Medizinische Universität Graz - Research portal
Selected Publication:
Schwarz, J.
Resection of nasal turbinates in endoscopic, transnasal surgery of the anterior skull base; a retrospective study.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 47
[OPEN ACCESS]
FullText
- Authors Med Uni Graz:
- Advisor:
- Gellner Verena
- Wolf Axel
- Altmetrics:
- Abstract:
- Introduction: Nasal turbinates are bony lamellae covered with respiratory mucosa of the nasal cavity. The aim is to preserve them in transnasal surgery of the anterior skull base due to their physiological function. This study aims to quantify the frequency of nasal turbinate resections during endoscopic transnasal tumor surgery of the anterior base of the skull and to identify factors leading to this measure. Materials and Methods: This study encompassed a total of 306 patients of the University Hospital Graz, who underwent a total of 323 endoscopic tumor surgeries of the anterior skull. The patient records were retrospectively analyzed with regard to age, sex, removal of nasal turbinates, tumor type, tumor size, tumor location, closure technique and surgical approach. Results: A total of 25 cases involved the removal of one or at most two nasal turbinates. 15 superior nasal turbinates and 17 middle nasal turbinates were resected. A resection of the inferior nasal turbinate was performed only once. Statistically significant correlations with regard to the removal of nasal turbinates were found for the factors of surgical access (p =,000), tumor type (p =,000), tumor size (transverse: p=,015, sagittal: p=,045 , craniocaudal: p=,101) tumor location (p =,000) and closure by fascia (p =,032). No statistical significance was found for the factors age (p = 0,794), sex (p =,6), closure by Hadad flap (p = ,263) and pneumatization of the sphenoidal sinus (p = ,102). The surgical reports ́ evaluation showed that deviations of the nasal anatomy were a frequent reason for a nasal turbinate removal. Conclusion: In most cases, it could be shown that a nasal turbinate resection can be avoided (resection in 7.7%). Tumor size, tumor type, tumor location and surgical access can be assumed as influencing factors for a nasal turbinate resection. However, a causal relationship cannot be confirmed in this study. The creation of a Hadad flap and a poorly ventilated sphenoidal sinus cannot be confirmed as influencing factors. Closure using fascia is associated with a statistically significant increase in nasal turbinate resections, but only a statistical correlation and no causality is suspected.