Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction

Richard J. Harvey, Joanne Malek, Mark Winder, Andrew Davidson, Tim Steel, Nadine Mrad, Henry Barham, Anna Knisely, Charles Teo

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    BACKGROUND: Sinonasal function can be affected by multiple treatment modalities but surgical techniques, such as the nasoseptal flap or Draf 3 procedure, have been implicated in poor post-treatment function. Prior studies have rarely used comparable populations and this study aims to assess the impact of surgical technique, mainly the nasoseptal flap, on sinonasal function in a group of comparable patients.

    METHODS: A prospective cohort of patients undergoing endoscopic surgery for sinonasal and skull base tumours was studied. Patients were analysed according to whether a nasoseptal flap was used. Other treatment factors included; use of the Draf 3, radiotherapy, removal of olfactory apparatus and dural resection. The Sinonasal Outcome Test 22 (SNOT22), a nasal symptom score (NSS), global function score and nasal obstruction scores were recorded pre and post treatment.

    RESULTS: One hundred and eighteen patients were assessed. Forty-two patients had a nasoseptal flap. Perioperative radiotherapy was higher in the nasoseptal group, as was dural resection and the need to remove the olfactory apparatus. Despite this, there was no significant difference in SNOT22 scores and NSS. Radiotherapy was detrimental to sinonasal function with SNOT22 and NSS.

    CONCLUSION: The use of a nasospetal flap in surgery does not affect patient quality of life and sinonasal function after endoscopic tumour resection. Pathology is a better predictor of morbidity, with loss of function from radiotherapy or resection of functional areas such as the olfactory apparatus having a greater impact.

    LanguageEnglish
    Pages122-128
    Number of pages7
    JournalRhinology
    Volume53
    Issue number2
    DOIs
    Publication statusPublished - Jun 2015

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    Morbidity
    Radiotherapy
    Nose
    Neoplasms
    Nasal Obstruction
    Skull Base
    Therapeutics
    Quality of Life
    Pathology
    Population

    Cite this

    Harvey, Richard J. ; Malek, Joanne ; Winder, Mark ; Davidson, Andrew ; Steel, Tim ; Mrad, Nadine ; Barham, Henry ; Knisely, Anna ; Teo, Charles. / Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction. In: Rhinology. 2015 ; Vol. 53, No. 2. pp. 122-128.
    @article{66b8f98dfe604312a8ba780f896f39f5,
    title = "Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction",
    abstract = "BACKGROUND: Sinonasal function can be affected by multiple treatment modalities but surgical techniques, such as the nasoseptal flap or Draf 3 procedure, have been implicated in poor post-treatment function. Prior studies have rarely used comparable populations and this study aims to assess the impact of surgical technique, mainly the nasoseptal flap, on sinonasal function in a group of comparable patients.METHODS: A prospective cohort of patients undergoing endoscopic surgery for sinonasal and skull base tumours was studied. Patients were analysed according to whether a nasoseptal flap was used. Other treatment factors included; use of the Draf 3, radiotherapy, removal of olfactory apparatus and dural resection. The Sinonasal Outcome Test 22 (SNOT22), a nasal symptom score (NSS), global function score and nasal obstruction scores were recorded pre and post treatment.RESULTS: One hundred and eighteen patients were assessed. Forty-two patients had a nasoseptal flap. Perioperative radiotherapy was higher in the nasoseptal group, as was dural resection and the need to remove the olfactory apparatus. Despite this, there was no significant difference in SNOT22 scores and NSS. Radiotherapy was detrimental to sinonasal function with SNOT22 and NSS.CONCLUSION: The use of a nasospetal flap in surgery does not affect patient quality of life and sinonasal function after endoscopic tumour resection. Pathology is a better predictor of morbidity, with loss of function from radiotherapy or resection of functional areas such as the olfactory apparatus having a greater impact.",
    author = "Harvey, {Richard J.} and Joanne Malek and Mark Winder and Andrew Davidson and Tim Steel and Nadine Mrad and Henry Barham and Anna Knisely and Charles Teo",
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    Harvey, RJ, Malek, J, Winder, M, Davidson, A, Steel, T, Mrad, N, Barham, H, Knisely, A & Teo, C 2015, 'Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction', Rhinology, vol. 53, no. 2, pp. 122-128. https://doi.org/10.4193/Rhin14.247

    Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction. / Harvey, Richard J.; Malek, Joanne; Winder, Mark; Davidson, Andrew; Steel, Tim; Mrad, Nadine; Barham, Henry; Knisely, Anna; Teo, Charles.

    In: Rhinology, Vol. 53, No. 2, 06.2015, p. 122-128.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction

    AU - Harvey, Richard J.

    AU - Malek, Joanne

    AU - Winder, Mark

    AU - Davidson, Andrew

    AU - Steel, Tim

    AU - Mrad, Nadine

    AU - Barham, Henry

    AU - Knisely, Anna

    AU - Teo, Charles

    PY - 2015/6

    Y1 - 2015/6

    N2 - BACKGROUND: Sinonasal function can be affected by multiple treatment modalities but surgical techniques, such as the nasoseptal flap or Draf 3 procedure, have been implicated in poor post-treatment function. Prior studies have rarely used comparable populations and this study aims to assess the impact of surgical technique, mainly the nasoseptal flap, on sinonasal function in a group of comparable patients.METHODS: A prospective cohort of patients undergoing endoscopic surgery for sinonasal and skull base tumours was studied. Patients were analysed according to whether a nasoseptal flap was used. Other treatment factors included; use of the Draf 3, radiotherapy, removal of olfactory apparatus and dural resection. The Sinonasal Outcome Test 22 (SNOT22), a nasal symptom score (NSS), global function score and nasal obstruction scores were recorded pre and post treatment.RESULTS: One hundred and eighteen patients were assessed. Forty-two patients had a nasoseptal flap. Perioperative radiotherapy was higher in the nasoseptal group, as was dural resection and the need to remove the olfactory apparatus. Despite this, there was no significant difference in SNOT22 scores and NSS. Radiotherapy was detrimental to sinonasal function with SNOT22 and NSS.CONCLUSION: The use of a nasospetal flap in surgery does not affect patient quality of life and sinonasal function after endoscopic tumour resection. Pathology is a better predictor of morbidity, with loss of function from radiotherapy or resection of functional areas such as the olfactory apparatus having a greater impact.

    AB - BACKGROUND: Sinonasal function can be affected by multiple treatment modalities but surgical techniques, such as the nasoseptal flap or Draf 3 procedure, have been implicated in poor post-treatment function. Prior studies have rarely used comparable populations and this study aims to assess the impact of surgical technique, mainly the nasoseptal flap, on sinonasal function in a group of comparable patients.METHODS: A prospective cohort of patients undergoing endoscopic surgery for sinonasal and skull base tumours was studied. Patients were analysed according to whether a nasoseptal flap was used. Other treatment factors included; use of the Draf 3, radiotherapy, removal of olfactory apparatus and dural resection. The Sinonasal Outcome Test 22 (SNOT22), a nasal symptom score (NSS), global function score and nasal obstruction scores were recorded pre and post treatment.RESULTS: One hundred and eighteen patients were assessed. Forty-two patients had a nasoseptal flap. Perioperative radiotherapy was higher in the nasoseptal group, as was dural resection and the need to remove the olfactory apparatus. Despite this, there was no significant difference in SNOT22 scores and NSS. Radiotherapy was detrimental to sinonasal function with SNOT22 and NSS.CONCLUSION: The use of a nasospetal flap in surgery does not affect patient quality of life and sinonasal function after endoscopic tumour resection. Pathology is a better predictor of morbidity, with loss of function from radiotherapy or resection of functional areas such as the olfactory apparatus having a greater impact.

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