title: Risk factors for complications of endoscopic sinus surgery for chronic rhinosinusitis.
abstract: BACKGROUND
  Patients undergoing endoscopic sinus surgery (ESS) are at risk of complications because of the close proximity of the sinuses to the orbit and anterior skull base. The aim of this study was to evaluate the complications of ESS and to identify patient characteristics  that were risk factors for the complications.
  
  
  METHODS
  We conducted a prospective study of 706 patients who underwent ESS for chronic rhinosinusitis. Patients completed preoperative examinations that included computed tomography, endoscopic observation for nasal polyps,  and tests for comorbidities including asthma and vascular disease. Perioperative complications were evaluated based on information provided by the surgeons. Multivariate analysis was performed to identify patient characteristics that were risk factors for complications.
  
  
  RESULTS
  Overall, perioperative complications occurred in 41 patients (5.8%). A major complication, cerebrospinal fluid leakage, occurred in one patient (0.1%). Minor complications occurred in 40 patients (5.7%), with the most common being intraoperative hemorrhage (n = 18). Multivariate analysis  indicated that presence of asthma and the total polyp score correlated significantly with the occurrence of complications.
  
  
  CONCLUSIONS
  The risk factors for perioperative complications were asthma and the polyp score. We conclude that the surgeon should confirm whether the  patient has lower airway disease, especially asthma, before operating. The surgeon should also determine the grade of nasal polyps.
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato, Tokyo, Japan. asaka@jikei.ac.jp
authors.forename: Daiya
authors.initials: D
authors.lastname: Asaka
authors.forename: Tsuguhisa
authors.initials: T
authors.lastname: Nakayama
authors.forename: Takanori
authors.initials: T
authors.lastname: Hama
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Okushi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Matsuwaki
authors.forename: Mamoru
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yanagi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriyama
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Otori
mesh_terms: D000328:Adult; D001249:Asthma / Q000097:blood / Q000150:complications / Q000601:surgery*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D002908:Chronic Disease; D015897:Comorbidity; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011859:Radiography; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012307:Risk Factors; D012852:Sinusitis / Q000150:complications / Q000601:surgery*