{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:35:13Z","timestamp":1761824113916,"version":"3.32.0"},"reference-count":13,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T00:00:00Z","timestamp":1551744000000},"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":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Chronic rhinosinusitis (CRS) is a proposed risk factor for meningitis and other intracranial complications following the endoscopic endonasal transsphenoidal approach (TSA). Some have recommended staging TSA following surgery for CRS; however, delaying TSA has important ramifications. The objective of this study is to determine whether asymptomatic sinonasal inflammation (RSNI) on preoperative computed tomography scans, without clinical CRS, is associated with postoperative complications following TSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive TSA cases performed at a single tertiary care institution from January 1, 2009, to December 31, 2017, were reviewed for patient demographics, prior surgery, presence of RSNI on preoperative computed tomography scan based on Lund\u2010Mackay (LM) score, intraoperative cerebrospinal fluid (CSF) leak, and postoperative complications (postoperative CSF leak, bleeding, infection). The association between preoperative RSNI and postoperative complications was analyzed via multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred seventy\u2010one cases of TSA were included with mean patient age of 52.6\u2009years, 42.7% males, 18.1% revision cases, and mean LM score of 1.9\u2009\u00b1\u20092.7. Complications were identified in 9.9% of patients at the following rates: 5.3% postoperative CSF leak, 2.9% bleeding, and 1.8% infection (all sinusitis, no episodes of meningitis). Neither total LM score nor LM score\u2009&gt;\u20095 (representative of clinically significant radiographic CRS) were predictors of any postoperative complication (both <jats:italic>P<\/jats:italic> &gt;\u20090.05). Age, sex, revision status, intraoperative CSF leak, and total LM score were not independent predictors of any postoperative complication on multivariate analysis (all <jats:italic>P<\/jats:italic> &gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In asymptomatic patients, radiographic evidence of sinonasal inflammation is not associated with increased risk of complications following TSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:1545\u20131548, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27893","type":"journal-article","created":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T02:27:11Z","timestamp":1551839231000},"page":"1545-1548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Asymptomatic radiographic sinonasal inflammation does not affect pituitary surgery outcomes"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-0718","authenticated-orcid":false,"given":"Edward C.","family":"Kuan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine Medical Center  Orange California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruthi K.","family":"Rereddy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1365-9130","authenticated-orcid":false,"given":"Neil N.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivy W.","family":"Maina","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasiliki","family":"Triantafillou","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Kohanski","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4471-5134","authenticated-orcid":false,"given":"Charles C.L.","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed A.","family":"Nabavizadeh","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Y.K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Sean","family":"Grady","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Bert W.","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/515533"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2013.07.003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.119324"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215107000801"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180caa177"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1342916"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21476"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2008.22.3220"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2012.664284"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003393"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.2.JNS161582"},{"key":"e_1_2_6_13_1","first-page":"82","article-title":"Incidental detection of sinus mucosal abnormalities on CT and MRI imaging of the head","volume":"3","author":"Nazri M","year":"2013","journal-title":"Quant Imaging Med Surg"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21382"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27893","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27893","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T09:00:39Z","timestamp":1734685239000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,5]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1002\/lary.27893"],"URL":"https:\/\/doi.org\/10.1002\/lary.27893","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2019,3,5]]},"assertion":[{"value":"2018-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}