Standardized training of nasal endoscopic surgery and standardized access system are means to improve the efficacy and reduce complications.
Most reported complications of nasal endoscopic surgery are 4%, and the incidence of serious complications such as: intracranial infection from cerebrospinal fluid nasal leakage, optic nerve injury from visual loss or blindness, and severe nasal bleeding leading to death has not decreased. A large body of data suggests that the incidence of complications varies among operators of different skill levels. In one author’s statistical study of postoperative complications in 300 consecutive FESS cases, the incidence of complications was 29% in the first 150 cases and 2.2% in the last 150 cases. Among the many factors influencing the occurrence of complications, the experience of the operator and the endoscopic technique take the first place, which is also very important for surgeons with extensive experience in traditional rhinological surgery. According to epidemiological statistics, there are tens of millions of patients suffering from chronic sinusitis and nasal polyps in China, and the current technical strength and number of doctors are still far from meeting the needs of patients. With such a good intention, nasal endoscopic surgery has been flourishing in China.
However, due to the lack of theoretical knowledge and the lack of strict and systematic training, not only a variety of surgical procedures, but also serious complications still occur, and the overall treatment effect of nasal endoscopic surgery is worrying. Compared with the traditional procedures, the number of complications has not decreased due to the introduction of nasal endoscopy, but rather the absolute number of complications has increased due to the significant increase in the number of procedures. This is one of the most important reasons for discussing the establishment of an access system for nasal endoscopic surgery. In terms of medical ethics, neither medical institutions nor individuals can, under any pretext, ignore the protection of public interest, the absence of unified standards for nasal endoscopic surgery, the absence of an access system, and the absence of a system that allows those who perform it blindly and in a crude manner.
To develop a relevant access system, we must first establish a complete set of theoretical system and systematic treatment norms, and on this basis, establish a relevant training and assessment system
In order to regulate the operation of doctors. We should vigorously carry out various levels of nasal endoscopic surgical techniques and short-term special training courses and the promotion of new equipment and techniques, so that nasal endoscopic surgery techniques can be standardized, promoted and popularized to benefit patients.