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Komplikationen der Nasennebenhöhlen-Chirurgie

Topographische Einteilung und therapeutisches Management

Surgical complications of paranasal sinus surgery

Topographical classification and therapeutic management

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Zusammenfassung

Die Chirurgie der Nasennebenhöhlen (NNH) gehört heute zu den am häufigsten durchgeführten Eingriffen in der HNO-Heilkunde. Trotz ausgefeilter, minimalinvasiver, endoskopischer bzw. mikroskopischer Techniken hat sich das potenzielle Komplikationsspektrum dieser operativen Intervention nicht verändert. Das Risiko einer Schädigung von dem NNH-System benachbarten Strukturen (Orbita, Endokranium, arterielle Gefäße) ist nach wie vor immanent. Neben einer systematisch-topographisch gegliederten Abhandlung der möglichen Komplikationen, die im Rahmen der NNH-Chirurgie auftreten können, wird insbesondere das therapeutische Management dieser unerwünschten Operationsfolgen dargelegt. Darüber hinaus werden medizinrechtliche Aspekte zur suffizienten Patientenaufklärung sowie Empfehlungen zur Vermeidung solcher Komplikationen diskutiert.

Abstract

Surgery of the paranasal sinuses is one of the most frequently performed surgical interventions in otorhinolaryngology today. The potential for surgical complications with damage to paranasal structures in the close vicinity (orbit, endocranium, vital arteries) is still significant despite very elaborate, minimally invasive endoscopic and microscopic techniques. Reviewing the wide range of surgical complications of paranasal sinus surgery in a systematic and topographical fashion, elucidated by typical clinical case reports, we discuss the therapeutic management of such surgical sequelae. In addition, medicolegal aspects of informed patient consent as well as general recommendations to possibly avoid such complications are given.

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  1. Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf-, Hals- und plastische Gesichtschirurgie, Klinikum Darmstadt, Heidelberger Landstraße 379, 64297, Darmstadt-Eberstadt, Deutschland

    I. Ott & G. Baier

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Correspondence to I. Ott.

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Ott, I., Baier, G. Komplikationen der Nasennebenhöhlen-Chirurgie. HNO 57, 73–90 (2009). https://doi.org/10.1007/s00106-008-1858-z

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