Less 'Oops' and More 'Ahs': Strategies to Prevent Intraoperative Complications in Nasal and Sinus Surgery

PROGRAM DESCRIPTION: Preventing complications during nasal and sinus surgery is a critical focus for comprehensive otolaryngologists aiming to optimize patient outcomes. Despite advancements in surgical techniques, intraoperative injuries remain a concern and can significantly impact patient recovery, long-term quality of life, and surgeon confidence. Building on the promoted education gap identified for 2025, this session is designed to enhance the understanding and skills needed to avoid common and complex intraoperative complications in sinus surgery and functional nasal surgery (e.g. septoplasty).

This presentation will focus on:
1. Risk Assessment and Preoperative Planning: Strategies for thorough patient evaluation, including systematic CT scan review, preoperative medical optimization, and identifying patient-specific anatomical or pathological challenges.

2. Avoiding Surgical Landmines: A comprehensive review of potential complications (both minor and major) and how to prevent them. We will review technical pearls that enhance surgical precision through visualization, hemostasis, and intraoperative navigation. Practical tips for instrument handling and tissue handling will be discussed.

3. Intraoperative Error Management: Protocols for immediate identification and mitigation of injuries during surgery, including repair techniques, management of hemorrhagic complications, and when to refer for advanced intervention. Discussion of decision-making and communication strategies to maintain patient trust and minimize long-term sequelae.

4. Educational Tools and Briefings: Integration of simulation-based training, peer review, and team briefing/debriefing to improve surgical preparedness and reduce errors.

OUTCOME OBJECTIVE 1: Identify patient-specific risks and employ preoperative planning techniques to minimize intraoperative complications in nasal and sinus surgery.

OUTCOME OBJECTIVE 2: Describe surgical techniques and technical pearls to avoid complications during critical steps of septal and sinus surgery.

OUTCOME OBJECTIVE 3: Implement strategies for intraoperative error management, including repair techniques (e.g. skull base repair, septal perforation prevention), hemorrhagic complication management, effective communication, and patient-centered care to optimize outcomes following a complication.

BACKGROUND STATEMENT: This session addresses the 2025 education gap in preventing nasal and sinus surgery complications and patient injury. It equips otolaryngologists with advanced skills, practical insights, and peer-reviewed literature to manage complex cases, enhance patient safety, and ensure success.

Comprehensive Otolaryngology Track Statement : This session aligns with the Comprehensive Otolaryngology track by equipping otolaryngologists with holistic strategies to prevent and manage complications in nasal and sinus surgery, addressing the growing complexity of cases and advancing patient-centered care.