PMID- 27456601
OWN - NLM
STAT- MEDLINE
DCOM- 20170310
LR  - 20170310
IS  - 1945-8932 (Electronic)
IS  - 1945-8932 (Linking)
VI  - 30
IP  - 4
DP  - 2016 Jul
TI  - A comparison of radiographic evidence of frontal sinusitis in middle-turbinate 
      sacrificing versus middle-turbinate sparing approaches to the sella.
PG  - 306-9
LID - 10.2500/ajra.2016.30.4326 [doi]
AB  - BACKGROUND: Initial descriptions of endoscopic approaches to the sella and 
      pituitary involved resecting the middle turbinate (MT) to help improve access and 
      visualization. Modifications of these procedures to preserve the MT have since 
      been described, one rationale being to reduce the incidence of frontal sinusitis. 
      The objective of this study was to establish the incidence of postoperative 
      frontal sinusitis in MT sparing (MTsp) and MT sacrificing (MTsc) approaches to 
      the sella. OBJECTIVE: A retrospective cohort study that compared radiographic 
      evidence of frontal rhinosinusitis or frontal recess obstruction after skull base 
      surgery in patients who underwent MTsc and MTsp endonasal approaches to the 
      sella. METHODS: Consecutive retrospective review of pre- and postoperative 
      magnetic resonance imaging from two institutions in geographic proximity but with 
      different approaches to the sella. Mucosal thickening in the frontal sinus was 
      measured and graded by a radiologist blinded to patient cohorts. RESULTS: 
      Seventy-five patients, based on sample size calculations, were included at each 
      site. Baseline demographics and indications for surgery were not significantly 
      different between the groups. No difference was seen between the groups in the 
      overall grade of radiographic frontal sinusitis seen on postoperative imaging. A 
      total of 8 patients (10%) in the MTsc group had measured mucosal thickening, 
      which was increased from their preoperative scan versus 15 in the MTsp group 
      (20%) (p = 0.10). New mucosal thickening of >1 mm was found in three patients in 
      the MTsc group and eight patients in the MTsp group (p = 0.21); the only patient 
      with postoperative complete frontal sinus opacification was in the MTsp group. 
      CONCLUSIONS: The choice of MTsc versus MTsp in endonasal endoscopic approach to 
      the sella does not seem to make a difference in the incidence of postoperative 
      radiographic frontal sinusitis.
FAU - Sowerby, Leigh J
AU  - Sowerby LJ
AD  - Department of Otolaryngology, Western University, London, Ontario, Canada.
FAU - Mann, Sumeer
AU  - Mann S
FAU - Starreveld, Yves
AU  - Starreveld Y
FAU - Kotylak, Trevor
AU  - Kotylak T
FAU - Mechor, Brad
AU  - Mechor B
FAU - Wright, Erin D
AU  - Wright ED
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Rhinol Allergy
JT  - American journal of rhinology & allergy
JID - 101490775
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Frontal Sinus/pathology
MH  - Frontal Sinusitis/diagnostic imaging/*epidemiology/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology
MH  - Retrospective Studies
MH  - Sella Turcica/*surgery
MH  - Turbinates/*surgery
EDAT- 2016/07/28 06:00
MHDA- 2017/03/11 06:00
CRDT- 2016/07/27 06:00
PHST- 2016/07/27 06:00 [entrez]
PHST- 2016/07/28 06:00 [pubmed]
PHST- 2017/03/11 06:00 [medline]
AID - 10.2500/ajra.2016.30.4326 [doi]
PST - ppublish
SO  - Am J Rhinol Allergy. 2016 Jul;30(4):306-9. doi: 10.2500/ajra.2016.30.4326.