title: Evaluation of the application of rhino-septal splints in endoscopic transsphenoidal skull base surgery.
abstract: The endoscopic transnasal route for the surgical removal of tumors in the sellar region is frequently associated with nasal complications such as synechiae or impaired nasal breathing. In this study, we investigated the impact of septal splints on avoiding surgery-related co-morbidities. 49 patients in whom endoscopic transnasal, transsphenoidal surgery for sellar tumors was performed between 2012 and 2014 were studied. In 30 of these, nasal septal splints were applied at the end of surgery to both sides of the septum and left in situ for 10 days (group 1), 19 patients received no splints (group 2). A standardized postsurgical follow-up investigation with endoscopic nasal examination, rhinomanometry and olfactory testing was performed on average 2 months postoperatively. Patients' subjective nose-related discomfort at follow-up was assessed descriptively using a set of standardized self-rating statements on nasal problems. Synechias occurred less likely with nasal septal splints (n = 15; 50 %) than without (n = 16; 84.2 %). Moreover, multiple synechiae were predominantly observed in the group without septal splints (n = 10 vs. n = 2). Rhinomanometry showed improved flow-V150-inspiration scores when splints were used (with significant differences between groups for the left nostril: p = 0.039 and p = 0.022, resp.). In accordance, impaired nasal breathing after surgery was reported more frequently by 76.9 % of patients without splints, but only 56 % of patients with splints. Our results provide support for the application of nasal septal splints when operating endoscopically on tumors in the sellar region to reduce postoperative synechias and to improve nasal breathing.
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Schlüter
authors.affiliation: Department of Neurosurgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Ahmadipour
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Trutz
authors.initials: T
authors.lastname: Vogelsang
authors.affiliation: Department of Neurosurgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Ilonka
authors.initials: I
authors.lastname: Kreitschmann-Andermahr
authors.affiliation: Department of Neurosurgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kleist
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Weller
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Holtmann
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Mattheis
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Lang
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bergmann
authors.affiliation: Department of Neurosurgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany. oliver.mueller@uk-essen.de.
authors.forename: Oliver
authors.identifier: http://orcid.org/0000-0003-4690-370X
authors.initials: O
authors.lastname: Mueller
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012120:Respiration Disorders / Q000517:prevention & control*; D025363:Rhinomanometry; D019292:Skull Base Neoplasms / Q000601:surgery*; D013165:Splints; D000267:Tissue Adhesions / Q000517:prevention & control*
keywords: Endoscopy; Nasal health; Rhino-septal splints; Skull base surgery