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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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nasal complications after endoscopic endonasal procedures

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  • Benjamin Prokein - Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Joachim Oertel - Universitätskliniken des Saarlandes, Neurochirurgische Klinik, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
  • Stefan Linsler - Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.26.06

doi: 10.3205/17dgnc160, urn:nbn:de:0183-17dgnc1608

Published: June 9, 2017

© 2017 Prokein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The microsurgical and endoscopic endonasal approach is well established for endonasal skull base surgery. However, there are only few studies pointing out the nasal complaints after surgery. In this study, the authors evaluated postoperative nasal complications after mononostril endoscopic procedures.

Methods: In order to evaluate complications, a retrospective questioning of 144 patients operated in our department was performed. Applicable data of 81 patients could be included in this study. Endpoints were the quantitative evaluation of complications and correlation of these data. In addition to this, in some cases olfactometry data were generated and compared to these data.

Results: Nasal pain (12.3%), reduced nasal breathing (30.9%), reduced olfaction (24.7%), reduced gustatory sense (16.0%) and dry nose (48.1%) were the most frequent reported complaints. In 18% synechia and in 11% septum perforation was detected. Further treatment by ENT physician was necessary in 29.6% of all cases. Thereby, 12.3% of patients required resurgery of the nose by ENT physician. Reoperation of sellar lesions had a significant increase of nasal complications and complaints. The use of a tamponades reduced significantly the risk of nasal complaints and ENT treatment for sinusitis or synechia. The results of olfactometry did not show any statistically significant reduction of olfaction after surgery.

Conclusion: Endoscopic endonasal procedures to skull base lesions induce nasal complaints in some patients. Reoperations increase the risk of nasal complaints and complications significantly. The use of nasal tamponades reduces the risk of complications in postsurgical follow up. Further prospective studies are necessary to objectify the evaluation of postsurgical nasal complications and to compare the outcome of different surgical approaches and techniques.