title: Long-term outcomes of endoscopic endonasal approach for skull base surgery: a prospective study.
abstract: Little is known about the long-term effects of either transnasal transsphenoidal endoscopic approach (TTEA) or expanded endonasal approach (EEA). This study assessed the long-term impact of endoscopic skull base surgery on olfaction, sinonasal symptoms, mucociliary clearance time (MCT), and quality of life (QoL). Patients with pituitary adenomas underwent TTEA (n = 38), while patients with other benign parasellar tumours who underwent an EEA with vascularised septal flap reconstruction (n = 17) were enrolled in this prospective study between 2009 and 2012. Sinonasal symptoms (Visual Analogue Scale), subjective olfactometry (Barcelona Smell Test-24, BAST-24), MCT (saccharin test), and QoL (short form SF-36, rhinosinusitis outcome measure/RSOM) were evaluated before, and 12 months after, surgery. At baseline, sinonasal symptoms, MCT, BAST-24, and QoL were similar between groups. Twelve months after surgery, both TTEA and EEA groups experienced smell impairment compared to baseline. Moreover, EEA (but not TTEA) patients reported increased posterior nasal discharge and longer MCTs compared to baseline. No significant changes in olfactometry or QoL were detected in either group 12 months after surgery. Over the long-term, expanded skull base surgery, using EEA, produced more sinonasal symptoms (including loss of smell) and longer MCTs than pituitary surgery (TTEA). EEA showed no long-term impact on smell test or QoL.
  
  
  METHODS
  IIb.
authors.affiliation: Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clínic de Barcelona, Universitat de Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain.|ENT-Department, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Rioja
authors.affiliation: Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clínic de Barcelona, Universitat de Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Bernal-Sprekelsen
authors.affiliation: Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clínic de Barcelona, Universitat de Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain.|Clinical and Experimental Respiratory Immunology, IDIBAPS, Catalonia, Barcelona, Spain.
authors.forename: Karla
authors.initials: K
authors.lastname: Enriquez
authors.affiliation: Neurosurgery Department, University of Barcelona, Barcelona, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Enseñat
authors.affiliation: Anesthesiology Department, Medical School, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Valero
authors.affiliation: Department of Neuroscience, Division of Neurosurgery, "G. Rummo" Hospital, Benevento, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: de Notaris
authors.affiliation: Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clínic de Barcelona, Universitat de Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain.|Clinical and Experimental Respiratory Immunology, IDIBAPS, Catalonia, Barcelona, Spain.|CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Mullol
authors.affiliation: Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clínic de Barcelona, Universitat de Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain. isamalobid@gmail.com.|Clinical and Experimental Respiratory Immunology, IDIBAPS, Catalonia, Barcelona, Spain. isamalobid@gmail.com.|CIBER of Respiratory Diseases (CIBERES), Madrid, Spain. isamalobid@gmail.com.
authors.forename: Isam
authors.initials: I
authors.lastname: Alobid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D009666:Nose; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D019291:Skull Base / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Expanded endoscopic skull base surgery; Mucociliary clearance time; Olfaction; Pituitary; Quality of life; Sinonasal symptoms; Smell test