1. Audit Meeting 22nd September 2011
Consent
Audit Meeting
22nd September 2011

2. Risks and Complications
Laryngoscopy
Oesophagoscopy
Pharyngoscopy
Septoplasty
FESS
Tonsillectomy
Myringoplasty

3. Laryngoscopy Endoscopic evaluation of the larynx under GA
Insertion of rigid scope into upper airway
Benefits
Allows direct detailed inspection of larynx + biopsy/intervention
Alternatives
Nasendoscopy – but GA scope usually after flexiscope

4. Laryngoscopy - Risks Dental damage Cut/bruised lips/gum/tongue
Sore throat
Numb tongue
Voice change
Laryngeal swelling
Airway obstruction
Tracheostomy

5. Oesophagoscopy Endoscopic evaluation of the oesophagus under GA
Insertion of rigid scope into upper oesophagus
Benefits
Allows direct detailed inspection of oesophagus + biopsy/intervention
Alternatives
Flexible oesophagoscopy

6. Oesophagoscopy - Risks
Dental damage
Cut/bruised lips/gum/tongue
Sore throat
Numb tongue
Bleeding
Oesophageal perforation
Rare but serious
Naso-gastric feeding
Open exploration

7. Pharyngoscopy Endoscopic evaluation of the pharynx under GA
Insertion of rigid scope into pharynx
Benefits
Allows direct detailed inspection of pharynx + biopsy/intervention
Alternatives?

8. Pharyngoscopy - Risks Dental damage Cut/bruised lips/gum/tongue
Sore throat
Numb tongue
Pharyngeal perforation
Rare but serious
Naso-gastric feeding
Open exploration

9. Septoplasty Procedure to straighten nasal septum GA or LA Benefits
Improve nasal blockage
Access for nasal surgery
Alternatives
Topical nasal treatment
Leave it alone

10. Septoplasty - Risks Bleeding Infection Septal haematoma
Septal abscess
Septal haematoma
Re-admission
Return to theatre
Drainage and packing
Septal perforation
Dorsal saddle
Numbness of teeth
Nasal crusting
Persistent deviation
Failure of procedure
Continued symptoms

11. FESS Surgical treatment for sinus disease
Recurrent acute sinusitis
Nasal polyp
Chronic sinusitis
Trans nasal surgery using endoscope & instruments
+/- powered instruments
Benefits
Improve nasal/sinus symptoms
Alternatives
Continued use of topical nasal treatment
Leave it alone

12. FESS - Risks Bleeding Infection Nasal crusting
Alteration in sense of smell
Numbness of teeth
CSF leak
Meningitis
Further surgery
Orbital injury
Infection
Abscess/cellulitis
Subcutaneous emphysema
Double vision
Blindness
External incision
Persistent symptoms / non resolution of symptoms

13. Tonsillectomy Surgical removal of tonsils under GA Benefits
Treatment for recurrent acute tonsilitis
Part of other procedure
Investigation of malignancy
Alternatives
Watch & wait

14. Tonsillectomy - Risks Dental damage Cut/bruised lips/gum/tongue
Sore throat
Infection
Haemorrhage
Return to theatre
Primary
Re-admission

15. Myringoplasty Repair of TM perforation GA or LA Benefits Alternatives
Stop recurrent ottorhoea
Alternatives
Medical treatment

16. Myringoplasty - Risks Scar Bleeding Infection Failure of graft
Ottorhoea
Failure of graft
Hearing loss
Tinnitus
Vertigo
Facial palsy
Alteration in taste
External canal stenosis

17. Further Information If necessary discuss with senior colleague
Patient information available

18. Any Questions?