Sinonasal outcomes following endoscopic anterior skull base surgery with nasoseptal flap reconstruction: a prospective study

AbstractObjective: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).Conclusion: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.

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In reference toSimultaneous pericranial and nasoseptal flap reconstruction of anterior skull base defects following endoscopic-assisted craniofacial resection

The Laryngoscope ◽

10.1002/lary.24499 ◽

2013 ◽

Vol 124 (4) ◽

pp. E149-E149 ◽

Cited By ~ 2

Author(s):

Jean Anderson Eloy ◽

James K. Liu

Keyword(s):

Skull Base ◽

Anterior Skull Base ◽

Flap Reconstruction ◽

Nasoseptal Flap ◽

Craniofacial Resection ◽

Skull Base Defects

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In response to Simultaneous pericranial and nasoseptal flap reconstruction of anterior skull base defects following endoscopic-assisted craniofacial resection

The Laryngoscope ◽

10.1002/lary.24554 ◽

2013 ◽

Vol 124 (4) ◽

pp. E150-E150

Author(s):

Mohamad R. Chaaban ◽

Ajaz Chaudhry ◽

Bradford A. Woodworth ◽

Kristen O. Riley

Keyword(s):

Skull Base ◽

Anterior Skull Base ◽

Flap Reconstruction ◽

Nasoseptal Flap ◽

Craniofacial Resection ◽

Skull Base Defects

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Evaluation of a nasal surgical questionnaire designed for monitoring surgical outcomes and comparing different techniques

The Journal of Laryngology & Otology ◽

10.1017/s0022215115001188 ◽

2015 ◽

Vol 129 (7) ◽

pp. 656-661 ◽

Cited By ~ 4

Author(s):

R Haye ◽

L K Døsen ◽

O Shiryaeva ◽

E Amlie

Keyword(s):

Visual Analogue Scale ◽

Nasal Obstruction ◽

Surgical Outcomes ◽

Analogue Scale ◽

Initial Assessment ◽

Nasal Surgery ◽

Nasal Symptoms ◽

Scale Scores ◽

Minimum Interval ◽

Obstruction Severity

AbstractObjective:This study evaluated a nasal surgical questionnaire designed for monitoring surgical outcomes and comparing different techniques.Methods:Eighty-three healthy volunteers answered the same questionnaire twice with a minimum interval of five weeks. Three visual analogue scale items were used to assess nasal obstruction during the day, at night and during exercise. Respondents rated nasal obstruction severity by marking on a 10 cm line, with scores ranging from 0 to 100 (measured in millimetres). Other nasal symptoms, considered secondary outcomes, were graded using four-point Likert scales.Results:Mean visual analogue scale scores for nasal obstruction severity experienced during the day, at night and during exercise at initial assessment were 9.99, 12.95 and 11.67, respectively. Thirty-eight per cent of scores indicated no obstruction (scores of 0), 47 per cent indicated mild obstruction (scores 1–30), 13 per cent indicated moderate obstruction (scores 31–70) and 2 per cent indicated severe obstruction (scores 71–100). Males had higher scores than females. The scores for the first and second assessment did not differ, except at night for obstruction in allergic individuals which was considered clinically unimportant.Conclusion:The questionnaire reliably assesses nasal symptoms and may be useful for prospective studies of nasal surgery.

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Impairment of Olfaction and Mucociliary Clearance After Expanded Endonasal Approach Using Vascularized Septal Flap Reconstruction for Skull Base Tumors

Neurosurgery ◽

10.1227/neu.0b013e318282a535 ◽

2012 ◽

Vol 72 (4) ◽

pp. 540-546 ◽

Cited By ~ 60

Author(s):

Isam Alobid ◽

Joaquim Enseñat ◽

Franklin Mariño-Sánchez ◽

Matteo de Notaris ◽

Silvia Centellas ◽

...

Keyword(s):

Visual Analogue Scale ◽

Skull Base ◽

Analogue Scale ◽

Mucociliary Clearance ◽

Skull Base Surgery ◽

Nasal Discharge ◽

Healthy Population ◽

Endonasal Approach ◽

Skull Base Tumors ◽

Expanded Endonasal Approach

Abstract BACKGROUND: Endoscopic skull base surgery is now the preferred treatment option to remove skull base tumors. OBJECTIVE: To evaluate the patient's sense of smell and mucociliary clearance time (MCT) after skull base surgery. METHODS: Patients with pituitary adenoma underwent a transnasal transsphenoidal endoscopic approach (TTEA group, n = 36), whereas patients with other benign parasellar tumors underwent an expanded endonasal approach (EEA group, n = 14) with a vascularized septal flap. Assessment of symptoms (Visual Analogue Scale), olfactometry (Barcelona Smell Test, BAST-24), and MCT (saccharin test) were performed before and 3 months after surgery. RESULTS: Before surgery, patients reported poorer BAST-24 scores on detection, identification, and forced choice than the healthy population, but both study groups had similar sinonasal symptoms, BAST-24, and MCT scores. After surgery, no changes in symptom scores (Visual Analogue Scale) were observed except for the loss of smell (26.7 ± 30.5 mm, P < .05) and posterior nasal discharge (29.7 ± 30.3 mm, P < .05) compared with baseline (5.2 ± 11.3, 19.1 ± 25.3, respectively). EEA patients reported higher loss of smell and posterior nasal discharge compared with TTEA. TTEA and EEA groups had similar scores on postoperative BAST-24. After surgery, however, patients showed prolonged saccharin test (15.6 ± 10.8 min, P < .05) compared with baseline (8.4 ± 4.4 min). In addition, EEA patients reported longer MCT than TTEA patients. CONCLUSION: EEA but not TTEA has a short-term (3 months) negative impact on patient's olfaction and mucociliary clearance. Patients should be informed about smell loss as a consequence of skull base surgery to prevent legal claims. Likewise, further research and some modifications on reconstruction flaps are encouraged to avoid damaging the olfactory neuroepithelium.

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Good correlation between visual analogue scale and numerical rating scale in the assessment of nasal obstruction

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000257 ◽

2018 ◽

Vol 132 (4) ◽

pp. 327-328 ◽

Cited By ~ 4

Author(s):

R Haye ◽

L K Døsen ◽

M Tarangen ◽

O Shiryaeva

Keyword(s):

Visual Analogue Scale ◽

Nasal Obstruction ◽

Analogue Scale ◽

Rating Scale ◽

Numerical Rating Scale ◽

Telephone Interviews ◽

Septal Surgery ◽

Significant Difference ◽

Scale Scores ◽

Numerical Rating

AbstractObjective:Results from telephone interviews may be needed to supplement those from mailed questionnaires when response rates are inadequate. This study assessed the correlation between visual analogue scale ratings used in mailed questionnaires and numerical rating scale scores used in telephone interviews.Methods:Patients scheduled for nasal septal surgery routinely respond to a visual analogue scale of obstruction during the day and at night. In this study, they were also asked to verbally rate their sense of obstruction using whole numbers.Results:There was no significant difference between visual analogue scale and numerical rating scale obstruction scores.Conclusion:Ratings of nasal obstruction obtained with a numerical rating scale in telephone interviews are comparable to visual analogue scale scores in mailed questionnaires.

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