Department of Neurosurgery, University Medical Center Mainz, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, Germany.
Oper Neurosurg (Hagerstown). 2023 Mar 1;24(3):223-231. doi: 10.1227/ons.0000000000000532. Epub 2022 Dec 12.
The sinonasal outcome after transnasal skull base surgery has often been neglected aside from major outcome criteria as extent of tumor resection, ophthalmological, and endocrinological parameters.
To analyze rhinological outcome after endoscopic transnasal neurosurgery.
Patients were treated using a middle turbinate-preserving transnasal endoscopic approach for sellar/parasellar lesions. As major variables, olfactory function and nose breathing ability were assessed. The study participants were investigated by odor testing ("Sniffin' sticks"), rhinomanometry, and endoscopic inspection of the nasal cavity before and 6 months after surgery. Furthermore, sinonasal-associated quality of life was measured before, immediately and 6 months after surgery with a standardized questionnaire (SNOT-20-GAV).
Eighty-two patients (47 male, 35 female, median age 55 years) matched the inclusion criteria. Before surgery, the average odor was found to be 30.75 (≥31 = normosmia); in the postinterventional examination at 6 months, the average increased to 33.08 (n.s.). Rhinomanometric examination of binostril nasal airflow showed an average of 590.42 mL/s on inspiration before and an increase to 729.78 mL/s at 6 months after surgery. SNOT-20 symptom scores had a maximum score right after and no difference at 6 months after surgery (scores 23.76 and 14.91 vs 15.53 before surgery).
Based on the study, the endoscopic transnasal technique preserving the middle turbinate has no significant negative effects on the rhinological outcome.
除了肿瘤切除范围、眼科和内分泌学参数等主要结果标准外，经鼻颅底手术后的鼻腔鼻窦结果往往被忽视。
分析经鼻内镜神经外科手术后的鼻科学结果。
采用保留中鼻甲的经鼻内镜方法治疗鞍区/鞍旁病变。嗅觉功能和鼻腔通气能力作为主要变量进行评估。研究参与者在手术前和手术后 6 个月接受嗅觉测试（“Sniffin' sticks”）、鼻阻力测量和鼻腔内镜检查。此外，使用标准化问卷（SNOT-20-GAV）在手术前、立即和手术后 6 个月测量鼻-鼻窦相关生活质量。
82 例患者（47 例男性，35 例女性，中位年龄 55 岁）符合纳入标准。手术前平均嗅觉为 30.75（≥31=嗅觉正常）；术后 6 个月平均增加到 33.08（n.s.）。双鼻孔鼻气流鼻阻力测量显示，术前平均吸气量为 590.42mL/s，术后 6 个月增加至 729.78mL/s。SNOT-20 症状评分在术后即刻最高，术后 6 个月无差异（评分分别为 23.76、14.91 和 15.53）。
基于该研究，保留中鼻甲的经鼻内镜技术对鼻科学结果没有显著的负面影响。
