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Komplikationen bei Operationen an der Rhinobasis

Complications of anterior skull base surgery

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Zusammenfassung

Operationen der Rhinobasis werden zur Behandlung ernsthafter und komplizierter Krankheitsbilder durchgeführt und zählen zu den komplexen Eingriffen. Komplikationen sind bei diesen Eingriffen trotz erheblicher Fortschritte in den Operationstechniken relativ häufig und teilweise schwerwiegend. Die endoskopischen Operationstechniken der Rhinobasis scheinen seltener mit Komplikationen assoziiert zu sein als offene Operationsmethoden. Es werden verschiedene Klassifikationen zur Kategorisierung dieser Komplikationen vorgeschlagen, deren Anwendung beim Bericht über Komplikationsraten empfohlen werden kann. Zu den wichtigsten und häufigsten Komplikationen bei Rhinobasisoperationen zählen Blutungen, Liquorrhö, Meningitis und Hirnnervenschädigungen. Zur Vermeidung von Komplikationen sind eine sorgfältige Planung, eine enge interdisziplinäre Kooperation, die Kompetenz des Schädelbasiszentrums und seiner Mitarbeiter und ein stringentes Qualitätsmanagement von entscheidender Bedeutung. Im Hinblick auf die Häufigkeit und Schwere der möglichen Komplikationen spielt die sorgfältige und vollständige Aufklärung der Patienten eine zentrale Rolle.

Abstract

Anterior skull base operations are complex surgical procedures that are performed to treat serious and complicated diseases. Despite significant advances in surgical techniques, complications are relatively frequent and can be serious. Endoscopic skull base surgery seems to be associated with less complications than open techniques. Different classifications aimed at categorizing these complications have been suggested, the use of which can be recommended when reporting complication rates. The most relevant and frequent complications of anterior skull base surgery are hemorrhage, cerebrospinal fluid (CSF) leak, meningitis, and cranial nerve injury. Careful planning, close interdisciplinary cooperation, the competence of the skull base center and its members, and rigorous quality management are decisive for the avoidance of complications. With respect to the frequency and the seriousness of the complications, their meticulous and complete discussion with the patient before obtaining informed consent plays a central role.

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Authors and Affiliations

  1. Rhinologie, Allergologie und Endoskopische Schädelbasischirurgie, Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    M. Wagenmann, K. Scheckenbach & I. Stenin

  2. Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

    B. Kraus

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  1. M. Wagenmann
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  2. K. Scheckenbach
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  3. B. Kraus
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  4. I. Stenin
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Correspondence to M. Wagenmann.

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Interessenkonflikt

M. Wagenmann hat Gelder für Studiendurchführung, Berater- und/oder Gutachtertätigkeit, Vortrags- und/oder Schulungstätigkeiten und/oder bezahlte Mitarbeit in einem wissenschaftlichen Beirat erhalten von den Firmen: ALK-Abelló, Allakos, Allergopharma, AstraZeneca, Bencard Allergie, Bionorica SE, Biotech Tools, DüsseldorfCongress Veranstaltungsgesellschaft, GlaxoSmithKline, HAL Allergie, Meda Pharma, Otonomy, Sanofi-Aventis, Stallergenes, Strekin, TEVA. Ein direkter Interessenkonflikt besteht nicht.

K. Scheckenbach ist Mitinhaberin eines Patents auf RAD51c, das vorübergehend an Myriad Genetics veräußert war. Ein direkter Interessenkonflikt besteht nicht.

B. Kraus und I. Stenin geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Wagenmann, M., Scheckenbach, K., Kraus, B. et al. Komplikationen bei Operationen an der Rhinobasis. HNO 66, 438–446 (2018). https://doi.org/10.1007/s00106-018-0508-3

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  • DOI: https://doi.org/10.1007/s00106-018-0508-3

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