Long-term radiological findings after endonasal endoscopic approach to the skull base

Objective: To study the long-term radiological findings after endonasal endoscopic approach to the skull base. Material and methods: Prospective study that included 55 patients who underwent advance endoscopic skull base surgery. All patients were evaluated with MRI before, 3 months and 12 months after surgery. We used the Lund-Mackay staging system for chronic rhinosinusitis to evaluate the paranasal cavities and the sinonasal scoring system to assess sinonasal symptoms. Results: Seventeen patients (30.9%) underwent extended endonasal approach that required a nasoseptal flap (NSF) for reconstruction of skull base. At baseline the mean total Lund-Mackay score was 0.63 +/- 1.2 (range 0-4), and at 3 and 12 months postoperatively the mean scores were 3.5 +/- 3.8 (range 0-14) and 2.0 +/- 2.5 (range 0-8) respectively. Patients who needed an NSF for reconstruction had a greater Lund-Mackay score (p < 0.05). Moreover, NSF is correlated with sinonasal mucosal thickening and fluid retention at 3 months (r = 0.45, p < 0.01) and 12 months (r = 0.4, p < 0.01). Total 5-symptom score (T5SS) was similar between both groups at baseline. Patients with extended endoscopic approach reported more smell loss (40.1 +/- 26.2; p < 0.05) and posterior nasal discharge (49.3 +/- 30.1; p < 0.05) than TTEA patients (21.6 +/- 30.9 and 22.5 +/- 27.5 respectively). Conclusions: We observed that sinus opacity is still present after one year of advance endoscopic skull base surgery but symptoms seems to return to basal after 12 months of follow-up. (C) 2016 Elsevier Inc. All rights reserved.