Long-term radiological findings after endonasal endoscopic approach to the skull base.

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Long-term radiological findings after endonasal endoscopic approach to the skull base.

Am J Otolaryngol. 2016 Mar-Apr;37(2):103-7

Authors: Langdon C, Enseñat J, Rioja E, Jaume F, Berenguer J, Oleaga L, Bernal-Sprekelsen M, Alobid I

Abstract
OBJECTIVE: To study the long-term radiological findings after endonasal endoscopic approach to the skull base.
MATERIAL AND METHODS: Prospective study that included 55 patients who underwent advance endoscopic skull base surgery. All patients were evaluated with MRI before, 3months and 12months after surgery. We used the Lund-Mackay staging system for chronic rhinosinusitis to evaluate the paranasal cavities and the sinonasal scoring system to assess sinonasal symptoms.
RESULTS: Seventeen patients (30.9%) underwent extended endonasal approach that required a nasoseptal flap (NSF) for reconstruction of skull base. At baseline the mean total Lund-Mackay score was 0.63±1.2 (range 0-4), and at 3 and 12months postoperatively the mean scores were 3.5±3.8 (range 0-14) and 2.0±2.5 (range 0-8) respectively. Patients who needed an NSF for reconstruction had a greater Lund-Mackay score (p<0.05). Moreover, NSF is correlated with sinonasal mucosal thickening and fluid retention at 3months (r=0.45, p<0.01) and 12months (r=0.4, p<0.01). Total 5-symptom score (T5SS) was similar between both groups at baseline. Patients with extended endoscopic approach reported more smell loss (40.1±26.2; p<0.05) and posterior nasal discharge (49.3±30.1; p<0.05) than TTEA patients (21.6±30.9 and 22.5±27.5 respectively).
CONCLUSIONS: We observed that sinus opacity is still present after one year of advance endoscopic skull base surgery but symptoms seems to return to basal after 12months of follow-up.

PMID: 26954861 [PubMed - in process]

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