Ethical aspects in endoscopic sinus surgery complications

Functional endoscopic sinus surgery is a field that has underwent dramatic development in the past years. The advancements in the techniques, materials and technologies made possible the approach of a wide range of pathologies, from chronic rhinosinusitis to tumours of the skull base, orbital problems and cerebrospinal fluid leaks by means of endoscopic surgery. However, this type of surgery associates a wide risk of complications. These have medical and ethical aspects that must be carefully considered and thoroughly explained to the patient prior to the intervention. We analysed a wide range of cases that required endoscopic sinus surgery in a period of ten years in our department, performed by eight doctors. The pathology ranged from chronic sinusitis to difficult problems of the skull base or the orbit. The rate of major and minor complications was documented, taking into account the necessary measures required to solve these complications. Although our complication rates did not exceed the ones available in the literature, we must always be careful to explain thoroughly to the patient all the risks and make sure we have a proper informed consent. Whenever an unexpected complication occurs, the patient must be informed immediately as to the nature of the problem and the necessary measures to solve the situation, a good communication being the key to avoid unwanted legal action.