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Functional sinonasal outcomes were evaluated in both groups in terms of sinonasal outcome test (SNOT-22), crusting, adhesions, and olfaction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>the sinonasal outcome test (SNOT-22), as well as the olfaction scores were significantly better in the double flap group compared to the rescue flap group. Crusting and adhesions occurred more frequently in the rescue flap group. The nasal stage operative time was significantly longer in the double flap group than the rescue flap group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Endoscopic pituitary surgery can adversely affect the sinonasal functions. Double nasoseptal flap technique allows posterior septectomy with bilateral septal mucosa preservation. Although it requires longer operative time than the rescue flap technique, better functional sinonasal outcomes and olfaction scores are achieved.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-025-09342-8","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T21:03:57Z","timestamp":1744491837000},"page":"2437-2445","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional sinonasal outcomes after rescue flap versus double nasoseptal flap in endoscopic trans-sphenoid pituitary surgery: a randomized clinical trial"],"prefix":"10.1007","volume":"282","author":[{"given":"Ahmad Muhammad","family":"Al-Arman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Moneir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazem Emam","family":"Amer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Saad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4848-9223","authenticated-orcid":false,"given":"Hisham Atef","family":"Ebada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,12]]},"reference":[{"issue":"9","key":"9342_CR1","doi-asserted-by":"publisher","first-page":"4091","DOI":"10.1007\/s00405-023-07934-w","volume":"280","author":"NA Gstrein","year":"2023","unstructured":"Gstrein NA, Zwicky S, Serra C, Hugelshofer M, Regli L, Soyka MB, Holzmann D, Meerwein CM (2023) Rhinologic outcome of endoscopic transnasal-transsphenoidal pituitary surgery: an institutional series, systematic review, and meta-analysis. 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