Characterizing the complexity of frontal endoscopic sinus surgery: a multi-institutional, prospective, observational trial

• Type of Material: Article
• Authors: Philip G Chen, University of Texas Health San Antonio; Joshua Levy, Emory University; Garret Choby, Mayo Clinic; Kristine Smith, University of Manitoba; William C Yao, The University of Texas Health Science Center at Houston; Ashleigh Halderman, University of Texas Southwestern; Gretchen M Oakley, University of Utah; Joseph Brunworth, St Louis University Hospital; JA Alt, University of Utah
• Language: English
• Date: 2020-12-04
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 ARS‐AAOA, LLC
• Final Published Version (URL): http://dx.doi.org/10.1002/alr.22746
• Title of Journal or Parent Work: INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY
• Volume: 11
• Issue: 5
• Start Page: 941
• End Page: 945
• Grant/Funding Information: Funding sources for the study: National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR002378 and KL2TR002381 to J.M.L.); National Heart Lung and Blood Institute (U54 HL-143541-02S2 to J.M.L.); National Institute on Deafness and Other Communication Disorders (R01 DC005805 to J.A.A.); National Institute of Allergy and Infectious Diseases (R44AI126987 to J.A.A.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: Mucocele; Science & Technology; Otorhinolaryngology; Chronic Rhinosinusitis; Endoscopic Sinus Surgery; Life Sciences & Biomedicine; Osteitis; Frontal sinusotomy

Abstract

The frontal sinus has been cited as the most difficult sinus to manage secondary to its anatomic location, proximity to critical structures, and variable anatomy.1 Although indicated by a single Current Procedural Terminology code, “frontal sinusotomy,” there may be vastly different time and equipment requirements to complete the procedure based on anatomy and planned extent of surgery. To date, there are few data on the variables that affect the time to complete frontal sinus surgery, which is pertinent given the difficulty of adequately managing this sinus in particular. As hospitals try to maximize operating room utilization, understanding factors that affect surgical duration is vital. The objective of this study was therefore to evaluate: (1) the relative complexity of frontal endoscopic sinus surgery (ESS) by assessing the time required for frontal ESS among a cohort of fellowship-trained rhinologists; and (2) characterize the surgical and patient cofactors associated with increased operative time during frontal ESS.