BACKGROUND: The nasoseptal flap (NSF) is a universally used surgical technique to cover defects of the skull base after extended sinonasal surgery. Long-term follow-up of complications, sequelae, and smell function is largely unknown. OBJECTIVE: The main objective of this study was to investigate monorhinal olfaction after transsphenoidal skull base surgery. METHODS: Patients who underwent skull base surgery for midline lesions (craniopharyngioma and pituitary tumors) by using a NSF, also referred to as the Haddad flap, were assessed for their long-term outcome. Endoscopic examination was conducted and the bilateral "Sniffin' Sticks" test was performed before surgery. Each side was tested separately in the postoperative follow-up consultation. RESULTS: Twenty patients were included in the study. No flap failures were observed. One anterior perforation and one small posterior septal perforation were found during long-term follow-up. None of the patients had nasal breathing impairment, whereas two patients had nose bleeds. A significant decrease in olfactory function was observed on the flap donor side in four patients (20%) compared with that observed in one patient (5%) on the opposite side. CONCLUSION: NSF reconstructions for midline lesions were efficient and safe in the long term. Olfactory impairment on the donor side was frequently encountered. Although subclinical, these findings justified a monorhinal smell testing before surgery, which possibly prevented bilateral smell impairment in patient with preexisting single-sided olfactory loss.
BACKGROUND: The nasoseptal flap (NSF) is a universally used surgical technique to cover defects of the skull base after extended sinonasal surgery. Long-term follow-up of complications, sequelae, and smell function is largely unknown. OBJECTIVE: The main objective of this study was to investigate monorhinal olfaction after transsphenoidal skull base surgery. METHODS:Patients who underwent skull base surgery for midline lesions (craniopharyngioma and pituitary tumors) by using a NSF, also referred to as the Haddad flap, were assessed for their long-term outcome. Endoscopic examination was conducted and the bilateral "Sniffin' Sticks" test was performed before surgery. Each side was tested separately in the postoperative follow-up consultation. RESULTS: Twenty patients were included in the study. No flap failures were observed. One anterior perforation and one small posterior septal perforation were found during long-term follow-up. None of the patients had nasal breathing impairment, whereas two patients had nose bleeds. A significant decrease in olfactory function was observed on the flap donor side in four patients (20%) compared with that observed in one patient (5%) on the opposite side. CONCLUSION: NSF reconstructions for midline lesions were efficient and safe in the long term. Olfactory impairment on the donor side was frequently encountered. Although subclinical, these findings justified a monorhinal smell testing before surgery, which possibly prevented bilateral smell impairment in patient with preexisting single-sided olfactory loss.
Authors: Mark B Chaskes; Tawfiq Khoury; Chandala Chitguppi; Pascal Lavergne; Gurston G Nyquist; Mindy R Rabinowitz; Marc R Rosen; James J Evans Journal: J Neurol Surg B Skull Base Date: 2020-12-14
Authors: Milap D Raikundalia; Ryan J Huang; Lyndon Chan; Tracy Truong; Maragatha Kuchibhatla; James Merchant; Ralph Abi Hachem; Patrick J Codd; Ali R Zomorodi; Jordan I Teitelbaum; Bradley J Goldstein; David W Jang Journal: Allergy Rhinol (Providence) Date: 2021-10-29
Authors: Jake J Lee; Zindzi S Thompson; Jay F Piccirillo; Cristine N Klatt-Cromwell; Hilary L P Orlowski; Dorina Kallogjeri; Patrik Pipkorn; John S Schneider Journal: JAMA Otolaryngol Head Neck Surg Date: 2020-07-01 Impact factor: 6.223
Authors: Mark B Chaskes; Judd H Fastenberg; Swar Vimawala; Gurston F Nyquist; Mindy R Rabinowitz; Chandala Chitguppi; Meagan Falls; Tomas Garzon-Muvdi; Marc R Rosen; James J Evans Journal: J Neurol Surg B Skull Base Date: 2020-01-08
Authors: Sascha Marx; Ioanna Tsavdaridou; Sebastian Paul; Antje Steveling; Cornelia Schirmer; Marton Eördögh; Stephan Nowak; Marc Matthes; Ehab El Refaee; Steffen K Fleck; Joerg Baldauf; Markus M Lerch; Andreas Stahl; Werner Hosemann; Henry W S Schroeder Journal: Neurosurg Rev Date: 2020-07-10 Impact factor: 3.042