title: Long-term radiological findings after endonasal endoscopic approach to the skull base.
abstract: OBJECTIVE
  To study the long-term radiological findings after endonasal endoscopic approach to the skull base.
  
  
  METHODS
  Prospective study that included 55 patients who underwent advance endoscopic skull base surgery. All patients were evaluated with MRI before, 3 months and 12 months 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 12 months 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 3 months (r=0.45, p<0.01) and 12 months (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 12 months of follow-up.
authors.affiliation: Rhinology Unit and Smell Clinic, Otorhinolaryngology Department, Hospital Clinic, Universitat de Barcelona; Clinical and Experimental Respiratory Immunology, IDIBAPS, Barcelona, Catalonia, Spain. Electronic address: clangdon@clinic.ub.es.
authors.forename: Cristobal
authors.initials: C
authors.lastname: Langdon
authors.affiliation: Neurosurgery Department, Hospital Clinic, Universitat de Barcelona.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Enseñat
authors.affiliation: Otorhinolaryngology Department, Althaia Xarxa Assistencial de Manresa.
authors.forename: Elena
authors.initials: E
authors.lastname: Rioja
authors.affiliation: Rhinology Unit and Smell Clinic, Otorhinolaryngology Department, Hospital Clinic, Universitat de Barcelona.
authors.forename: Francesca
authors.initials: F
authors.lastname: Jaume
authors.affiliation: Radiology Department, Hospital Clinic, Universitat de Barcelona.
authors.forename: Joan
authors.initials: J
authors.lastname: Berenguer
authors.affiliation: Radiology Department, Hospital Clinic, Universitat de Barcelona.
authors.forename: Laura
authors.initials: L
authors.lastname: Oleaga
authors.affiliation: Rhinology Unit and Smell Clinic, Otorhinolaryngology Department, Hospital Clinic, Universitat de Barcelona.
authors.forename: Manuel
authors.initials: M
authors.lastname: Bernal-Sprekelsen
authors.affiliation: Rhinology Unit and Smell Clinic, Otorhinolaryngology Department, Hospital Clinic, Universitat de Barcelona; Clinical and Experimental Respiratory Immunology, IDIBAPS, Barcelona, Catalonia, Spain.
authors.forename: Isam
authors.initials: I
authors.lastname: Alobid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009666:Nose; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery*; D019291:Skull Base / Q000000981:diagnostic imaging* / Q000601:surgery; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult