{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T13:13:03Z","timestamp":1744290783329,"version":"3.37.3"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Sinonasal debridement is typically performed in the weeks following endonasal skull base surgery (ESBS). In the pediatric population, this second-look procedure may require general anesthesia; however, there is currently little evidence assessing the benefit of this practice.<\/jats:p><jats:p>\n          Methods\u2003This was a multicenter retrospective study of pediatric patients (age &lt;18 years) undergoing a planned second-look debridement under general anesthesia following ESBS. Intraoperative findings, interventions performed, and perioperative complications were reviewed. Multivariate regression analysis was performed to identify associations between intraoperative findings and clinical factors.<\/jats:p><jats:p>\n          Results\u2003We reviewed 69 cases of second-look debridements (age mean 8.6\u2009\u00b1\u20094.2 years, range: 2\u201318 years), occurring a mean of 18.3\u2009\u00b1\u200910.3 days following ESBS. All abnormal findings were noted in patients age \u226412 years. Synechiae were noted in 8.7% of cases, bacterial rhinosinusitis in 2.9%, and failed reconstruction with cerebrospinal fluid leak in 4.5% (two cases of flap malposition and one case of flap necrosis). All failed reconstructions were noted following expanded endonasal cases for craniopharyngioma, and in each case, a revision reconstruction was performed during the second-look surgery. Synechiae were not significantly associated with younger age, revision cases, or cases with reconstructive flaps. There were no perioperative complications.<\/jats:p><jats:p>\n          Conclusion\u2003Second-look debridement under general anesthesia may be useful in the identification and intervention of sinonasal pathology following endoscopic skull base surgery, particularly in children \u226412 years old or those with pedicled flap reconstructions. Larger controlled studies are warranted to validate this practice and refine indications and timing of this second procedure.<\/jats:p>","DOI":"10.1055\/a-2048-7564","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:13:05Z","timestamp":1678234385000},"page":"313-317","source":"Crossref","is-referenced-by-count":1,"title":["The Utility of a \u201cSecond-Look\u201d Debridement Following Endonasal Skull Base Surgery in the Pediatric Population"],"prefix":"10.1055","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-5880","authenticated-orcid":false,"given":"Michael T.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice E.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Quon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher Z.","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob G.","family":"Eide","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3113-2685","authenticated-orcid":false,"given":"Rijul S.","family":"Kshirsagar","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z Jason","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1002\/lio2.369","article-title":"The expanded endonasal approach in pediatric skull base surgery: A review","volume":"5","author":"N R London Jr","year":"2020","journal-title":"Laryngoscope Investig Otolaryngol"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1177\/0003489420922865","article-title":"Utility of second-look endoscopy with debridement after pediatric functional endoscopic sinus surgery in patients with cystic fibrosis","volume":"129","author":"Z M Helmen","year":"2020","journal-title":"Ann Otol Rhinol 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debridement for the postoperative care of patients undergoing endoscopic sinus surgery","volume":"11","author":"S Tzelnick","year":"2018","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Journal of Neurological Surgery Part B: Skull 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