Nasoseptal flaps: Postoperative findings and quality of life

Introduction The nasoseptal flap (SVL) is used in many skull base procedures. It can lead to synechiae, perforations and dryness or crusts within the nose. Therefore, the size of the graft should not be too large. The aim of the present study was to analyse postoperative findings after transnasal skull base procedures and their impact on quality of life (QoL).

Material and methods Patients who had received transsphenoidal skull base surgery at the ENT and Neurosurgical Dept. of the University Hospital Ulm between 2015 and 2021 were included. The case group (FG) consisted of patients in whom a SVL was used, and the control group (KG) consisted of free and non-vascularised reconstruction techniques. Subjective sinunasal QoL was assessed by the NOSE-GAV and SNOT-20-GAV questionnaires. In addition, a postoperative endoscopy was performed.

Results 95 patients were included in the analysis. The mean time interval between surgery and follow-up in the study was 47.6 ± 2.81 months. Septal crusting and postoperative mucosal changes were significantly more frequent in the KG (70 % and 30 %, respectively), and synechiae were significantly more frequent in the KG (86.7 %). The evaluation of the SNOT20-GAV and the NOSE-GAV showed no statistically significant differences between FG and KG.

Conclusions The use of SVL has high success rates as well as long-term effects on the nasal mucosa, which have a differential impact on QoL. Significantly more synechiae developed after transnasal hyopophyseal surgery performed by neurosurgery, underlining the importance of the interdisciplinary approach.

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Artikel online veröffentlicht:
12. Mai 2023