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Long‐term neurological morbidity following endoscopic transnasal resection of juvenile angiofibroma
Author(s) -
Mattavelli Davide,
Rampinelli Vittorio,
Ferrari Marco,
Schreiber Alberto,
Guarneri Bruno,
Nicolai Piero
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27466
Subject(s) - medicine , otorhinolaryngology , neurovascular bundle , surgery , visual analogue scale , angiofibroma , retrospective cohort study , quality of life (healthcare) , cohort , nursing
Objectives/Hypothesis Although transnasal endoscopic resection (TER) of juvenile angiofibroma (JA) is unquestionably less invasive than traditional external approaches, several endonasal and neurovascular structures are sacrificed during the procedure. The aim of this study was to evaluate long‐term neurological morbidity and related quality of life following TER of JA. Study Design Retrospective cohort study. Methods All patients who underwent TER for JA at the Unit of Otorhinolaryngology–Head and Neck Surgery of the University of Brescia from 1994 to 2016 were contacted to know their availability to undergo a battery of tests aimed to assess lacrimal secretion (Schirmer test), impairment of sensitive nerves (electrophysiological threshold test), and impact on quality of life of tearing reduction and sensitivity impairment with the Ocular Surface Disease Index (OSDI) and visual analogue scale (VAS) (0–10), respectively. Results Thirteen patients were included. Mean follow‐up was 77 months (range, 19–156 months). The median Schirmer test value was 5.5 mm and 28.5 mm for the treated and untreated sides, respectively ( P = .003). Analysis of sensitivity revealed significant impairment only in the hard palate. The mean OSDI score was 6.8 (normal). The mean values of the VAS scores for hard palate, buccal mucosa, gum, and premaxillary skin were 1.7, 1.7, 1.2, and 2.3, respectively. Conclusions TER for JA can result in objective reduction of lacrimal secretion and sensitivity impairment; nevertheless, their impact on quality of life is negligible. The predictable neurological morbidity of TER should be discussed during preoperative counseling. Level of Evidence 4 Laryngoscope , 129:2184–2188, 2019