Sinonasal outcomes following endoscopic anterior skull base surgery with nasoseptal flap reconstruction: a prospective study.
OBJECTIVE
To assess nasal morbidity resulting from nasoseptal flap use in the repair of skull base defects in endoscopic anterior skull base surgery.


METHODS
Thirty-six patients awaiting endoscopic anterior skull base surgery were prospectively recruited. A nasoseptal flap was used for reconstruction in all cases. Patients were assessed pre-operatively and 90 days post-operatively via the Sino-Nasal Outcome Test 20 questionnaire and visual analogue scales for nasal obstruction, pain, secretions and smell; endoscopic examination findings and mucociliary clearance times were also recorded.


RESULTS
Sino-Nasal Outcome Test 20 questionnaire data and visual analogue scale scores for pain, smell and secretions showed no significant differences between pre- and post-operative outcomes, with visual analogue scale scores for nasal obstruction actually showing a significant improvement (p = 0.0007). A significant deterioration for both flap and non-flap sides was demonstrated post-operatively on endoscopic examination (p = 0.002 and p = 0.02 respectively).


CONCLUSIONS
Whilst elevation of a nasoseptal flap in endoscopic surgery of the anterior skull base engendered significant clinical deterioration on examination post-operatively, quality of life outcomes showed that no such deterioration was subjectively experienced by the patient. In fact, there was significant nasal airway improvement following nasoseptal flap reconstruction.
Department of Otolaryngology,Head and Neck Surgery,Princess Alexandra Hospital,Woolloongabba,Australia.
M
M
Hanson
Department of Otolaryngology,Head and Neck Surgery,Princess Alexandra Hospital,Woolloongabba,Australia.
P M
PM
Patel
Department of Otolaryngology,Head and Neck Surgery,Princess Alexandra Hospital,Woolloongabba,Australia.
C
C
Betz
School of Medicine,University of Queensland,Woolloongabba,Australia.
S
S
Olson
Department of Otolaryngology,Head and Neck Surgery,Princess Alexandra Hospital,Woolloongabba,Australia.
B
B
Panizza
Department of Otolaryngology,Head and Neck Surgery,Princess Alexandra Hospital,Woolloongabba,Australia.
B
B
Wallwork
D004724:Endoscopy / Q000379:methods; D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D019291:Skull Base / Q000601:surgery*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Hypophysectomy; Natural Orifice Endoscopic Surgery; Paranasal Sinus Disease; Pedicled Flap; Pituitary Neoplasms