Intra-operative complications

Problems that arose during a procedure included:

diathermy burns causing scarring or nerve damage
dental damage or loss of teeth
perforations such as of the septum or oesophagus
nerve damage and bone damage such as cracking of the orbital plate
severe bleeding and stroke.

Post-operative complications

Post-operative complications occurred in 40% of cases. Some were known complications such as pain, nausea, dizziness, scarring, poor healing, infections and mild to major sensory loss.

Neurological damage was seen in several cases. Examples included:

nerve damage causing muscle paralysis and reduced arm function following excision of a neck lesion
swallowing and speech difficulties after the laryngeal nerve was damaged during a thyroidectomy
subarachnoid haemorrhage following revision sinus surgery
stroke after a septoplasty
brain infections or meningitis necessitating further procedures and a poor outcome for the patient.

In one case following mastoidectomy and myringoplasty, the patient developed sepsis and multi-organ failure secondary to a post-operative infection, although made a good recovery. The case was settled for around £325,000 in compensation and claimant's legal costs.

Delayed diagnosis or referral

Allegations of delayed diagnoses or referral were also common. The diagnoses allegedly missed or delayed included:

brain tumours
cholesteatomas
sensorineural hearing loss
meningitis
labyrinthitis
post-operative infections or haematomas
cleft palate
mucocele
cancers of the tonsil, skin, nasopharynx, oropharynx and larynx.

In one case, in which a patient died, a delayed diagnosis of malignant otitis externa led to the patient developing bacterial meningitis and invasive laryngeal candidosis. In another case a patient having sinus surgery was found to have a congenital skull defect, which was mistaken for a mucocele. This led to complications and the need for the patient to have further operations.

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