Skull base surgery via extended endoscopic endonasal approach: Predictors of ear-nose-throat complications

Anna Penella; Alejandro Portillo; Ricardo Bartel; Jose María Caballero; Enric Cisa; Francesc Cruellas; Mireia Golet; Jose L Sanmillan; Alberto Torres; Xavier González-Compta

doi:10.1016/j.otoeng.2025.512264

Skull base surgery via extended endoscopic endonasal approach: Predictors of ear-nose-throat complications

Acta Otorrinolaringol Esp (Engl Ed). 2025 Sep-Oct;76(5):512264. doi: 10.1016/j.otoeng.2025.512264. Epub 2025 Jun 19.

Affiliations

¹ Otorhinolaryngology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona (UB), IDIBELL, Feixa Llarga s/n, 08907, l'Hospitalet de Llobregat, Spain; Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Feixa Llarga s/n, 08907, l'Hospitalet de Llobregat, Spain. Electronic address: apenella@bellvitgehospital.cat.
² Otorhinolaryngology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona (UB), IDIBELL, Feixa Llarga s/n, 08907, l'Hospitalet de Llobregat, Spain.
³ Otorhinolaryngology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona (UB), IDIBELL, Feixa Llarga s/n, 08907, l'Hospitalet de Llobregat, Spain; Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Feixa Llarga s/n, 08907, l'Hospitalet de Llobregat, Spain.
⁴ Neurosurgery Department, Hospital Universitari de Bellvitge, Universitat de Barcelona (UB), IDIBELL, Feixa Llarga s/n, 08907, l'Hospitalet de Llobregat, Spain.

PMID: 40543752
DOI: 10.1016/j.otoeng.2025.512264

Abstract

Objective: To identify predictive factors for ear-nose-throat (ENT) complications in patients undergoing skull base surgery via extended endoscopic endonasal approaches (EEEA).

Methods: Single-center retrospective observational study of a cohort of patients who underwent EEEA for skull base surgery between January 2015 and December 2021. Patients were stratified according to ENT complications.

Results: Sixty-one patients were included in the study: 37 women (60.66%) and 24 men (39.34%). Craniopharyngioma was the most frequently observed pathology (36%). 40 patients (65,57%) presented with ENT complications, being olfactory disturbance the most common complication (40,98%), followed by nasal obstruction (24,59%) and synechiae formation (18,03%). Logistic regression analysis revealed that younger age (P = .026) and excision of middle turbinates during EEEA surgery (P = .034) were independent factors with a significant association with ENT complications. Anterior septal deviation was an independent factor significantly associated with synechiae formation (P = .023).

Conclusion: Surgeons performing skull base surgery using EEEA should be aware that excision of middle turbinate, younger age and anterior septal deviation may be risk factors for ENT postoperative complications.

Keywords: Abordaje extendido; Base de cráneo; Complicaciones; Complications; ENT; Endoscopic; Endoscópica; Extended approach; ORL; Skull base.

Publication types

Observational Study

MeSH terms

Adolescent
Adult
Age Factors
Aged
Craniopharyngioma / surgery
Endoscopy* / adverse effects
Endoscopy* / methods
Female
Humans
Male
Middle Aged
Nasal Obstruction / epidemiology
Nasal Obstruction / etiology
Natural Orifice Endoscopic Surgery* / adverse effects
Natural Orifice Endoscopic Surgery* / methods
Otorhinolaryngologic Diseases* / epidemiology
Otorhinolaryngologic Diseases* / etiology
Postoperative Complications* / epidemiology
Postoperative Complications* / etiology
Retrospective Studies
Risk Factors
Skull Base* / surgery
Turbinates / surgery
Young Adult