{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:28Z","timestamp":1786978108861,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The utilization of the nasoseptal flap (NSF) in endoscopic anterior skull base surgery (EASB) has resulted in reduced rates of postoperative cerebrospinal fluid leak (CSF). The long\u2010term impact on sinonasal function after surgery remains incompletely defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A consecutive series of patients undergoing EASB with NSF and with at least 3 years follow\u2010up was prospectively evaluated. Patient demographics, pre\u2010 and postoperative Sino\u2010nasal Outcome Test\u201022 (SNOT\u201022) scores, Lund\u2010Mackay scores (LMS), CSF leak, and sinonasal complications were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 46 patients undergoing EASB with NSF met inclusion criteria. The mean follow\u2010up was 67.4 months (range 39\u201390, standard deviation [SD] 14.2 months). No statistically significant differences were noted between the mean overall pre\u2010 (16) and postoperative SNOT\u201022 scores (18). SNOT\u201022 scores improved in 27 patients (58.7%), deteriorated in 17 patients (37.0%) and stayed the same in two patients (4.3%). Deterioration in SNOT\u201022 scores was greater in younger (mean change\u2009+\u20097.2 [SD17.4] vs. older patients \u22123.4 [SD 7.5],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.010). A statistically significant increase in LMS was noted (mean preoperative LMS0.9 vs. mean postoperative LMS 2.2,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). The LMS decreased in nine patients (19.6%), increased in 22 patients (47.8%), and remained the same in 15 patients (32.6%). One patient (2.2%) developed a postoperative CSF leak following resection of metastatic skull base lesion and was successfully treated with placement of a lumbar drain, Foley catheter balloon, and strict bed rest. One patient (2.2%) developed a postoperative mucocele requiring decompression 3 years after initial surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Whereas long\u2010term sinonasal quality of life is overall improved in the majority of patients following NSF use for EASB, younger patients show higher incidence of deterioration. Increased sinus opacification on imaging is generally noted and may require continued follow\u2010up and management. The incidence of reoperation for symptomatic mucocele formation is low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 129:1035\u20131040, 2019\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.27637","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T02:25:11Z","timestamp":1545272711000},"page":"1035-1040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Long\u2010term sinonasal outcomes after endoscopic skull base surgery with nasoseptal flap reconstruction"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1993-7018","authenticated-orcid":false,"given":"Charles A.","family":"Riley","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York Presbyterian Hospital\u2013Weill Cornell Medicine  New York New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abtin","family":"Tabaee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York Presbyterian Hospital\u2013Weill Cornell Medicine  New York New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Conley","sequence":"additional","affiliation":[{"name":"Department of Radiology New York Presbyterian Hospital\u2013Weill Cornell Medicine  New York New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhamad","family":"Amine","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York Presbyterian Hospital\u2013Weill Cornell Medicine  New York New 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