Abstract
Objectives To identify sinuses demonstrating postoperative radiographic mucosal thickening after
endoscopic exposure of the cranial base through the transsphenoidal corridor.
Design Retrospective review.
Setting University-based medical center.
Participants Patients undergoing endoscopic transnasal transsphenoidal approaches to the skull
base who had both preoperative and postoperative imaging.
Main Outcome Measures Change in preoperative and postoperative imaging scores for each sinus and side at
3 and 6 months. The left-sided undissected sinuses served as internal controls for
comparison.
Results Fifty-one patients were identified with the aforementioned inclusion and exclusion
criteria. The mean difference in preoperative and postoperative imaging scores for
the right anterior ethmoid sinus was significantly different from the left-sided equivalents
(p = 0.0020). The difference in the frontal sinuses approached significance (p = 0.0625).
Conclusions Resection of the lower half of the middle turbinate and maxillary antrostomy and
harvest of a nasoseptal flap are associated with an increased radiographic incidence
of mucosal thickening of the ipsilateral anterior ethmoids compared with the undissected
contralateral side. When accessing the transnasal transsphenoidal corridor for skull
base surgery, preservation of native anatomy is associated with a lower incidence
of mucosal thickening on postoperative imaging.
Keywords
endoscopic skull base - middle turbinate - sinusitis - maxillary sinus - radiographic
