Complications of Frontal Sinus Surgery

  • Conner J. Massey
  • Vijay R. Ramakrishnan


Surgery of the frontal sinus continues to be the most technically challenging of all of the paranasal sinuses. Safe surgery of the frontal sinus requires thorough preoperative planning, understanding of patient-specific anatomy, and meticulous surgical technique. Various complications can occur, including scarring and stenosis, mucocele formation, hemorrhage, orbital injury, and intracranial injury. Although serious complications are rare, patients must be made aware of these risks, and surgeons must be prepared to recognize and address any complications in an expeditious manner.

Endoscopic sinus surgery is one of the more common outpatient surgeries performed today and is generally considered very safe, with recent studies demonstrating an overall major complication rate of around 1% at the national level. Surgery of the frontal sinus is considered one of the more difficult aspects of sinus surgery due to the complex anatomy and demanding technical aspects of surgery in this area, as well as the close anatomic relationship to critical neurovascular structures. That external approaches to the frontal sinus are still occasionally used in an era dominated by endoscopic technique which speaks to the difficulty in accessing the frontal sinus and the numerous challenging disease processes that occur in this area. A thorough understanding of the various complications that may arise from frontal sinus surgery, with special attention paid to their prevention and management, is crucial to maintaining patient safety and improving postoperative outcomes. This chapter will focus on complications specific to frontal sinus surgery in all its forms – endoscopic, external approaches, and frontal balloon sinuplasty.


Sinus surgery complications Frontal sinus CSF leak Mucocele Osteoplastic flap 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Conner J. Massey
    • 1
  • Vijay R. Ramakrishnan
    • 1
  1. 1.University of Colorado School of Medicine, Department of OtolaryngologyAuroraUSA

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