Download PDF
J Neurol Surg B Skull Base 2023; 84(05): 507-512
DOI: 10.1055/s-0042-1755602
Original Article

Impact of Concurrent Chronic Rhinosinusitis on Complication Rates after Endonasal Endoscopic Skull Base Surgery: A Single-Center Experience

Hussain Albaharna 
1   Department of Otolaryngology, Head and Neck Surgery, Qatif Central Hospital, Qatif City, Saudi Arabia
2   Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Ashwag Alqurashi
3   Department of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Mohammad Alshareef
2   Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
4   Department of Otolaryngology, Head and Neck Surgery, Khamis Mushait General Hospital, Khamis Mushait City, Saudi Arabia
,
Saud Alromaih
2   Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Abdulaziz S. Alrasheed
2   Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Ahmad Alroqi
2   Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Abdulrazag Ajlan
3   Department of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Saad Alsaleh
2   Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objectives Preoperative planning of endoscopic skull base surgery (ESBS) is essential. The safety of performing surgery before managing sinus pathologies including concurrent chronic rhinosinusitis (CRS) in patients undergoing ESBS has been questioned. The current study aimed to evaluate and compare the complication rates between patients with and without CRS undergoing ESBS.

Design This is a retrospective study.

Setting Present study was conducted at tertiary referral center.

Participants We included all patients who underwent ESBS between March 2015 and March 2021. However, patients who had surgical revision for remnant tumor, primary sinonasal tumor excision, and cerebrospinal fluid (CSF) leakage repair were excluded. The presence of concurrent CRS was determined according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020) criteria by reviewing electronic charts about the preoperative clinical assessment and CT scan images of the paranasal sinuses. Then, the incidence rates of postoperative meningitis, CSF leakage, and surgical site infection were compared between patients with and without concurrent CRS undergoing ESBS.

Main Outcome Measures Postoperative complication rates in patients underwent ESBS with and without CRS.

Results From a total of 130 ESBS cases, 99 patients were included in this study. Among them, 24 had concurrent CRS. One patient presented with postoperative meningitis, one with CSF leakage, and two with surgical site infections. The incidence rate of postoperative meningitis, CSF leakage, and surgical site infection did not significantly differ between patients with and without concurrent CRS.

Conclusion Concurrent CRS is not a contraindication for ESBS. Moreover, simultaneous endoscopic sinus surgery can safely be performed without additional morbidity in ESBS.

Keywords

endoscopic - endonasal - skull base - rhinosinusitis - sinusitis - complications - contraindications - morbidity - paranasal sinuses


Publication History

Received: 23 October 2021

Accepted: 20 June 2022

Article published online:
25 August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 El-Maghraby H, Walton G, Ahmed S, Shad A. Indications and limitations of endoscopic skull base surgery: single institute experience. J Neurol Surg B Skull Base 2012; 73 (S 02): 263-277
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Kasemsiri P, Carrau RL, Ditzel Filho LFS. et al. Advantages and limitations of endoscopic endonasal approaches to the skull base. World Neurosurg 2014; 82 (suppl 6): S12-S21
    CrossrefPubMedGoogle Scholar
  • 3 Castelnuovo P, Turri-Zanoni M, Battaglia P, Antognoni P, Bossi P, Locatelli D. Sinonasal malignancies of anterior skull base: histology-driven treatment strategies. Otolaryngol Clin North Am 2016; 49 (01) 183-200
    CrossrefPubMedGoogle Scholar
  • 4 Hussaini AS, Clark CM, DeKlotz TR. Perioperative considerations in endoscopic skull base surgery. Curr Otorhinolaryngol Rep 2020; 8 (02) 129-135
    CrossrefPubMedGoogle Scholar
  • 5 Hanson M, Li H, Geer E, Karimi S, Tabar V, Cohen MA. Perioperative management of endoscopic transsphenoidal pituitary surgery. World J Otorhinolaryngol Head Neck Surg 2020; 6 (02) 84-93
    CrossrefPubMedGoogle Scholar
  • 6 Boling CC, Karnezis TT, Baker AB. et al. Multi-institutional study of risk factors for perioperative morbidity following transnasal endoscopic pituitary adenoma surgery. Int Forum Allergy Rhinol 2016; 6 (01) 101-107
    CrossrefPubMedGoogle Scholar
  • 7 DeConde AS, Soler ZM. Chronic rhinosinusitis: epidemiology and burden of disease. Am J Rhinol Allergy 2016; 30 (02) 134-139
    CrossrefPubMedGoogle Scholar
  • 8 Halawi AM, Smith SS, Chandra RK. Chronic rhinosinusitis: epidemiology and cost. Allergy Asthma Proc 2013; 34 (04) 328-334
    CrossrefPubMedGoogle Scholar
  • 9 Kim YS, Kim NH, Seong SY, Kim KR, Lee GB, Kim KS. Prevalence and risk factors of chronic rhinosinusitis in Korea. Am J Rhinol Allergy 2011; 25 (03) 117-121
    CrossrefPubMedGoogle Scholar
  • 10 Chen Y, Dales R, Lin M. The epidemiology of chronic rhinosinusitis in Canadians. Laryngoscope 2003; 113 (07) 1199-1205
    CrossrefPubMedGoogle Scholar
  • 11 Shi JB, Fu QL, Zhang H. et al. Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy 2015; 70 (05) 533-539
    CrossrefPubMedGoogle Scholar
  • 12 Fokkens WJ, Lund VJ, Hopkins C. et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology 2020; 58 (suppl S29): 1-464
    CrossrefPubMedGoogle Scholar
  • 13 Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology 1993; 31 (04) 183-184
    PubMedGoogle Scholar
  • 14 Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36 (05) 309-332
    CrossrefPubMedGoogle Scholar
  • 15 Alsaleh S, Albakr A, Alromaih S, Alatar A, Alroqi AS, Ajlan A. Expanded transnasal approaches to the skull base in the Middle East: where do we stand?. Ann Saudi Med 2020; 40 (02) 94-104
    CrossrefPubMedGoogle Scholar
  • 16 Park SY, Park SK, Lee D. et al. Validation of simultaneous endoscopic sinus surgery and transsphenoidal surgery in patients with chronic rhinosinusitis and pituitary tumors. Korean J Otorhinolaryngol Neck Surg 2020; 63 (11) 505-510
    CrossrefPubMedGoogle Scholar
  • 17 Nyquist GG, Rosen MR, Friedel ME, Beahm DD, Farrell CJ, Evans JJ. Comprehensive management of the paranasal sinuses in patients undergoing endoscopic endonasal skull base surgery. World Neurosurg 2014; 82 (suppl 6): S54-S58
    CrossrefPubMedGoogle Scholar
  • 18 Cappabianca P, Cavallo LM, Esposito F, De Divitiis O, Messina A, De Divitiis E. Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery. Adv Tech Stand Neurosurg 2008; 33: 151-199
    CrossrefPubMedGoogle Scholar
  • 19 van Aken MO, de Marie S, van der Lely AJ. et al. Risk factors for meningitis after transsphenoidal surgery. Clin Infect Dis 1997; 25 (04) 852-856
    CrossrefPubMedGoogle Scholar
  • 20 Schaberg MR, Shah GB, Evans JJ, Rosen MR. Concomitant transsphenoidal approach to the anterior skull base and endoscopic sinus surgery in patients with chronic rhinosinusitis. J Neurol Surg B Skull Base 2013; 74 (04) 241-246
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Fraser S, Gardner PA, Koutourousiou M. et al. Risk factors associated with postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery. J Neurosurg 2018; 128 (04) 1066-1071
    CrossrefPubMedGoogle Scholar
  • 22 Gruss CL, Al Komser M, Aghi MK. et al. Risk factors for cerebrospinal leak after endoscopic skull base reconstruction with nasoseptal flap. Otolaryngol Head Neck Surg 2014; 151 (03) 516-521
    CrossrefPubMedGoogle Scholar
  • 23 Nyquist GG, Friedel ME, Singhal S. et al. Surgical management of rhinosinusitis in endoscopic-endonasal skull-base surgery. Int Forum Allergy Rhinol 2015; 5 (04) 339-343
    CrossrefPubMedGoogle Scholar
  • 24 de Almeida JR, Witterick IJ, Gullane PJ. et al. Physical morbidity by surgical approach and tumor location in skull base surgery. Head Neck 2013; 35 (04) 493-499
    CrossrefPubMedGoogle Scholar
  • 25 Leoncini E, Ricciardi W, Cadoni G. et al. Outcomes and quality of life following skull base surgery. Curr Otorhinolaryngol Rep 2013; 1 (10) 214-220
    PubMedGoogle Scholar
  • 26 Gallagher MJ, Durnford AJ, Wahab SS, Nair S, Rokade A, Mathad N. Patient-reported nasal morbidity following endoscopic endonasal skull base surgery. Br J Neurosurg 2014; 28 (05) 622-625
    CrossrefPubMedGoogle Scholar
  • 27 Oostra A, van Furth W, Georgalas C. Extended endoscopic endonasal skull base surgery: from the sella to the anterior and posterior cranial fossa. ANZ J Surg 2012; 82 (03) 122-130
    CrossrefPubMedGoogle Scholar
  • 28 Ben-Ari O, Wengier A, Ringel B. et al. Nasoseptal flap for skull base reconstruction in children. J Neurol Surg B Skull Base 2018; 79 (01) 37-41
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Jones M, Johans S, Ziegler A. et al. Outcomes of patients undergoing endoscopic endonasal skull base surgery at a VA Hospital. JAMA Surg 2016; 151 (12) 1186-1187
    CrossrefPubMedGoogle Scholar