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Straws Don't Suck: Are Straws Dangerous after Endoscopic Skull Base Surgery?Funding Integra LifeSciences provided financial support in the form of equipment donation.
Objective Patients undergoing endoscopic endonasal surgery have historically been restricted from using straws postoperatively, due to the concern that this activity generates negative pressure. The objective of this study is to evaluate the pressure dynamics in the sinonasal cavity associated with the use of a straw.
Methods Intracranial pressure catheters were placed in the nasal cavity of 20 healthy individuals. Pressure measurements were then recorded while participants drank liquids of different viscosities from a cup and from a straw. Measurements were recorded with and without subjects occluding their nose to simulate postoperative nasal obstruction.
Results The average pressure in the nasal cavity while drinking water from a cup was −0.86 cmH2O, from a straw was −1.09 cmH2O, and while occluding the nose and using a straw was −0.81 cmH2O. The average pressure in the nasal cavity while drinking a milkshake from a cup was −0.98 cmH2O, from a straw was −1.88 cmH2O, and while occluding the nose and using a straw was −1.37 cmH2O. There was no statistically significant difference in pressure measurements when comparing either task or consistency (p > 0.05).
Conclusion Straw use is not associated with the generation of significant negative pressure in the nasal cavity. The pressure generated when drinking from a straw is not significantly different from that of drinking from a cup. This data suggest that straw use may be safe for patients following endoscopic skull base surgery, but further investigation is warranted.
Oral presentation at: North American Skull Base Society Meeting, February 7 to 9, 2019, San Antonio, TX.
Received: 27 February 2020
Accepted: 30 April 2020
05 August 2020 (online)
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- 1 Lobo B, Heng A, Barkhoudarian G, Griffiths CF, Kelly DF. The expanding role of the endonasal endoscopic approach in pituitary and skull base surgery: a 2014 perspective. Surg Neurol Int 2015; 6: 82
- 2 Rimmer RA, Chitguppi C, Garcia HG. et al. A cadaveric model for measuring sinonasal continuous positive airway pressure-a proof-of-concept study. Int Forum Allergy Rh 2019; 9 (02) 197-203
- 3 Nadimi S, Caballero N, Carpenter P, Sowa L, Cunningham R, Welch KC. Immediate postoperative imaging after uncomplicated endoscopic approach to the anterior skull base: is it necessary?. Int Forum Allergy Rhinol 2014; 4 (12) 1024-1029
- 4 Diaz L, Mady LJ, Mendelson ZS, Liu JK, Eloy JA. Endoscopic ventral skull base surgery: Is early postoperative imaging warranted for detecting complications?. Laryngoscope 2015; 125 (05) 1072-1076
- 5 Brown SM, Anand VK, Tabaee A, Schwartz TH. Role of perioperative antibiotics in endoscopic skull base surgery. Laryngoscope 2007; 117 (09) 1528-1532
- 6 Kraus DH, Gonen M, Mener D, Brown AE, Bilsky MH, Shah JP. A standardized regimen of antibiotics prevents infectious complications in skull base surgery. Laryngoscope 2005; 115 (08) 1347-1357
- 7 Roxbury CR, Lobo BC, Kshettry VR. et al. Perioperative management in endoscopic endonasal skull-base surgery: a survey of the North American Skull Base Society. Int Forum Allergy Rhinol 2018; 8 (05) 631-640
- 8 Choi DL, Reddy K, Weitzel EK. et al. Postoperative continuous positive airway pressure use and nasal saline rinses after endonasal endoscopic skull base surgery in patients with obstructive sleep apnea: a practice pattern survey. Am J Rhinol Allergy 2019; 33 (01) 51-55
- 9 Wannemuehler TJ, Rabbani CC, Burgeson JE. et al. Survey of endoscopic skull base surgery practice patterns among otolaryngologists. Laryngoscope Investig Otolaryngol 2018; 3 (03) 143-155
- 10 Gravbrot N, Jahnke H, White WL, Little AS. Resumption of positive-pressure ventilation devices for obstructive sleep apnea following transsphenoidal surgery: an institutional experience of a surgical cohort. J Neurol Surg B Skull Base 2019; 80 (06) 237-243
- 11 Chitguppi C, Rimmer RA, Garcia HG. et al. Evaluation of cranial base repair techniques utilizing a novel cadaveric CPAP model. Int Forum Allergy Rhinol 2019; 9 (07) 795-803
- 12 Reilly EK, Huntley CT, Boon MS. et al. Qualitative assessment of the effect of continuous positive airway pressure on the nasal cavity. Am J Rhinol Allergy 2020; 34 (04) 487-493
- 13 Cooper JC, Langley LR, Meyerhoff WL, Gates GA. The significance of negative middle ear pressure. Laryngoscope 1977; 87 (01) 92-97
- 14 Takahashi H, Sato H, Nakamura H, Naito Y, Umeki H. Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. Auris Nasus Larynx 2007; 34 (02) 173-176
- 15 Bloomer CR. Straws do not cause dry sockets when third molars are extracted. Tex Dent J 2012; 129 (01) 25-32
- 16 Ayoub N, Chitsuthipakorn W, Nayak JV, Patel ZM, Hwang PH. Nose blowing after endoscopic sinus surgery does not adversely affect outcomes. Laryngoscope 2018; 128 (06) 1268-1273