| Multidisciplinary collaboration |
A multidisciplinary team should consist of neurosurgeons, endocrinologists, radiologists, radiation oncologists, anesthesiologists, neurosurgical nurses, and operating room nurses (16) |
3c |
| Preoperative evaluation and informed consent |
Preoperatively, the patient’s medical history should be investigated, including symptoms related to sinusitis such as rhinorrhea, nasal congestion, and epistaxis (13,14). If the patient has sinusitis, it should be actively treated and controlled (25) |
2b |
| Patients should undergo a nasal examination before surgery for assessment of the structure of the nose and the condition of the mucous membrane and to optimize the surgical approach (13,17) |
3e |
| The patient should be assessed for potential comorbidities such as diabetes, hypertension, and heart failure (13,14) |
2d |
| In patients with diabetes, blood glucose levels should be actively controlled before surgery to maintain stability, with the target blood glucose level being 6.1–8.3 mmol/L (12,15,21) |
1c |
| Preoperative nasal preparation should be thoroughly conducted (13,17,26,27) |
1a |
| Preoperative use of safe and inexpensive antimicrobial agents for prophylaxis is appropriate (15,16,22) |
1a |
| Preoperatively, patients should be thoroughly informed of potential surgical complications and prognostic outcomes by both neurosurgeons and endocrinologists in obtaining their informed consent (14) |
3b |
| Intraoperative prevention and control |
The patient can be positioned in the reverse Trendelenburg position during surgery, which can effectively reduce intraoperative bleeding (14) |
1c |
| A facial exposure area for the patient is appropriate for avoiding potential contamination (14) |
2c |
| Normal body temperature should be maintained in patients during the perioperative period (15) |
1a |
| The requirements of “Surgical Hand Disinfection Techniques” should be strictly adhered to according to the principles of asepsis during surgery (12,18,19,26) |
1c |
| The number of times personnel move in and out of the operating room during surgery should be minimized (18) |
1d |
| During surgery, 0.05% povidone-iodine and 3% hydrogen peroxide solution can be alternately used to rinse the nasal passages (20,25) |
1a |
| The surgical field should be maintained with saline irrigation at a temperature of 34–37 ℃ throughout the procedure (25) |
3b |
| Antibiotics should be administered intravenously 30 minutes before the start of surgery or during the induction of anesthesia and be completed within 30 minutes. If the surgery extends beyond 3 hours, or if blood loss exceeds 1,500 mL (24), a supplementary dose can be administered intraoperatively (18) |
1a |
| After tumor resection, cranial base reconstruction must be performed, with the distinct properties of various materials being leveraged to partition and seal the cranial base in order to reduce the risk of postoperative cerebrospinal fluid leakage and related complications (22,23) |
1a |
| During surgery, when a cerebrospinal fluid (CSF) leak is definitively identified, appropriate repair methods can be selected based on the volume of CSF leakage (22,27) |
2b |
| Postoperative observation, prevention, and control |
After the patients awaken from anesthesia, it is recommended that they maintain a head-up position with the upper body elevated 20–30° (22-23). |
2b |
| Timely postoperative monitoring and care should be applied, including neurological system assessment and monitoring, blood tests, consciousness level, blood pressure, headache, nosebleeds, cerebrospinal fluid leakage, etc. (17) |
1a |
|
If a patient is found to be coughing, complaining of itching, or with a salty fluid flowing down and a foreign body sensation in the posterior pharyngeal wall, it should be reported to the doctor in a timely manner, and secretions should be collected for testing (17) |
1a |
| After surgery, sneezing, violent coughing, straining during bowel movements, and other factors that may induce cerebrospinal fluid leakage should be avoided as much as possible. If constipation occurs, it should be intervened in a timely manner (25) |
1a |
| If an external ventricular drain is placed, aseptic maintenance should be observed to prevent possible iatrogenic contamination. The volume of drainage should be 150–200 mL/d. If the patient’s condition permits, the drain should be removed as soon as possible. The duration of placement should not exceed 2–3 weeks, and a new tube should be replaced as necessary (24,26) |
1a |
| Depending on the different methods of skull base reconstruction, the duration of postoperative nasal packing should be minimized as much as possible. If there is no significant exudate, the nasal packing should be removed as soon as possible, and the maximum packing time should not exceed 2 weeks (23) |
1a |
