Intraoperative Emergencies During Endoscopic Sinus Surgery: CSF Leak and Orbital Hematoma

Kevin C. Welch, James N. Palmer*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations


Among the several risks encountered in endoscopic sinus surgery, catastrophic orbital bleeding and iatrogenic cerebrospinal fluid leak are the two serious complications surgeons most fear. This article discusses these avoidable complications and provides treatment algorithms for intraoperative maneuvers. A thorough understanding of the anatomy of the paranasal sinuses and their relationships with the anterior skull base, appropriate preoperative planning, and meticulous surgical technique are essential for preventing intraoperative cerebrospinal fluid leaks. Intraoperative orbital hematoma is discussed and a stepwise approach to reduce complications is provided.

Original languageEnglish (US)
Pages (from-to)581-596
Number of pages16
JournalOtolaryngologic Clinics of North America
Issue number3
StatePublished - Jun 2008

ASJC Scopus subject areas

  • Otorhinolaryngology


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