Postoperative care following skull base reconstruction

Postoperative care following skull base surgery and reconstruction is critical for achieving optimal outcomes and patient satisfaction. The choice of reconstructive technique and grafting materials may significantly influence the postoperative planning and monitoring for each patient. The overarching goals of postoperative management include avoidance and early recognition of complications, facilitation of wound healing at the surgical site(s), and quick recovery for the patient. Planning for postoperative care is initiated in the preoperative and intraoperative settings. Throughout the reconstruction, the surgical team must actively and meticulously evaluate the potential effects of each maneuver in regard to the subsequent clinical course. During the immediate postoperative period, it is helpful to have clinical protocols in place that address potential surgical complications, allow for early detection of neurological or hormonal dysfunction, and maximize patient safety and comfort. Longer-term postoperative follow-up continues until symptoms resolve and the endoscopic examination is normal. During this time period, well-defined goals and issues of concern should be clearly provided to the patient. In addition, disease-dependent schedules of surveillance are critical for patients with potentially recurrent pathology. This chapter will address decision-making for such topics during postoperative care following skull base reconstruction.