Complications of endoscopic sinus surgery. The role of the radiologist in prevention.

Intranasal surgery via the endoscope has become an extremely popular technique for refractory rhinosinusitis, but like all procedures it carries a risk of complications. Mosher in 1912 stated that intranasal ethmoidectomy is "the blindest and most dangerous (operation) in all surgery." Complications of a surgical procedure are among the most devastating problems in the practice of medicine. A thorough knowledge on the part of the radiologist of what the otolaryngologist is attempting to do can only enhance patient care. All screening CT scans should be approached as if they are preoperative examinations. It is not enough for the radiologist to merely describe air-fluid levels or mucoperiosteal thickening. Instead, the radiologist is an important member of the health care team, and an active role should be assumed to describe anatomic variants that may place the patient at increased surgical risk and to assist the surgeon in the appropriate evaluation of the patient who has a surgical complication.