Middle Turbinate Medialization With Absorbable Packing After Trans-sphenoidal Skull Base Surgery: Outcomes and...

Area of Science:

• Otolaryngology
• Neurosurgery
• Endoscopic Skull Base Surgery

Background:

• Middle turbinate (MT) medialization post-endoscopic skull base surgery (ESBS) aids natural sinus positioning and protects against iatrogenic injury.
• Our institution employs bioabsorbable nasal packing in the middle meatus to preserve and medialize MTs during ESBS.

Purpose of the Study:

• To objectively assess the efficacy and durability of using bioabsorbable nasal packing for MT medialization after trans-sphenoidal ESBS.
• To evaluate MT positioning against the septum using standardized endoscopic scoring systems.

Main Methods:

• Retrospective review of 50 consecutive trans-sphenoidal ESBS patients (2023-2024) with postoperative endoscopies (>20 days post-op).
• Two independent raters assessed MT station and apposition using standardized scoring systems.
• Subgroup analysis examined the effect of time on MT position using multiple postoperative endoscopies.

Main Results:

• High rates of MT medialization (96%) and apposition to the septum (88%) were observed.
• Substantial inter-rater reliability was achieved (Cohen's kappa: 0.90 for station, 0.63 for apposition).
• No significant time-dependent changes in MT station or apposition were detected.

Conclusions:

• Bioabsorbable nasal packing is a simple and effective technique for achieving durable MT medialization after ESBS.
• Optimized MT positioning can enhance postoperative sinus function and mitigate risks of skull base injury.