Comparing the Effects of Absorbable versus Nonabsorbable Nasal Packing on Postoperative Outcomes Following Endoscopic...

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• Endoscopic endonasal approaches are advancing ventral skull base surgery.
• Complex resections and reconstructions are becoming more common.
• Nasal packing is used to support skull base reconstructions.

Purpose of the Study:

• To investigate differences in postoperative outcomes based on nasal packing type.
• To compare rates of cerebrospinal fluid (CSF) leak and infection.
• To evaluate outcomes associated with absorbable versus nonabsorbable nasal packing.

Main Methods:

• Retrospective chart review at a single tertiary care institution.
• Included patients undergoing ventral skull base surgery with nasal packing (Jan 2020 - Dec 2023).
• Focused on outcomes of postoperative CSF leaks and infections.

Main Results:

• 179 patients included: 105 (58.7%) absorbable packing, 72 (40.2%) nonabsorbable packing.
• Absorbable packing group: 5.7% CSF leak rate; Nonabsorbable packing group: 12.5% CSF leak rate.
• Infection rates were 8.6% for absorbable and 8.3% for nonabsorbable packing, with no statistical significance (p=0.168 for leaks, p=0.309 for infections).

Conclusions:

• No significant difference in postoperative CSF leak or infection rates between absorbable and nonabsorbable nasal packing.
• Patient-specific factors should guide the choice of nasal packing.
• Further consideration of individual patient factors is recommended for optimal reconstruction outcomes.