A Comparison of Radiographic Evidence of Frontal Sinusitis in Middle-turbinate Sacrificing versus Middle-Turbinate Sparing Approaches to the Sella

Author:

Sowerby Leigh J.1,Mann Sumeer2,Starreveld Yves3,Kotylak Trevor2,Mechor Brad4,Wright Erin D.5

Affiliation:

1. Department of Otolaryngology, Western University, London, Ontario, Canada

2. Department of Radiology, University of Alberta, Edmonton, Alberta, Canada

3. Division of Neurosurgery, University of Calgary, Calgary, Alberta, Canada

4. Division of Otolaryngology, University of Calgary, Calgary, Alberta, Canada

5. Division of Otolaryngology, University of Alberta, Edmonton, Alberta, Canada

Abstract

Background Initial descriptions of endoscopic approaches to the sella and pituitary involved resecting the middle turbinate (MT) to help improve access and visualization. Modifications of these procedures to preserve the MT have since been described, one rationale being to reduce the incidence of frontal sinusitis. The objective of this study was to establish the incidence of postoperative frontal sinusitis in MT sparing (MTsp) and MT sacrificing (MTsc) approaches to the sella. Objective A retrospective cohort study that compared radiographic evidence of frontal rhinosinusitis or frontal recess obstruction after skull base surgery in patients who underwent MTsc and MTsp endonasal approaches to the sella. Methods Consecutive retrospective review of pre- and postoperative magnetic resonance imaging from two institutions in geographic proximity but with different approaches to the sella. Mucosal thickening in the frontal sinus was measured and graded by a radiologist blinded to patient cohorts. Results Seventy-five patients, based on sample size calculations, were included at each site. Baseline demographics and indications for surgery were not significantly different between the groups. No difference was seen between the groups in the overall grade of radiographic frontal sinusitis seen on postoperative imaging. A total of 8 patients (10%) in the MTsc group had measured mucosal thickening, which was increased from their preoperative scan versus 15 in the MTsp group (20%) (p = 0.10). New mucosal thickening of >1 mm was found in three patients in the MTsc group and eight patients in the MTsp group (p = 0.21); the only patient with postoperative complete frontal sinus opacification was in the MTsp group. Conclusions The choice of MTsc versus MTsp in endonasal endoscopic approach to the sella does not seem to make a difference in the incidence of postoperative radiographic frontal sinusitis.

Publisher

SAGE Publications

Subject

General Medicine,Otorhinolaryngology,Immunology and Allergy

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Preservation versus resection of middle turbinate in endoscopic transnasal transsphenoidal pituitary surgery;American Journal of Otolaryngology;2023-05

2. Management of the middle turbinate during and after sinus surgery;Current Opinion in Otolaryngology & Head & Neck Surgery;2021-12-09

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