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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(02): e336-e341
DOI: 10.1055/s-0042-1745853
Original Research

Nasal Crust-Related Morbidity and Debridement After Endoscopic Skull Base Surgery

Kent Curran 
1   Department of Otolaryngology- Head and Neck Surgery, Albany Medical College, Albany Medical Center, Albany, New York, United States
,
Adedamola Adepoju
1   Department of Otolaryngology- Head and Neck Surgery, Albany Medical College, Albany Medical Center, Albany, New York, United States
,
Carlos Pinheiro-Neto
1   Department of Otolaryngology- Head and Neck Surgery, Albany Medical College, Albany Medical Center, Albany, New York, United States
,
Maria Peris-Celda
1   Department of Otolaryngology- Head and Neck Surgery, Albany Medical College, Albany Medical Center, Albany, New York, United States
,
Tyler Kenning
1   Department of Otolaryngology- Head and Neck Surgery, Albany Medical College, Albany Medical Center, Albany, New York, United States
› Author Affiliations
Funding The present research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Introduction: Nasal crust after endoscopic skull base surgery can cause nasal congestion, obstruction, and pain, which can affect quality of life. The use of debridement aims to provide symptomatic relief and improve quality of life. Generally, most adult patients tolerate office-based debridement, except in a few select patients that require further sedation in the operating room for a debridement. The study sought to determine the rate of symptomatic crust-related morbidity and the rate of debridement in both the office and the operating room.

Methods: Premorbid, operative, and postoperative data of adult patients who had endoscopic skull base surgery in our institution from 2014 to 2018 were reviewed retrospectively. The characteristics of nasal symptoms in the postoperative period were determined and the number of debridements in the office and the operating room were analyzed.

Results: Two hundred and thirty-four (234) patients with 244 surgeries were included in the study. The majority, 68.9%, had a sellar lesion and a free mucosa graft (FMG) was the most common skull base reconstruction at 53.5%. One hundred and twenty (49.0%) had crust-related symptoms during the postoperative period and 11 patients (4.5%) required the operating room for debridement. The use of a pedicled flap, anxiety, and preoperative radiotherapy were significantly associated with intolerance to in-office debridement (p-value=0.05).

Conclusions: The use of a pedicled flap or anxiety may predispose patients to require an OR debridement. Previous radiotherapy also influenced the tolerance to the in-office debridement.

Keywords

Nasal crusting - endoscopic skull base surgery - nasal congestion - debridement - anxiety


Publication History

Received: 27 January 2021

Accepted: 01 March 2022

Article published online:
28 April 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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