Ambulatory sinus and nasal surgery in the United States: Demographics and perioperative outcomes

OBJECTIVES/HYPOTHESIS: Determine the prevalence of ambulatory sinonasal surgical procedures and perioperative outcomes in the United States. METHODS: The National Survey of Ambulatory Surgery 2006 release was examined, extracting all cases of nasal or sinus surgery. Sinonasal surgical procedures were grouped according to septoplasty and/or turbinate surgery, sinus surgery, facial plastic surgery, and other procedures. Overall and group population-based sinonasal procedure prevalences were estimated from the sample. Frequency of general anesthesia, discharge status, and unexpected emergency room visit estimates were obtained. Perioperative complication rates for cardiac arrest, malignant hyperthermia, postoperative emesis, and blood transfusion were determined as well. RESULTS: Overall, an estimated 600,000 patients underwent ambulatory sinonasal procedures in 2006 with a mean age of 40.4 years and 53.7% male predominance. On a per patient basis, there were 260,000 septoplasties, 257,000 sinus cases, 134,000 plastics cases, and 103,000 other cases. Facial plastics procedures were less likely to use general anesthesia (72.8%) than the overall cohort (90.7%, P < .001). The vast majority of patients were discharged to home with an unexpected admission rate of 2.65%. Among the sample, there were no cases of cardiac arrest, malignant hyperthermia, or blood transfusion. The postprocedure emesis rate was 1.3%, not significantly different among procedure groups (P = .692). Only 0.1% of patients visited the emergency room postprocedure. CONCLUSIONS: Approximately 600,000 ambulatory sinonasal cases are performed each year in the United States. Complication rates and unexpected postprocedure mission rates are quite low indicating the safety and effectiveness of the ambulatory setting for sinonasal surgery.