Causes of failure in endoscopic frontal sinus surgery in chronic rhinosinusitis patients
Bibliographic record
Abstract
BACKGROUND: The frontal sinus is the most challenging area to address in endoscopic sinus surgery (ESS). Incomplete surgery or iatrogenic injury in the narrow space of the frontal recess with synechia formation can lead to recurrence or persistence of disease. The goal of this study was to identify causes of failure of endoscopic frontal sinus surgery and to determine complication rates. METHODS: A cross-sectional retrospective study was conducted. Charts and preoperative sinus computed tomography (CT) scans of patients who underwent revision frontal ESS for chronic frontal rhinosinusitis, between 2006 and 2012 were reviewed. RESULTS: Of 829 patients who underwent ESS during the study period, 740 had the frontal recess dissected and frontal sinus opened. Of these, 66 patients had revision surgery of the frontal sinus, with a total of 109 frontal sinuses. The mean ± standard deviation (SD) age was 52 ± 12.9 years. Forty patients were male (59.1%). The most common findings were the following: edematous or hypertrophic mucosa (92.7%); retained agger nasi cell (73.4%); neo-osteogenesis within the frontal recess (45.9%); lateral scarring of the middle turbinate (47.7%); residual anterior ethmoid air cell (32.1.%); and residual frontal cells (24.8%). CONCLUSION: With the exception of mucosal disease and neo-osteogenesis, all identified causes of failure of frontal sinus surgery are a result of surgical technique. Careful preoperative planning and meticulous and complete surgical execution are therefore critical for a successful surgical outcome in primary frontal sinus surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".