• Ji-Eun Choi, Yang-Sub Noh, Kyung Eun Lee, Yong Gi Jung, Seung-Kyu Chung, Hyo Yeol Kim, Doo-Sik Kong, Do-Hyun Nam, and Sang Duk Hong.
• Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
• World Neurosurg. 2020 May 1; 137: e43-e51.

ObjectiveAlthough the endoscopic transpterygoid approach has been popularized, there are no studies about anatomy-specific morbidities of this approach. The objective of this study is to investigate the surgical morbidities associated with the endoscopic transpterygoid approach for resection of anatomic structures.MethodsA retrospective analysis was carried out of prospectively collected data of patients who underwent the endoscopic transpterygoid approach for skull base tumor by a single ear nose and throat surgeon in a tertiary-care center from November 2013 to January 2019. Postoperative patient symptom prevalence associated with surgical findings and SNOT-22 (Sino-Nasal Outcome Test-22) score were included in the analysis.ResultsThirty-seven consecutive patients were enrolled. The mean follow-up period was 12.4 months (range, 1-39 months). Twenty-six (70.3%) vidian nerves were sacrificed, but only 38.5% of those patients (10/26) reported mild dry eye symptoms. Fourteen nasolacrimal ducts (37.8%) were resected, with only 1 patient (7.1%) who had undergone previous radiation therapy reporting transient epiphora. SNOT-22 scores before and after surgery did not present statistical difference in inferior turbinate sacrifice group and preservation group.ConclusionsSacrifice of sinonasal structures such as the inferior turbinate or vidian nerve is sometimes inevitable for safe tumor resection with the endoscopic transpterygoid approach. Subjective symptoms were not apparent in most patients, despite the structural sacrifice.Copyright © 2019 Elsevier Inc. All rights reserved.

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