2026 Proffered Presentations
S189: IMPACT OF MIDDLE TURBINATE RESECTION ON SINONASAL COMPLICATIONS IN PEDIATRIC ENDOSCOPIC ENDONASAL SKULL BASE SURGERY
Megan E McNutt1; Haley Ellett, MS, RN, CPNPPC2; Isaac Kistler, MS2; Patrick Walz, MD, FACS, FAAP2; Rishabh Sethia, MD2; 1The Ohio State University; 2Nationwide Children's Hospital
Introduction: The endoscopic endonasal approach (EEA) for skull base surgery often employs resection of the middle turbinate (MT) to improve surgical access. While studies of the adult population demonstrate little impact of MT resection on sinonasal function, pediatric data remain limited, particularly regarding MT resection, CSF leak, and other sinonasal complications.
Objectives: We investigated the relationship between MT resection and sinonasal complications including CSF leak in the pediatric population.
Methods: We performed a retrospective chart review of all patients undergoing EEA from January 2007 to May 2025 at a single tertiary pediatric hospital. Data collection included patient demographics and history, intraoperative techniques, perioperative variables, and postoperative course.
Results: We identified 81 patients. One patient was excluded due to death within two weeks of surgery date. Median patient age was 13.8 years, 55% were male, and 77% were non-Hispanic White. Middle turbinate resection was collected as “None” (39%), “Unilateral” (60%), and “Bilateral” (1.3%). Nasal complications were experienced by 31% of the cohort, including congestion (3.8%), sinusitis (11%), and epistaxis (6.3%); 10% experienced postoperative CSF leak. We found that patients who had unilateral or bilateral MT resected had no significant difference in odds of nasal complications (OR = 0.38, 95% CI: 0.12-1.05, p = 0.073) versus no MT resection, and there was no difference in odds of postoperative CSF leak (OR = 5.12, 95% CI: 0.85-98.4, p = 0.14).
Discussion and Conclusion: Sinonasal complications including CSF leak are commonly reported complications from EEA surgery in the pediatric population. Although generalizability is limited due to wide confidence intervals, our results suggest that MT resection does not appear to increase the risk of sinonasal complications or postoperative CSF leak. Our results suggest that MT resection may be a safe and effective method for gaining access during EEA surgery.