gms | German Medical Science

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

Methods: A retrospective questioning of 140 patients operated in our department was performed. Applicable data of 79 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: There was a significant decrease of nasal complaints during follow up after 2 years (p<0.001). In 16.4% of all cases synechiae and in 6.3% septum perforation was detected. Further surgical treatment by ENT physician was necessary in 11.4%. 23.1% of patients reported about persistent dry nose, 10.3% of alteration of olfactory performance and decreased nasal air flow. Reoperation increased significantly the risk of postsurgical complaints (p < 0.005). The use of a tamponade reduced significantly the risk of postsurgical reduced nasal airflow (p = 0.026) and sinusitis (p = 0.002). The results of olfactometry did not show any statistically significant reduction of olfaction after surgery (p = 0.362).

Conclusion: Endoscopic endonasal procedures to skull base lesions induce temporary and permanent nasal complaints and complications. Thereby, reoperations increase the risk of nasal complaints and the use of nasal tamponades increases the sinonasal outcome.

Further prospective studies are necessary to objectify the evaluation of postsurgical nasal complications.