Effect of middle turbinate resection in endoscopic endonasal skull base surgery : Comparative study / Ahmed Adel Abdallah Hassan ; Supervised Mohammed Abdelrahman Elshazly , Abdelrahman Younes , Osama Hassan

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of E.N.T

Endoscopic endonasal skull base surgery allowed excellent exposure of skull base permitting excision of wide variety of lesions with less morbidity and mortality than open approaches. Management of middle turbinate in Endoscopic endonasal skull base surgery is a source of continuous debate, whether to be resected for wider exposure or to be preserved for functional and anatomical considerations. In this study two hundred and eight patients with skull base lesions who are candidate for endoscopic trans-nasal trans-sphenoid (sella and planum) surgery were included. Patients with lesions candidate for endoscopic skull base approach that necessitate mandatory resection of middle turbinate were excluded from the study. Patients were divided into three groups according to intraoperative management of middle turbinate (resection, partial resection and preservation). They were subjected to detailed assessment protocol preoperatively and postoperatively. Follow up assessment was done two weeks, one month and three months postoperatively. CT scan was done on 3rd month to assess development of postoperative frontal sinusitis. In conclusion: Middle turbinate should be preserved in endoscopic trans-nasal trans sphenoid surgery as long as it doesn`t compromise safe and total tumor excision as it has less early post-operative morbidity regarding development of crustations nasal discharge and smell dysfunction and less late postoperative morbidity regarding development of postoperative frontal sinusitis

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