Table 3.
Complications from endonasal endoscopic surgery of the skull base, per disease.
| Olfactory alterations | Cerebrospinal fluid leak | Meningitis | Nasal synechia | INVF | P/M/E | |
|---|---|---|---|---|---|---|
| Adenoma | 7 | 2 | 2 | 7 | 5 | |
| Craniopharyngioma | 1 | |||||
| Tuberculum sellae meningioma | ||||||
| Olfactory groove meningioma | 1 | 1 | 1 | |||
| Intracranial abscess | 1 | 1 | 1 | |||
| Total | 10 | 3 | 3 | 8 | 6 | 0 |
When complications were divided by surgical access, the following were observed: in three cases (7.3%), cerebrospinal fluid leak and meningitis; in the two abovementioned complications, two patients underwent surgery for adrenocorticotropic hormone (ACTH)-producer pituitary adenomas (Cushing's syndrome) and one for treatment of olfactory groove meningioma. Among the changes of the nasal cavity: in eight (19.5%) patients, synechia was observed, seven in patients undergoing surgery for pituitary adenoma, and one for intracranial abscess. Six (14.6%) patients developed changes in the internal nasal valve, five patients undergoing surgery for pituitary adenoma, and one for intracranial abscess (three patients showed synechia and alteration of the internal nasal valve). The most common complication in this study was a change in olfaction, observed in ten patients, and documented by the olfactory test Connecticut Chemosensory Clinical Research Center Test [CCCRC]. Of these ten patients, seven patients underwent surgery for pituitary adenoma, one for a craniopharyngioma, one because of an intracranial abscess, and one for an olfactory groove meningioma. Four patients who raised the complaint postoperatively were examined and were found normosmic. Two patients with the complaint did not undergo the examination; one was lost to follow-up and another due to cognitive impairment. No patients developed septal perforation, epistaxis, or mucocele. INVF, internal nasal valve failure; P/M/E, septal perforation/mucocele/epistaxis.