PMID- 29917327
OWN - NLM
STAT- MEDLINE
DCOM- 20190919
LR  - 20190919
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Linking)
VI  - 8
IP  - 10
DP  - 2018 Oct
TI  - Middle turbinate manipulation and postoperative sinus obstruction after 
      endoscopic endonasal skull-base surgery.
PG  - 1132-1135
LID - 10.1002/alr.22151 [doi]
AB  - BACKGROUND: Inadvertent lateralization of the middle turbinate (MT) after 
      endoscopic sinus surgery (ESS) is cited as a common complication that results in 
      both outflow tract obstruction and recurrent symptoms. In endoscopic endonasal 
      skull-base surgery, the MT is frequently lateralized during the parasagittal 
      approach. Little is known about whether this strategy has unintended consequences 
      on the adjacent paranasal sinuses. Intentional lateralization vs surgical 
      resection of the MT were compared for radiographic evidence of sinus obstruction 
      in this patient population. METHODS: A retrospective evaluation was conducted of 
      pre- and postoperative Lund-MacKay (LM) scores in patients who underwent an 
      endoscopic endonasal approach (EEA) for resection of a pituitary tumor or 
      craniopharyngioma (transsellar or suprasellar approach) between 2012 and 2014. 
      Side-specific LM scores were calculated at 0-3 months, 3-6 months, and >6 months. 
      MT lateralization vs resection sides were compared. RESULTS: Of the cases 
      reviewed, 122 met the inclusion criteria. There were no statistically significant 
      differences in LM scores of the adjacent paranasal sinuses between resected MTs 
      as compared with surgically lateralized MTs at 3-6 months or >6 months (p = 
      0.551) postoperatively. Time-point of assessment was statistically significant 
      with regard to the outcome of LM = 0 (p < 0.001), with earlier postoperative 
      imaging correlating with higher LM scores. CONCLUSION: Unlike after ESS, MT 
      lateralization does not appear to be correlated with higher LM scores after EEA. 
      Postoperative radiographic sinus outflow obstruction was similar in patients at 
      all measured intervals despite differences in technical management of the MT.
CI  - (c) 2018 ARS-AAOA, LLC.
FAU - Willson, Thomas J
AU  - Willson TJ
AD  - Department of Otolaryngology, University of Pittsburgh Medical Center, 
      Pittsburgh, PA.
AD  - Department of Otolaryngology, San Antonio Military Medical Center, San Antonio, 
      TX.
AD  - Department of Surgery, Uniformed Services University, Bethesda, MD.
FAU - Rowan, Nicholas R
AU  - Rowan NR
AD  - Department of Otolaryngology, University of Pittsburgh Medical Center, 
      Pittsburgh, PA.
FAU - Wang, Eric W
AU  - Wang EW
AD  - Department of Otolaryngology, University of Pittsburgh Medical Center, 
      Pittsburgh, PA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20180619
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
SB  - IM
MH  - Craniopharyngioma/surgery
MH  - Endoscopy/*methods
MH  - Humans
MH  - Nasal Obstruction/diagnostic imaging/*pathology
MH  - Neurosurgical Procedures/*methods
MH  - Paranasal Sinuses/diagnostic imaging/pathology/surgery
MH  - Pituitary Neoplasms/surgery
MH  - Postoperative Complications/diagnostic imaging/*pathology
MH  - Radiography
MH  - Retrospective Studies
MH  - Skull Base/*surgery
MH  - Turbinates/*surgery
OTO - NOTNLM
OT  - endoscopic endonasal approach to the pituitary
OT  - endoscopic skull base surgery
OT  - postoperative
OT  - skull base
EDAT- 2018/06/20 06:00
MHDA- 2019/09/20 06:00
CRDT- 2018/06/20 06:00
PHST- 2018/02/03 00:00 [received]
PHST- 2018/05/03 00:00 [revised]
PHST- 2018/05/08 00:00 [accepted]
PHST- 2018/06/20 06:00 [pubmed]
PHST- 2019/09/20 06:00 [medline]
PHST- 2018/06/20 06:00 [entrez]
AID - 10.1002/alr.22151 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2018 Oct;8(10):1132-1135. doi: 10.1002/alr.22151. Epub 
      2018 Jun 19.