Complications of Nasoseptal Flap Reconstruction: A Systematic Review

Lavigne, Philippe; Faden, Daniel L.; Wang, Eric; Snyderman, Carl H.

doi:10.1055/s-0038-1668158

Cited by 79 publications

(56 citation statements)

References 47 publications

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“…12 Because the NSF has become more commonly used, the reported rate of postoperative CSF leaks in large skull base defects has declined from 50% to less than 5%. [13][14][15][16][17] Complication rates of the NSF are low and include mucocele formation, septal perforation, olfactory loss, and nasal dorsum collapse. 17 Flap necrosis is a particularly rare complication.…”

Section: Discussionmentioning

confidence: 99%

Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of COVID-19 Pandemic

et al. 2020

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Section: Discussionmentioning

confidence: 99%

Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of COVID-19 Pandemic

et al. 2020

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“…Intranasal postoperative morbidities following EES of the skull base are well recognized [6][7][8][9][10][11] ; however, cosmetic external deformities are less widely reported and until now, have only been anecdotal or retrospectively reported. 12 In this study, we prospectively analyzed patients' nasal architecture with both objective and subjective measures, demonstrating that external nasal deformities following EES of the skull base are more common than previously acknowledged.…”

Section: Discussionmentioning

confidence: 99%

“…Though EES oftentimes affords many benefits, including similar or improved outcomes as compared to traditional open approaches, improved visualization, decreased perioperative complications and length of stay, the use of the sinonasal corridor introduces additional morbidity. Well‐characterized effects of EES on sinonasal QOL include nasal crusting, nasal obstruction, and changes in olfaction …”

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confidence: 99%

“…Well-characterized effects of EES on sinonasal QOL include nasal crusting, nasal obstruction, and changes in olfaction. [6][7][8][9][10][11] Beyond changes in sinonasal function, we previously retrospectively described the incidence of objective postoperative nasal deformities in a large cohort of patients undergoing EES. 12 Deformities were characterized as nasal dorsum collapse, new septal deviations, or new postoperative nasal septal perforations.…”

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confidence: 99%

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Prospective characterization of postoperative nasal deformities in patients undergoing endoscopic endonasal skull‐base surgery

Rowan

Valappil

Chen

et al. 2019

Int Forum Allergy Rhinol

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Background Surgeons have become increasingly aware of the impact of endoscopic endonasal surgery (EES) of the skull base on sinonasal‐related quality of life. Prior retrospective investigation described a correlation between nasoseptal flap (NSF) reconstruction in EES with postoperative nasal deformities, such as nasal dorsum collapse. The primary objective of this study was to prospectively evaluate the incidence of, and contributing factors to, postoperative changes in nasal structure following EES. Secondary goals included assessing subjective changes in nasal appearance as well as objective nasal analysis. Methods Clinical demographics and detailed perioperative information was prospectively collected for patients undergoing transsellar/suprasellar EES for skull‐base tumors. Preoperatively, 1‐month and 6‐month photographs were completed for objective photographic nasal analysis and blinded assessment by surgeons. Subjective patient feedback was also solicited. Results Overall, 14.7% (5/34) of patients subjectively reported postoperative nasal deformities, whereas both blinded‐surgeon and objective nasal measurements identified deformities in 12.9% (4/31) of patients. Patients with postoperative deformities were more likely to have skull‐base reconstruction with an NSF (p = 0.01) and trended toward an increased incidence in patients with nonpituitary neoplasms (p = 0.07). There were no other associations between clinical or operative characteristics and external deformities. No patients planned to undergo corrective repair. Conclusion External nasal deformities following EES are more frequent than previously acknowledged. Postoperative deformities appear to be associated with NSF reconstruction and may be associated with surgery for nonpituitary neoplasms. Patients should be counseled on this potential outcome, and future studies should investigate how to minimize postoperative sequela.

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“…Therefore, we have decided to extend our study while keeping the pack in situ only for 48 hours and compare the results. Development of a new techniques like endoscopic surgery decrease injury to the olfactory epithelium minimizing olfactory dysfunction [18,19,20] . This could preserve quality of life.…”

Section: Discussionmentioning

confidence: 99%

Transsphenoidal hypophysectomy surgery

Dayasena

Kularathne

Jayalath

2019

Ceylon J Otolaryngology

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Objective The aim of this study was to systematically collect data of patients undergoing transsphenoidal hypophysectomy and analyse with regard to clinical presentation, short and long term complications and demographic details. Methods This is a prospective study of transsphenoidal pituitary surgery at National Hospital Sri Lanka from May 2013 to August 2019. 108 patients who underwent transsphenoidal hypophysectomy for pituitary tumours were included. All the patients who underwent the procedure for the first time and for revision surgery were included in the study. Results Out of 108 patients, there were 87 primary cases and 21 revision cases. The average age at presentation was 45.39 years. The youngest patient was 2 years and 6 months old while the oldest was 76 years. 55 patients were male and 53 patients were female. The most common complaint at presentation was headache which affected 36 patients (33.3%). The visual disturbance was the second most common presentation, occurring in 32 individuals (29.6%). 103 patients out of 108 have been operated using trans-nasal transseptal approach and rest (5) by trans labial transseptal method. The mean postoperative hospital stay was 9.8 days (range 3-17 days). The mean follow-up period was 35.7 months (range 3-75). 6 patients had died during the follow up period and 23 patients had defaulted follow up. Postoperative CSF leak occurred in 8 patients (7.4%) and anosmia was noted in 6 patients (5.5%). Conclusion Microscopic transsphenoidal pituitary is a safe and effective treatment for pituitary tumours, and the commonest complication is CSF leak. Anosmia is one of the complications of this procedure.

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Complications of Nasoseptal Flap Reconstruction: A Systematic Review

Cited by 79 publications

References 47 publications

Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of COVID-19 Pandemic

Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of COVID-19 Pandemic

Prospective characterization of postoperative nasal deformities in patients undergoing endoscopic endonasal skull‐base surgery

Transsphenoidal hypophysectomy surgery

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