, 40.2%; cerebrovascular accident, 17.9%; myocardial infarction, 81%; and death, 28.0%.


CONCLUSIONS
The study suggests that there is variability in specific informed consent practices for FESS among otolaryngologists. It also suggests that the incidence or severity of a complication does not necessarily correlate with whether or not it is mentioned during the informed consent process. The authors think that practicing otolaryngologists may be able to use this information to improve their consent practices.
Wolf
Jeffrey S
JS
Division of Otolaryngology-Head and Neck Surgery, University of Maryland Medical System, Baltimore 21201, USA. jwolf@smail.umaryland.edu
Malekzadeh
Sonya
S
Berry
Julie A
JA
O'Malley
Bert W
BW
D003430:Cross-Sectional Studies; D003625:Data Collection; D004724:Endoscopy; D006801:Humans; D015994:Incidence; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D010353:Patient Education as Topic / Q000331:legislation & jurisprudence; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors
Empirical Approach; Legal Approach; Professional Patient Relationship