Postoperative Management Following Endoscopic Skull Base Reconstruction: A Multidisciplinary Cross-Sectional Survey

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-02-18 DOI:10.1002/hed.28116

Khodayar Goshtasbi, Arash Abiri, Vidit Talati, Jagatkumar A. Patel, Theodore V. Nguyen, Jonathan C. Pang, John R. Craig, Peter Papagiannopoulos, Katie M. Phillips, Bobby A. Tajudeen, Nithin D. Adappa, James N. Palmer, Ahmad R. Sedaghat, Eric W. Wang, Shirley Y. Su, Edward C. Kuan

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Abstract

Background

There is limited consensus on management protocols and practice patterns following endoscopic skull base surgery (ESBS).

Methods

An online-based survey focusing on ESBS practice patterns was anonymously distributed to the American Rhinologic Society, North American Skull Base Society, and American Head and Neck Society Skull Base Section membership.

Results

A total of 130 surgeons (81.5% in academic positions) completed the survey. Regarding reconstructive materials, 36.9% always used autologous as opposed to synthetic materials, with variation in specific materials used. Lumbar drain was never used by 22.3% of respondents, while high BMI or suspected intracranial hypertension (43.1%) and high-flow leak or large dural defects (50.0%) were indications for lumbar drain usage. There was significant variation in types of nasal packing, type, and duration of postoperative activity restrictions, antibiotic use, and debridement protocols.

Conclusion

Postoperative management following endoscopic skull base reconstruction is highly complex, with a wide variety of practice patterns.

Level of Evidence

N/A.

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内镜下颅底重建的术后处理：一项多学科横断面调查。

背景：内窥镜颅底手术（ESBS）后的治疗方案和实践模式的共识有限。方法：一份关于ESBS实践模式的在线调查匿名分发给美国鼻科学学会、北美颅底学会和美国头颈学会颅底科会员。结果：共130名外科医生（81.5%）完成调查。在重建材料方面，36.9%的人总是使用自体材料而不是合成材料，具体使用的材料有所不同。22.3%的受访者从未使用过腰椎引流管，而高BMI或疑似颅内高压（43.1%）和高流量泄漏或大硬脑膜缺损（50.0%）是腰椎引流管使用的指征。鼻腔填塞类型、术后活动限制类型和持续时间、抗生素使用和清创方案存在显著差异。结论：内镜下颅底重建术的术后处理非常复杂，实践模式多种多样。证据级别：无。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.