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Surgical management of rhinosinusitis in endoscopic‐endonasal skull‐base surgery
Author(s) -
Nyquist Gurston G.,
Friedel Mark E.,
Singhal Saurabh,
Beahm D. David,
Farrell Christopher J.,
Evans James J.,
Rosen Marc R.
Publication year - 2015
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21476
Subject(s) - medicine , surgery , endoscopic sinus surgery , endoscopic endonasal surgery , paranasal sinuses , skull , chronic rhinosinusitis , sinusitis , nasal polyps , endoscopy , retrospective cohort study
Background Endoscopic‐endonasal skull base surgery (ESBS) provides an important approach to select pathologies. There remains a paucity of data, however, regarding morbidity in patients undergoing ESBS with comorbid acute rhinosinusitis (ARS), a fungal ball (FB), or chronic rhinosinusitis (CRS). Methods A retrospective database review between January 2008 and January 2013 identified 35 patients with concurrent skull‐base pathology and refractory ARS, FB, CRS, and CRS with nasal polyposis (CRSP) who underwent endoscopic sinus surgery (ESS) and ESBS. Results Two of 35 (5.7%) had an FB, 3 of 35 (8.6%) had ARS, 19 of 35 (54.2%) had CRSP, and 11 of 35 (31.4%) had CRS. Five of 35 (14.3%) were staged procedures whereas 30 of 35 (85.7%) underwent concurrent ESS and ESBS. Four patients (80%) who were staged carried diagnoses of an FB and ARS. Two patients in the concurrent group required revision ESS for recurrent polyposis. There were no cases of intraorbital or intracranial infectious complications. Conclusion Management of the paranasal sinuses is paramount to maintain healthy sinonasal function in patients undergoing ESBS. In our experience, most cases of CRS and CRSP can be surgically managed at the time of ESBS without increased risk of intracranial infection. Patients with ARS at the time of surgery or an FB should be staged to avoid postoperative ESBS morbidity.