The Baha system is safe and effective in the rehabilitation of patients with conductive or mixed hearing losses and with single-sided deafness. The high success rate, patient satisfaction rate, and predictable auditory outcome place the Baha among the leading choices for auditory rehabilitation.
Objectives The utilization of the nasoseptal flap (NSF) in endoscopic anterior skull base surgery (EASB) has resulted in reduced rates of postoperative cerebrospinal fluid leak (CSF). The long‐term impact on sinonasal function after surgery remains incompletely defined. Methods A consecutive series of patients undergoing EASB with NSF and with at least 3 years follow‐up was prospectively evaluated. Patient demographics, pre‐ and postoperative Sino‐nasal Outcome Test‐22 (SNOT‐22) scores, Lund‐Mackay scores (LMS), CSF leak, and sinonasal complications were analyzed. Results A total of 46 patients undergoing EASB with NSF met inclusion criteria. The mean follow‐up was 67.4 months (range 39–90, standard deviation [SD] 14.2 months). No statistically significant differences were noted between the mean overall pre‐ (16) and postoperative SNOT‐22 scores (18). SNOT‐22 scores improved in 27 patients (58.7%), deteriorated in 17 patients (37.0%) and stayed the same in two patients (4.3%). Deterioration in SNOT‐22 scores was greater in younger (mean change + 7.2 [SD17.4] vs. older patients −3.4 [SD 7.5], P = 0.010). A statistically significant increase in LMS was noted (mean preoperative LMS0.9 vs. mean postoperative LMS 2.2, P = 0.001). The LMS decreased in nine patients (19.6%), increased in 22 patients (47.8%), and remained the same in 15 patients (32.6%). One patient (2.2%) developed a postoperative CSF leak following resection of metastatic skull base lesion and was successfully treated with placement of a lumbar drain, Foley catheter balloon, and strict bed rest. One patient (2.2%) developed a postoperative mucocele requiring decompression 3 years after initial surgery. Conclusion Whereas long‐term sinonasal quality of life is overall improved in the majority of patients following NSF use for EASB, younger patients show higher incidence of deterioration. Increased sinus opacification on imaging is generally noted and may require continued follow‐up and management. The incidence of reoperation for symptomatic mucocele formation is low. Level of Evidence 4 Laryngoscope, 129:1035–1040, 2019
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