xRead - Nasal Obstruction (September 2024) Full Articles

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349

ICAR SINONASAL TUMORS

TABLE XXXI.B.3 Evidence surrounding morbidity related to intradural resection for sinonasal tumors.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusions

Tyler et al. 2113

1. Mean EQ-5D VAS score of 71.1 (22.3) 2. Mean ASBQ sum score of 128.3 (26.4) 3. Mean MDASI-22 composite score of 47.3 (35.1) 4. No difference in EQ-5D, VAS, ASBQ, and MDASI-22 scores with extradural versus transdural surgery 5. Patients had similar EQ-5D VAS scores as the general population 12 months after treatment 1. Most common complications were epistaxis (2), postoperative fever (3), lacrimal stenosis (4), CSF leak (2), and pulmonary embolism (2) 2. 46% of patients after uERTC had olfactory function, with a median UPSIT of 12 (range 5–27) 3. Statistically similar postoperative SNOT-22 scores between uERTC and bERTC (median 13.5 vs. 11.0) 1. Complications included CSF leak, infection, meningitis, abscess, and pneumocephalus 2. Patients who underwent dural resection had higher but statistically insignificant postoperative complication rates 3. Similar rate of CSF leaks between groups 1. 28% overall complication rate 2. Complications included symptomatic pneumocephalus (7%), epidural hematoma (7%), CSF leak (5%), wound complications (4%), and infection (3%)—18% major complication rate (Clavien–Dindo classification [grades IIIb, IV, and V]) 3. 2.9% had ocular findings (5% permanent), with the most common being diplopia Six of 17 patients had perioperative complications, including CSF leak ( n = 3), free flap congestion andedema ( n = 1), subcortical

Specific QOL scores using 1. EQ-5D VAS 2. ASBQ 3. MDASI-22 4. Comparison of QOLscores

2019 3

Cross-sectional study

114 patients who underwent

treatment ( n = 38 surgical, n = 29 extradural and nine transdural) for sinonasal or nasopharyngeal carcinoma

Schreier et al. 374 2018 3

Retrospective cohort

54 patients with sinonasal

1. Complication rate 2. Olfaction 3. SNOT-22 score

adenocarcinoma: 27 underwent unilateral endoscopic resection with transnasal craniectomy

(uERTC) and 27 patients bilateral (bERTC)

Ziai et al. 2109

Postoperative

2018 3

Retrospective cohort

37 patients with SNM, 21 ofwhom

complications

underwent dural resection and 16 whodidnot

Mehta et al. 179

2022 4

Retrospective case series

252 patients with SNM involving the anterior skull base

1. Complications and associated factors 2.

withamean follow-up of 6.5 years

Ophthalmological outcomes

Yeung et al. 2108

Perioperative

2021 4

Retrospective case series

17 patients with T4b SNMwith intracranial extension who underwent salvage resection

complications

infarct without long-term sequelae ( n = 1), and death ( n = 1) from pneumonia and cardiogenic shock

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