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Complications in Endoscopic Sinus Surgery: Diagnosis, Prevention and Management
SK Kaluskar, Sanjay Sachdeva
CHAPTER 1:
Overview: Prevention of Complications
PREOPERATIVE PREPARATION
General Precautions
Preoperative Steroids
CT Scans
LOCAL ANAESTHESIA FOR FESS
CHAPTER 2:
Review of Literature
CHAPTER 3:
Intraoperative Anatomical Landmarks of Surgical Importance
ANTERIOR ETHMOIDECTOMY AND MIDDLE MEATAL ANTROSTOMY
Middle Turbinate
Uncinate Process
Natural Ostium of the Maxillary Sinus
Bulla Ethmoidalis
Upper Border of Inferior Turbinate
POSTERIOR ETHMOIDECTOMY AND SPHENOIDOTOMY
FRONTAL RECESS AND FRONTAL SINUS SURGERY
CHAPTER 4:
Haemorrhage During Operation: Causes, Prevention and Management
MUCOSAL BLEEDING
During Operation
ARTERIAL BLEEDING
Anterior Ethmoidal Artery
Sphenopalatine Artery
Posterior Branch of the Sphenopalatine Artery
Anterior Branch of Sphenopalatine Artery
Internal Carotid Artery
Internal Carotid Artery Injury
Prevention of Injury to ICA
Postoperative Haemorrhage
CHAPTER 5:
Orbital Complications: Injury to Lamina Papyracea, Medial Rectus Muscle, Nasolacrimal Duct, Retrobulbar Haemorrhage, Injury to Optic Nerve, Periorbital Emphysema
A. MINOR COMPLICATIONS
1. Damage to the Periorbita
2. Periorbital Surgical Emphysema
A. MAJOR COMPLICATIONS
1. Damage to the Medial Rectus Muscle
2. Damage to the Nasolacrimal Duct
Clinical Features
3. Intraorbital Haemorrhage
Pathology of Visual Loss
Diagnosis of Acute Orbital Haemorrhage
Symptoms
Management of Orbital Haematoma
General Measures
Increasing the Orbital Space
OPTIC NERVE INJURY
Clinical Assessment of the Optic Nerve Injury
Pathogenesis of Blindness
Management
CHAPTER 6:
Intracranial Complications: CSF Leak, Pneumocephalus, Meningitis, Brain Abscess
CSF LEAK: COMMONEST MAJOR COMPLICATION
Historical View
Physiology of CSF Fluid
Clinical Features
Diagnosis of CSF Rhinorrhea
Intraoperative Diagnosis
Diagnosis of Perioperative and Delayed CSF Leak
Laboratory Diagnosis of CSF Rhinorrhea
Radiological Localisation of the Source of CSF Rhinorrhea
Anatomical Considerations
Operative Technique to Prevent CSF Leak
Operative Technique of CSF Leak Repair
External Drainage of CSF
Endonasal Endoscopic Approach to Repair CSF Leak
Materials Used for the Repair
Subdural Empyema
Clinical Manifestations
Epidural Abscess
Treatment
Cavernous Sinus Thrombosis
Pneumocephalous
Management
CHAPTER 7:
Perioperative and Delayed Postoperative Complications: Adhesions, Osteitis, Infection, Crusting
1. HAEMORRHAGE
2. ADHESIONS
Predisposing Factors for the Formation of Adhesions
Prevention of Post-operative Adhesions
INFECTION
Toxic Shock Syndrome
OSTEITIS
CRUSTING (Fig 7.15)
RECIRCULATION OF MUCUS
MUCOUS CYST (Fig 7.16)
EPIPHORA
CHAPTER 8:
Complications in Revision Surgery: Rote of Laser, Microdebrider
THE COMMON ANATOMICAL SITES OF RESIDUAL DISEASE
USE OF LASER IN REVISION SURGERY
Why Use a Laser ?
Advantages of Lasers
Which Laser ?
Disadvantages of Lasers
KTP/532 LASER
Laser Parameters for KTP/532 Wavelength
Uncinate Process (Fig. 8.22)
Bulla Ethmoidalis (Fig. 8.23)
Agger Nasi Cells (Figs 8.24 and 8.25)
Posterior Ethmoids and Sphenoid (Figs 8.26 and 8.29)
Frontal Recess (Figs 8.30 to 8.34)
Middle Meatal Antrostomy (Figs 8.35 and 8.36)
ADHESIONS (Figs 8.37 and 8.38)
PREOPERATIVE EVALUATION
Postoperative Care
CONCLUSIONS
ROLE OF MICRODEBRIDER
Advantages
Disadvantages
CHAPTER 9:
Fungal Infections of the Nose and Paranasal Sinuses
HISTORY
WHAT IS A FUNGUS?
TYPES OF FUNGAL SINUSITIS
ETIOPATHOGENESIS
CLINICAL FEATURES
DIAGNOSIS
Imaging Studies
COMPLICATIONS
MUCORMYCOSIS
CHAPTER 10:
New Horizons: Complications of Endoscopic Transsphenoidal Pituitary Surgery, Endoscopic DCR, Mucoceles, Tumours, Funyallnfections, Orbital Abscess, etc.
COMPLICATIONS OF ENDOSCOPIC DCR (DACRYOCYSTORHINOSTOMY)
ANATOMICAL CONSIDERATION OF NASOLACRIMAL APPARATUS
Physiology
Specific Conditions
Preoperative Assessment
Important Points in DCR Surgery
Complications of the DCR Surgery
Haemorrhage
Orbital Emphysema
Orbital Haemorrhage
Problems with Silastic Tubes
Infection
Problem of Stenosis
COMPLICATIONS OF ENDOSCOPIC TRANSSPHENOIDAL PITUITARY SURGERY
Surgical Anatomy of the Sphenoid Sinus
The Trans-sphenoid Approach for Pituitary Surgery
Diagnosis and Preoperative Assessment to Prevent Complications
Key Points to Prevent Complications
MUCOCELES
FUNGAL INFECTIONS
TUMOURS
INTRA ORBITAL COMPLICATIONS OF ACUTE SINUSITIS
TRANSITIONAL CELL PAPILLOMA (TCP)
TRANS NASAL ENDOSCOPIC SPHENO PALATINE ARTERY LIGATION (ESPAL)
COMBINED APPROACH FRONTAL OSTIO PLASTY (CAFOP)
UNUSUAL CONDITIONS AFFECTING SINUSES
An Unusually Large Concha Bullosa
Dentigerous Cyst
Nasopharyngeal Angiofibroma
CHAPTER 11:
Situations and Solutions
KEY POINTS TO PREVENT COMPLICATIONS
Case No. 1: Nasal Cavity
Case No. 2: Maxillary Sinus
Problem
Solution
Case No. 3
Solution
Case No. 4
Solution
Case No. 5: Ethmoid Sinus Osteoma
Case No. 6: Frontal Sinus Osteoma
Case No. 7
Solution
Case No. 8
Solution
CHAPTER 12:
Tips and Quips for the Beginners
CHAPTER 13:
Documentation and Instruments
SURGICAL INSTRUMENTS
CCD CAMERA
VIDEO MONITOR
LIGHT SOURCE
LIGHT CABLE
ENDOSCOPES
ADVANCED INSTRUMENTATION TO AVOID COMPLICATIONS
C-Arm
VTI (Video Technique Imaging) or Image Guided Surgery
Bibliography
INDEX
TOC
Index
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