[Paranasal sinus surgery in chronic sinus disease and benign tumors indications, concepts and complications at a teaching institution].
METHODS
The medical records of 635 patients that underwent paranasal sinus surgery for chronic sinus disease or benign tumors during a 6.5 year span were assessed retrospectively to evaluate the status of sinus surgery at a teaching institution. The parameters analyzed were indication for surgery, surgical approach, extent of the procedures and complications.


RESULTS
The ratio between male and female patients was 2 : 1, with an average age of 44 (+/- 16) years. In 137 cases (21.5 %), revision surgery in patients previously treated at the University of Wuerzburg was necessary. In 80 cases (12.6 %), prior surgery had been performed elsewhere. The majority of the procedures (91.3 %) were carried out using endonasal techniques. External, transethmoid (6.5 %) or transmaxillar (2.2 %) approaches were chosen in 8.7 % of all cases, mainly when the preoperative diagnoses were mucoceles (65.2 %), benign tumors (40.9 %) or orbital complications (33.3 %). Surgery was assisted exclusively by the microscope in 78.7 %, solely by the endoscope in 15.9 % and with a combination of both optical tools in 5.4 % of all cases. The total rate of complications was 8.2 %. Minor complications were seen in 8.1 % of the endonasal and 4.9 % of the external transethmoid procedures. While no major complications occurred during endonasal or extranasal transmaxillar surgery, liquorrhoe was documented in three extranasal transethmoid procedures (7.3 %). Neither permanent impairment of vision, nor post-operative meningitis nor surgery-related mortality was observed in any case.


CONCLUSIONS
The study gives an overview over the paranasal sinus surgeries performed at a teaching institution, independent of the experience of the surgeon. It confirms the results of previous investigations and indicates that endonasal sinus surgery is a reproducible and reliable procedure that can be safely applied at a teaching institution. The results also show that the indication for extranasal approaches is further reduced to the less invasive endonasal techniques.
Aletsee
C
C
Bayerische Julius-Maximilians-Universität, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Würzberg.
Deglmann
M
M
Dieler
R
R
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004724:Endoscopy / Q000706:statistics & numerical data; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008866:Microsurgery / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012852:Sinusitis / Q000601:surgery*