COMPLICATIONS OF ETHMOIDECTOMY - A SURVEY OF FELLOWS OF THE AN-ACADEMY-OF-OTOLARYNGOLOGY-HEAD-AND-NECK-SURGERY

A survey regarding complications of sinus surgery was mailed to 6969 o tolaryngologists; 3933 responses (56.44%) were obtained, and 3043 of t hese physicians (77.37%) reported that they performed ethmoidectomy. C ompleted questionnaires were available for review from 42.21% of all A cademy fellows (2942 physicians). Responses were tabulated and summari zed question by question. Physicians generally did not rate their resi dency training in ethmoidectomy highly. The survey confirmed that ther e has been a marked rise in the frequency of ethmoidectomy and in the amount of training in ethmoidectomy since 1985. Empirical complication rates were calculated for different procedures and time periods. Pois son regression models were then constructed to describe the rate of co mplications under varying conditions such as the type of surgery perfo rmed, time period, experience and training of the surgeon, and type of complication encountered. The models permitted determination of the s tatistical significance of variables in relation to incidence of compl ications. The study did not demonstrate a clear and consistent statist ical relationship between the incidence of complications, the type of surgery performed, and the quality of training. Moreover, physicians w ho provided data from record review tended to report higher rates than those who estimated responses. The majority of physicians discussed s pecific potential complications with their patients before surgery and routinely performed preoperative computed tomography. The study demon strated that physicians who experienced complications at higher rates were more likely to discuss these complications with patients before s urgery.