{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T23:24:31Z","timestamp":1787268271523,"version":"build-2736575974"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Durable sellar reconstruction and preserving sinonasal function are pivotal objectives in endoscopic pituitary surgery.<\/jats:p>\n                  <jats:p>This study aimed to investigate the postoperative skull base and sinonasal morbidity associated with a modified nasoseptal flap (NSF) in endoscopic pituitary surgery.<\/jats:p>\n                  <jats:p>A retrospective cohort study was conducted on patients undergoing endoscopic transsphenoidal pituitary surgery with either an NSF or non-NSF reconstruction of the sella. Patients had an obvious or suspected intraoperative cerebrospinal leak. A minimum 6-month follow-up was required. Outcome measures included postoperative skull base morbidity (cerebrospinal fluid leak, flap necrosis, pneumocephalus, meningitis, other intracranial infections, intracranial hemorrhage), sinonasal morbidity (epistaxis, crusting, sinus infection, atrophic rhinitis, persistent crusting, sinus dysfunction, mucocele formation, septal perforation), and patient-reported outcome measures (Sinonasal Outcome Test 22 [SNOT22; range 0\u2013110], Nasal Symptom Score [NSS; range 0\u201330], and olfactory dysfunction score [range 0\u20135]).<\/jats:p>\n                  <jats:p>About 372 patients (age 53.8\u2009\u00b1\u200916.7 years, 53.5% female) were included. Most patients underwent NSF reconstruction (87.1%). There was no significant difference in skull base morbidity between the NSF and non-pedicle flap groups. The NSF group had fewer self-reported sinus infections (0.9% vs. 6.4%, p\u2009=\u20090.03) and sinus dysfunction (2.8% vs. 31.3%, p\u2009&lt;\u20090.01). Postoperative SNOT22 (12.9\u2009\u00b1\u200915.3 vs. 25.2\u2009\u00b1\u200921.3, p\u2009&lt;\u20090.01), NSSs (2.3\u2009\u00b1\u20093.5 vs. 5.9\u2009\u00b1\u20096.0, p\u2009&lt;\u20090.01), and olfactory dysfunction score (percentage of cases \u2265\u201cmoderate problem [score 3],\u201d 6.4% vs. 26.3%, p\u2009=\u20090.01) were also lower in the NSF group.<\/jats:p>\n                  <jats:p>Utilizing a modified NSF in endoscopic transsphenoidal pituitary surgery allows for a sellar reconstruction option without detrimental impact on sinonasal function.<\/jats:p>","DOI":"10.1055\/a-2717-2780","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T23:09:15Z","timestamp":1759878555000},"page":"577-583","source":"Crossref","is-referenced-by-count":0,"title":["Sinonasal and Skull Base Morbidity from a Modified Nasoseptal Flap versus No Flap in Pituitary Surgery"],"prefix":"10.1055","volume":"87","author":[{"given":"Ash Li","family":"Khoo","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Southwest Sydney Clinical School, University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0158-7638","authenticated-orcid":false,"given":"Kachorn","family":"Seresirikachorn","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen M.","family":"Oakley","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry P.","family":"Barham","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Baton Rouge General Medical Center, Baton Rouge, Louisiana, United States"},{"name":"Sinus and Nasal Specialists of Louisiana, Baton Rouge, Louisiana, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-8005","authenticated-orcid":false,"given":"Jessica W.","family":"Grayson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6331-1485","authenticated-orcid":false,"given":"Carolyn","family":"Orgain","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Vermont Larner College of Medicine, Burlington, Vermont, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Alvarado","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9441-1489","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Mangussi-Gomes","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry H.","family":"Kalish","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raewyn G.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia"},{"name":"Department of Otolaryngology, Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia"},{"name":"School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.wneu.2014.12.029","article-title":"The current status of endoscopy in transsphenoidal surgery: An international survey","volume":"83","author":"E de Divitiis","year":"2015","journal-title":"World Neurosurg"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1097\/00006534-199612000-00005","article-title":"Flap selection in cranial base reconstruction","volume":"98","author":"P C Neligan","year":"1996","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1002\/lary.22475","article-title":"Endoscopic skull base reconstruction of large dural defects: A systematic review of published evidence","volume":"122","author":"R J 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Horridge","year":"2013","journal-title":"Br J Neurosurg"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1007\/s00405-019-05531-4","article-title":"Endoscopic skull base reconstruction with the nasoseptal flap: Complications and risk factors","volume":"276","author":"A Wengier","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"S 04","key":"ref8","doi-asserted-by":"crossref","first-page":"S291","DOI":"10.1055\/s-0038-1668158","article-title":"Complications of nasoseptal flap reconstruction: A systematic review","volume":"79","author":"P Lavigne","year":"2018","journal-title":"J Neurol Surg B Skull Base"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1055\/s-0035-1554905","article-title":"The olfactory strip and its preservation in endoscopic pituitary surgery maintains smell and sinonasal function","volume":"76","author":"R J Harvey","year":"2015","journal-title":"J Neurol Surg B Skull 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postoperative sinonasal symptoms","volume":"75","author":"C F Thompson","year":"2014","journal-title":"J Neurol Surg B Skull Base"},{"issue":"02","key":"ref29","first-page":"122","article-title":"Sinonasal morbidity following tumour resection with and without nasoseptal flap reconstruction","volume":"53","author":"R J Harvey","year":"2015","journal-title":"Rhinology"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1177\/1945892420957505","article-title":"The effect of nasoseptal flap elevation on post-operative olfaction and sinonasal quality of life: A prospective double-blinded randomized controlled trial","volume":"35","author":"C T Chou","year":"2021","journal-title":"Am J Rhinol Allergy"},{"issue":"05","key":"ref31","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s00405-015-3729-z","article-title":"Impact of nasoseptal flap elevation on sinonasal quality of life in endoscopic endonasal approach to pituitary 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