BishtRef
Articles Journals Publishers Authors Subjects Most Cited New Papers Year Stats Open Access
journal article Open Access Apr 16, 2018

Survey of endoscopic skull base surgery practice patterns among otolaryngologists

Todd J. Wannemuehler ORCID Cyrus C. Rabbani Jack E. Burgeson Elisa A. Illing Evan S. Walgama Arthur W. Wu Jonathan Y. Ting
Laryngoscope Investigative Otolaryngology Vol. 3 No. 3 pp. 143-155 · Wiley
View at Publisher Save 10.1002/lio2.149
Abstract
BackgroundEndoscopic skull base surgery (ESBS) is a rapidly expanding field. Despite divergent reported preferences for reconstructive techniques and perioperative management, limited data exist regarding contemporary practice patterns among otolaryngologists performing ESBS. This study aims to elucidate current practice patterns, primarily the volumes of cases performed and secondarily a variety of other perioperative preferences.MethodsAn anonymous 32‐item electronic survey examining perioperative ESBS preferences was distributed to the American Rhinologic Society membership. Statistical significance between variables was determined utilizing Student t, chi‐square, and Fisher exact tests.ResultsSeventy otolaryngologists completed the survey. The effective response rate was approximately 22.5%. Sixty percent of respondents were in full‐time academic practice and 70% had completed rhinology/skull base fellowships. Annually, 43.3 mean ESBS cases were performed (29.1 private practice vs. 52.9 academic practice, P = .009). Academic practice averaged 24.1 expanded cases versus only 11 in private practice (P = .01). Of respondents, 55.7% stood on the same side as the neurosurgeon and 72.9% remained present for the entire case. Current procedural terminology coding and antibiotic regimens were widely divergent; 31.4% never placed lumbar drains preoperatively, while 41.4% did so for anticipated high‐flow cerebrospinal fluid leaks. While considerable variation in reconstructive techniques were noted, intradural defect repairs utilized vascularized flaps 86.3% of the time versus only 51.3% for extradural repairs (P < 0.001). Major complications were rare. Postoperative restrictions varied considerably, with most activity limitations between 2–8 weeks and positive airway pressure use for 2–6 weeks. Most respondents started saline irrigations 0–2 weeks postoperatively.ConclusionsBased on responses from fellowship‐ and non‐fellowship‐trained otolaryngologists in various practice settings, there remains considerable variation in the perioperative management of patients undergoing ESBS.Level of Evidence5
Topics

No keywords indexed for this article. Browse by subject →

References
47
[2]
Schloffer H. "Erfolgreiche Operation eines Hypophysentumors auf nasalem Wege" Wien Klin Wochenschr (1907)
[3]
Schloffer H. "Weiterer Bericht über den Fall von operiertem Hypophysentumor" Wien Klin Wochenschr (1907)
[4]
Schloffer H. "Zur Frage der Operationen an der Hypophyse" Beitr Klin Chir (1906)
[37]
Esposito F "Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery" Neurosurgery (2007)
Metrics
18
Citations
47
References
Details
Published
Apr 16, 2018
Vol/Issue
3(3)
Pages
143-155
License
View
Authors
T
Todd J. Wannemuehler

Department of Otolaryngology–Head & Neck Surgery Indiana University School of Medicine Indianapolis Indiana U.S.A.

C
Cyrus C. Rabbani

Department of Otolaryngology–Head & Neck Surgery Indiana University School of Medicine Indianapolis Indiana U.S.A.

J
Jack E. Burgeson

Department of Otolaryngology–Head & Neck Surgery Indiana University School of Medicine Indianapolis Indiana U.S.A.

E
Elisa A. Illing

Department of Otolaryngology–Head & Neck Surgery Indiana University School of Medicine Indianapolis Indiana U.S.A.

E
Evan S. Walgama

Department of Otolaryngology–Head & Neck Surgery Cedars Sinai Medical Center Los Angeles California U.S.A.

A
Arthur W. Wu

Department of Otolaryngology–Head & Neck Surgery Cedars Sinai Medical Center Los Angeles California U.S.A.

J
Jonathan Y. Ting

Department of Otolaryngology–Head & Neck Surgery Indiana University School of Medicine Indianapolis Indiana U.S.A.

Funding
American Rhinologic Society staff
Cite This Article
Todd J. Wannemuehler, Cyrus C. Rabbani, Jack E. Burgeson, et al. (2018). Survey of endoscopic skull base surgery practice patterns among otolaryngologists. Laryngoscope Investigative Otolaryngology, 3(3), 143-155. https://doi.org/10.1002/lio2.149
Related

You May Also Like

Odontogenic sinusitis: A review of the current literature

Ryan E. Little, Christopher M. Long · 2018

143 citations

Olfactory epithelium: Cells, clinical disorders, and insights from an adult stem cell niche

Rhea Choi, Bradley J. Goldstein · 2018

104 citations

Specimen mapping in head and neck cancer using fluorescence imaging

Nutte Teraphongphom, Christina S. Kong · 2017

46 citations

Autoimmune inner ear disease: A systematic review of management

Nathaniel K. Breslin, Varun V. Varadarajan · 2020

42 citations

Emerging options in immune‐mediated hearing loss

Hitomi Sakano, Jeffrey P. Harris · 2018

41 citations