Cargando…
Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base
OBJECTIVES: The endoscopic technique in transnasal skull base surgery offers optimal visualization and free manipulation in the surgical field. However, it may cause approach‐related sinonasal injury, influencing patients' quality of life (QOL). To minimize rhinological morbidity without restri...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655550/ https://www.ncbi.nlm.nih.gov/pubmed/29094072 http://dx.doi.org/10.1002/lio2.82 |
_version_ | 1783273551266054144 |
---|---|
author | Eördögh, Márton Briner, Hans Rudolf Simmen, Daniel Jones, Nicholas Reisch, Robert |
author_facet | Eördögh, Márton Briner, Hans Rudolf Simmen, Daniel Jones, Nicholas Reisch, Robert |
author_sort | Eördögh, Márton |
collection | PubMed |
description | OBJECTIVES: The endoscopic technique in transnasal skull base surgery offers optimal visualization and free manipulation in the surgical field. However, it may cause approach‐related sinonasal injury, influencing patients' quality of life (QOL). To minimize rhinological morbidity without restrictions in surgical manipulation and tumor resection, we introduced the unilateral transethmoidal‐paraseptal approach. In this article, we analyzed the long‐term results and sinonasal outcome of this technique. STUDY DESIGN: Retrospective analysis of medical records. METHODS: Forty‐two consecutive patients underwent surgery between June 2010 and March 2014 using the transethmoid‐paraseptal approach. Perioperative work‐up included neurological, radiological, endocrinological, ophthalmological, and rhinological analysis. Patients' preoperative, 1‐month and 1‐year postoperative QOL was measured using the Sino‐Nasal Outcome Test (SNOT‐22). RESULTS: At all individuals, a unilateral transethmoid‐paraseptal approach was performed. Removal of the turbinates, posterior septal resection or a conversion to biportal surgery could be avoided in all cases. There were no intraoperative neurovascular complications. All patients had a notable improvement in any disease‐related symptoms, as well as by objective criteria. Complete tumor resection was aimed in 39 cases and achieved in 31 of them. The SNOT‐22 scores transiently worsened 1 month after surgery and non‐significantly improved after 1 year, compared with the preoperative status. A subgroup of 7 patients with preoperative sinonasal disease evidence showed continuous significant improvement (p < .05) of SNOT‐22 scores across time. The smell screening tests showed no significant difference across time. CONCLUSION: The described approach allows safe removal of various skull base lesions without deterioration in sinonasal QOL and smell function. LEVEL OF EVIDENCE: 4. |
format | Online Article Text |
id | pubmed-5655550 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56555502017-11-01 Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base Eördögh, Márton Briner, Hans Rudolf Simmen, Daniel Jones, Nicholas Reisch, Robert Laryngoscope Investig Otolaryngol Allergy, Rhinology, and Immunology OBJECTIVES: The endoscopic technique in transnasal skull base surgery offers optimal visualization and free manipulation in the surgical field. However, it may cause approach‐related sinonasal injury, influencing patients' quality of life (QOL). To minimize rhinological morbidity without restrictions in surgical manipulation and tumor resection, we introduced the unilateral transethmoidal‐paraseptal approach. In this article, we analyzed the long‐term results and sinonasal outcome of this technique. STUDY DESIGN: Retrospective analysis of medical records. METHODS: Forty‐two consecutive patients underwent surgery between June 2010 and March 2014 using the transethmoid‐paraseptal approach. Perioperative work‐up included neurological, radiological, endocrinological, ophthalmological, and rhinological analysis. Patients' preoperative, 1‐month and 1‐year postoperative QOL was measured using the Sino‐Nasal Outcome Test (SNOT‐22). RESULTS: At all individuals, a unilateral transethmoid‐paraseptal approach was performed. Removal of the turbinates, posterior septal resection or a conversion to biportal surgery could be avoided in all cases. There were no intraoperative neurovascular complications. All patients had a notable improvement in any disease‐related symptoms, as well as by objective criteria. Complete tumor resection was aimed in 39 cases and achieved in 31 of them. The SNOT‐22 scores transiently worsened 1 month after surgery and non‐significantly improved after 1 year, compared with the preoperative status. A subgroup of 7 patients with preoperative sinonasal disease evidence showed continuous significant improvement (p < .05) of SNOT‐22 scores across time. The smell screening tests showed no significant difference across time. CONCLUSION: The described approach allows safe removal of various skull base lesions without deterioration in sinonasal QOL and smell function. LEVEL OF EVIDENCE: 4. John Wiley and Sons Inc. 2017-05-28 /pmc/articles/PMC5655550/ /pubmed/29094072 http://dx.doi.org/10.1002/lio2.82 Text en © 2017 The Authors Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Allergy, Rhinology, and Immunology Eördögh, Márton Briner, Hans Rudolf Simmen, Daniel Jones, Nicholas Reisch, Robert Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
title | Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
title_full | Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
title_fullStr | Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
title_full_unstemmed | Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
title_short | Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
title_sort | endoscopic unilateral transethmoid‐paraseptal approach to the central skull base |
topic | Allergy, Rhinology, and Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655550/ https://www.ncbi.nlm.nih.gov/pubmed/29094072 http://dx.doi.org/10.1002/lio2.82 |
work_keys_str_mv | AT eordoghmarton endoscopicunilateraltransethmoidparaseptalapproachtothecentralskullbase AT brinerhansrudolf endoscopicunilateraltransethmoidparaseptalapproachtothecentralskullbase AT simmendaniel endoscopicunilateraltransethmoidparaseptalapproachtothecentralskullbase AT jonesnicholas endoscopicunilateraltransethmoidparaseptalapproachtothecentralskullbase AT reischrobert endoscopicunilateraltransethmoidparaseptalapproachtothecentralskullbase |